Background: The number of women under community supervision in the US has increased to over one million. Research on women in prison and jails shows that sexually transmitted infections (STIs) are a serious public health problem. However, research on STIs among women under community supervision remains highly limited. This paper examines the prevalence and correlates of bacterial STIs among drug-involved women under community supervision in New York City.
Methods: Women were recruited from probation sites throughout New York City. Participants completed a survey containing items on sociodemographics, sexual behaviors, substance use, criminal history, and intimate partner violence. Biological samples were collected to test for C. trachomatis, N. gonorrhoeae, and T. vaginalis. Multivariate regression was used to examine associations between risk factors and any STI diagnosis.
Results: Of 333 women tested for STIs, 89 (26.7%) tested positive for an STI. Ten (3.0%) were positive for C. trachomatis, 4 (1.2%) were positive for N. gonorrhoeae, and 77 (22.8%) were positive for T. vaginalis. Women with any STI were more likely to be black (OR 1.85; 95% CI 1.04-3.32), make less than $400 per month (OR 2.87; 95% CI 1.15-6.95), have higher levels of hazardous drinking (OR 1.23; 95% CI [1.04-1.44]), and within the past 90 days, not have a regular place to sleep (OR 2.16; 95% CI 1.10-4.26), have been arrested (OR 2.29; 95% CI 1.37-3.81), have been in community court (OR 2.55; 95% CI 1.25-5.21), smoked crack (OR 1.95; 95% CI 1.04-3.68), and had a greater number of sex partners (OR 1.24; 95% CI 1.08-1.43).
Conclusions: Women under community supervision have a high burden of STIs. Achieving a successful decrease in STI prevalence among this marginalized population will depend on targeted STI intervention and prevention strategies to facilitate a reduction in risk behaviors and improve linkage to STI screening and treatment.