Background:
West Virginia has approximately 30 correctional sites, including regional jails, state department of corrections facilities, and juvenile facilities. Inmates in the state correctional facilities were not routinely screened prior to 2003. The average number of infections reported for any five month time period from 2001 to 2003 in the correctional facilities was 5 cases of CT and 4 cases of GC. In April 2003, West Virginia began screening for CT and GC in the South Central Regional Jail in Charleston, WV, using Gen-Probe Aptima Combo 2 Assay urine-based screening to target high-risk inmates.

Objective:
To ensure that an accurate positivity rate was being detected among WV inmates. To ensure screening is provided in WV's correctional facilities that don't provide STD services on a routine basis.


Method:
All inmates were offered urine based screening for CT and GC upon arrival to correctional facilities. The state began with one facility in 2003 and has increased to 26 facilities in 2005.

Result:
Between April and August 2003, 757 inmates were screened. Thirty (4%) CT infections and 6 (1%) GC cases were identified. During the first six months of 2005, 732 males and 229 females were tested. Results show 51 positive CT (7%) and 12 positive GC (1.6%) for males and 15 positive CT (6.6%) and 2 positive GC (0.9%) for females.

Conclusion:
Urine-based screening for CT and GC can be used to identify infections among high-risk inmates who may not have been screened at intake to correctional facilities.



Implications:
Screening in correctional facilities should be considered to detect STDs that might otherwise go undiagnosed and to prevent new infections. In order to improve screening efforts, WV is considering deleting some sites in 2006 and beginning testing regularly at a central intake facility located in Martinsburg, WV.