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Background: Literature reveals that incarcerated adolescents show higher rates of STDs compared to non-incarcerated peers. Following a change in Shelby County Juvenile Detention Center (JDC) policy, a protocol to test adolescents in the JDC for Chlamydia, Gonorrhea and HIV was implemented in October 2011.
Objectives: To determine the prevalence of Chlamydia and Gonorrhea in the Shelby County JDC and describe characteristics of at-risk detainees.
Methods: Adolescents (ages 13-18) entering the juvenile detention center were offered routine, opt-out Chlamydia and Gonorrhea urine-based screening beginning in October 2011. Screening for HIV was also included in this opt-out process, along with comprehensive sexual health education. Bivariate analysis and t-test procedures were used to identify characteristics of at-risk individuals.
Results: Between October 10 and December 27, 2011, 394 adolescents were screened for Chlamydia and Gonorrhea; the prevalence of infection was 20.7% and 4.1%, respectively. No positive HIV cases were reported. Females were significantly more likely to test positive for Chlamydia (OR=3.0, p <.0001) and Gonorrhea than males (OR=5.2, p <.0001). While 37% (31) of all females tested positive for Chlamydia, 16.2% (50) of males were positive. Fewer Gonorrhea cases were identified; 10.7% (9) of all females and 2.3% (7) of all males were positive. Males testing positive for Gonorrhea reported a statistically significantly higher mean age (17.4 years) than females (16.0 years).
Conclusions: JDCs are optimal environments to conduct STD testing, yielding high positivity. Although females were identified to have significantly higher morbidity than males, a large percentage of males were found to be positive for Chlamydia, which has not been described in juvenile detention programs elsewhere.
Implications for Programs, Policy, and Research: Routine, opt-out STD screening coupled with comprehensive sexual education will be continued in the Shelby County JDC. Further assessment is needed to identify behavioral risks to tailor educational messages.