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Background: The Maricopa County Correctional (MCC) facility system is the fourth largest in the nation. MCC, in partnership with the Arizona Department of Health Services STD Control Program (ADHS STD) and Maricopa Department of Public Health STD Program (MCSTD), screen women 35 years and younger for chlamydia trachomatis (CT) and Neisseria gonorrhea (GC) infections near the time of detention (5 – 7 days after booking). In order to examine screening and treatment outcomes, laboratory and surveillance data were analyzed to evaluate screening positivity and opportunities for service delivery improvements.
Methods: CT/GC laboratory screening results were available for analysis from MCSTD for the period January 1, 2013-December 31, 2015 (24 non-overlapping months). ADHS STD surveillance records were used to evaluate treatment completion and time to treatment for the period January 1, 2013-December 31, 2015 (24 non-overlapping months).
Results: During the two year period, January 1, 2013-December 31, 2015 (24 non-overlapping months), MCSTD submitted urine specimens from 6,900 female inmates for CT and GC nucleic acid amplification testing. Of these specimens, 740 (10.7%) were positive for CT only, 248 (4.0%) were positive for GC only, and 197 (2.9%) were positive for both CT and GC (17.6% positivity for one or both infections). During January 1, 2013-December 31, 2015, 1,161 CT and GC infections (156 co-infections) were reported to ADHS STD from 939 incarcerated females. There was no reported treatment for 217 (18.7%) cases. Of case-patients treated (816, 81% of case patients), median time to treatment was 7 days (range 0-184 days) and 731 (89.6%) were treated in 14 days or less.
Conclusions: CT and GC positivity is high among incarcerated females in Maricopa County. High rates of screening, treatment, and rapid time to treatment among this high-risk population reflects collaborated efforts between local health departments and corrections.