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D2.8 City and County Jails: Establishing and Sustaining Partnerships Critical to STD Control

Thursday, March 15, 2012
Peter R. Kerndt, MD, MPH1, Melina Boudov, MA1, Garret M. Cox, MPH2, Carmel Kadrnka, DO3, Mark Malek, MD, MPH2 and Ali Stirland, MBChB, MSc1, 1STD Program, Division of HIV and STD Programs, Los Angeles County Department of Public Health, Los Angeles, CA, 2Los Angeles County Sheriff's Department, Los Angeles, CA, 3Probation Department, Juvenile Court Health Services, Los Angeles, CA

Background: City and county jails house large populations at increased risk for sexually transmitted infections (STIs), hepatitis and HIV.  Screening incarcerated populations to identify, treat, and prevent further transmission of STIs/HIV provides an effective means to reduce community level of disease. The Los Angeles County (LAC) STD Program has had a long standing partnership with the Los Angeles County Sheriff’s Department (LASD) and the Juvenile Court Health Services (JCHS) to provide services to individuals who are among the least likely to have access to or to use traditional health care facilities.   

Objectives: To describe the experience with and the findings from STD/HIV screening, hepatitis vaccination and research programs implemented and expanded over the past 12 years to serve incarcerated adults and juveniles in LAC.

Project Description:  Each year LASD incarcerates approximately 2,700 men who have sex with men (MSM) and 26,000 adult females and JCHS incarcerates approximately 14,000 juveniles. Prostitution and drug related charges are common reasons for incarceration.  Chlamydia (CT) and gonorrhea (GC) screening is offered to all juveniles, MSM and to all adult females who are age 30 or under, or charged with a sex-related crime, pregnant or possibly pregnant.  Syphilis, HIV, and rectal and oral GC/CT screening is offered to all MSM. A hepatitis vaccination program for MSM was started in 2007.

Findings: The results of ten years of STIs/HIV screening and treatment programs in these incarcerated settings will be presented along with a description of the vaccination program and research programs.   

Conclusions: Jail-based programs present an opportunity to identify a pool of otherwise unrecognized STIs/HIV infections and deliver needed treatment, preventive care and education that have both individual and community benefit.  

Implications for Programs, Policy, and Research: Effective programs require strong collaborative partnership between local public health departments and city and county jails.

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