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P155 Prevalence of and Lack of Factors Predictive of Chlamydia Among Females Entering a Juvenile Correctional Facility — San Diego, California, 2009-2010

Tuesday, March 13, 2012
Hyatt Exhibit Hall
Elizabeth Torrone, MSPH, PhD, Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA, Tara Beeston, MPH, HIV, STD, and Hepatitis Branch, County of San Diego, Health and Human Services Agency, San Diego, CA, Rosemari Ochoa, MA, School of Communication, American University, Washington, DC, Marjorie Lee, MPH, HIV, STD, and Hepatitis Branch, Health and Human Services Agency, County of San Diego, San Diego, CA, Thomas Peterman, MD, MSc, Epidemiology and Surveillance Branch, Centers for Disease Control and Prevention, Atlanta, GA and Kenneth Katz, MD, MPH, Thailand MOPH-U.S. CDC Collaboration, and CDC/Southeast Asia Regional Office, Bangkok, Thailand

Background:  Chlamydia prevalence among females entering juvenile correctional facilities (JCFs) in the United States is high. JCF policy in San Diego County (SD), California, is to screen all females for chlamydia, with laboratory costs borne by the county. Identification of factors predictive for chlamydia among females entering the JCF could allow the county to target screening, reducing costs while still allowing for diagnosis of most cases.

Objectives: To identify prevalence of and criteria predictive for prevalent chlamydia among females entering SD’s JCF.

Methods: We used JCF and public health laboratory records to determine chlamydia screening coverage and prevalence among females aged 12–18 years entering SD’s JCF during January 2009–June 2010. We abstracted demographic, arrest, and health data from JCF records for all females testing positive for chlamydia (n=163) and a 10% sample of females testing negative (n=168) during that period.  We used logistic regression to identify factors associated with prevalent chlamydia. We calculated the sensitivity and proportion screened for different combinations of factors.

Results: Of 1890 females entering the JCF, 94% were screened for chlamydia. Prevalence was 10% overall and 4.3% among females reporting no sexual risk factors. Characteristics associated with chlamydia included older age, reported sexual risk factors, and a documented prior positive chlamydia test. However, using screening criteria based on these factors, to identify >80% of infections would require screening >75% of females.

Conclusions: Chlamydia prevalence among females entering SD’s JCF was high, even among females with no identifiable risk. No factor(s) to effectively target screening were identified.

Implications for Programs, Policy, and Research: High screening coverage of females entering a JCF is feasible. Chlamydia prevalence, even among females reporting no identifiable risk factors, supports continued universal screening in SD’s JCF. Other cost-saving approaches should be explored to effectively target resources.

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