Epidemiologic Analysis of Chlamydia trachomatis and Neisseria gonorrhoeae Infections in Female Federal Prisoners

摘要

Infections caused by Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC) are the most commonly reported bacterial sexually transmitted infections in the U.S. No studies have been conducted to determine the prevalence of these two infections in women federal prisoners. Information about the prevalence of and risk factors for the infections may assist the Federal Bureau of Prisons to implement a rational screening approach for CT and GC in female inmates. Two study phases were implemented as part of this protocol. The first study phase relied on qualitative techniques: focus groups and group-based cognitive interviews were implemented to assist in the design of the study instrument and study procedures to be used in the second phase of the study. For the second, quantitative phase, urine specimens and self-collected swabs were taken from 983 women incarcerated in two federal prison facilities in the U.S. Participants completed a self-administered questionnaire on socio-demographic characteristics, and sexual and clinical history. Another questionnaire was administered to participants after specimen collection on preferences for self- collected swab, urine collection and pelvic examination. Specimens were analyzed at the Johns Hopkins University Chlamydia laboratory using strand displacement amplification technology to detect the presence of CT and/or GC DNA. Prevalence of CT and GC was calculated for each of the prison sites. Potential risk markers associated with infection were assessed. Participants preferences of self- collected swab and urine were also compared between the two sites. CT infection was found in 1.3% of the participants at one site where women are screened when they enter the prison, and in 2.3% at the other site, where women are not screened.