Chlamydia and gonorrhea infections among inmates in Omaha's metropolitan correctional facility

Background: Concern has increased among county correction officials that Chlamydia trachomatis and Neisseria gonorrhoeae (collectively, GC) may be especially problematic among the 1,400 inmates in their facility.

Methods: Data were collected from 226 inmates from a self-designed demographic and risk behavior questionnaire and from PCR-based screening tests for these common sexually transmitted diseases (STD). Both cross-sectional and case-control study designs were used to (1) determine prevalence of GC among inmates, (2) compare this prevalence to overall disease rates in the community, (3) describe behavioral risk factors among inmates that may exacerbate GC infection in the population, and (4) identify any associated factors distinguishing inmates who seek screening for GC from those who opt out of participation in a screening program.

Results: The higher rate of positive GC results among this inmate population was significantly different from the overall Douglas County rate (p<0.001). Though no associations were found to be significant between the predictors and the infection outcome, most GC cases were found in black males over 24 years old who reported being sexually active and having been previously incarcerated. Both male gender (p=0.0041) and Hispanic race (p=0.0354) were associated with opting not to participate in the screening program.

Conclusions: Within a captive population, public health officials and their correction partners can use the evidence provided by this study to improve education, screening and treatment efforts in underserved populations, including individuals from racial minority groups, those without access to health care outside of the correctional facility, and persons with substance abuse problems.