A novel, urine-based screening program for sexually transmitted infections at a juvenile assessment center

It is widely documented that incarcerated adolescents are at an increased risk for sexually transmitted infections (STI) such as gonorrhea and chlamydia. These adolescents represent a core transmission group due in part to multiple social, physical, and family problems. The CDC and Institute of Medicine have recommended that STI screening be provided to adolescents in the juvenile justice system. The National Commission on Correctional Health Care recommends a health care assessment for adolescents entering juvenile detention facilities 7 days after admission. This assessment rarely includes STI screening, and testing and treatment are often symptom-based. This presents a missed opportunity to identify STIs in a high risk population as 1) many of the adolescents are released prior to 7 days, 2) the majority of gonorrhea and chlamydia infections are asymptomatic, and 3) a majority of arrested adolescents are not remanded to secure detention. Juvenile Assessment Centers (JAC) are central booking facilities that process all adolescents arrested within a specific jurisdiction. Youth are typically released back into the community within 10 hours or remanded to secure detention. From June 2006 to December 2006, urine-based screening for gonorrhea and chlamydia was offered at the Hillsborough County, Florida JAC, as part of a demonstration project. This presentation will describe this novel project, a first general STI screening protocol for newly arrested adolescents. Urine-based STI screening at JAC facilities is feasible, acceptable, and a needed public health service that can reduce the burden of infection that would otherwise be reintroduced back into the community.