What is the Importance of Urine-based Chlamydia/Gonorrhea Screening of Adolescents Incarcerated in Secure Juvenile Detention Facilities in New York State?

Background:
Adolescents incarcerated in juvenile detention centers (JDCs) are at high risk for Chlamydia/Gonorrhea (CT/GC) infection due to risky sexual behavior and lack of routine screening.

Objective:
To assess CT/GC screening penetration in New York State (NYS) JDCs, and to explore the prevalence of infection/co-infection with CT/GC among incarcerated youth.

Method:
CT/GC screening data from five NYS JDCs were obtained through the NYS Infertility Prevention Project (IPP) from June 2006 to June 2007. IPP data were merged with data from the NYS Office of Children and Family Services to obtain demographic and facility information. A retrospective, cross-sectional analysis was then performed. All analyses were performed using SAS v9.1.3.

Result:
Of approximately 2,836 adolescents admitted to JDCs during the study period, a total of 2,546 (89.8%) were screened for CT/GC. Unscreened adolescents were more likely than those screened to be female (23.8% vs. 20.2%), African-American (63.5% vs. 53.6%), and non-Hispanic (49.4% vs. 31.4%). Both groups had a mean age of 14.6 years. The prevalence of CT/GC infection was 12.4% and 4.1% among females and 3.2% and 0.4% among males, respectively. Those infected with CT/GC were more likely to be female (50.0% vs. 18.1%), African-American (74.3% vs. 59.0%), and non-Hispanic (12.3% vs. 10.1 %.). Overall, 2.2% females and 0.2% among males were co-infected with CT/GC. Also, 53.3% of GC-infected females and 50.0% of GC-infected males were co-infected with Chlamydia.

Conclusion:
While many adolescents admitted to secure JDCs in NYS are screened for CT/GC, there are still a substantial number of high risk adolescents not being screened, representing a missed opportunity. African-American females at are highest risk for CT/GC in JDCs.

Implications:
Screening in JDCs presents a unique opportunity to capture asymptomatic CT/GC infections, and prevent outcomes associated with untreated CT/GC infections among youth that may not have been screened otherwise.