Detained youth have high rates of sexually transmitted infections (STIs). The Centers for Diseases Control and Prevention recommends routine screening for STIs in incarcerated youth. The aim of this study was to determine the incidence of sexually transmitted infections and time to reinfection among residents readmitted into an urban juvenile temporary detention center (JTDC), from 2014-19.
Methods:
This is a longitudinal retrospective electronic medical record (EMR) review. Demographic data - gender, age, race/ethnicity; and episodes of infection (gonorrhea and chlamydia) were extracted from the EMR. Re-infection was defined as an STI infection after the first episode of infection. Missed opportunities were failure to complete an STI test during the admission process. Kaplan Meier survival curves were used to determine gender differences in re-infection rates. Time to event was the interval to reinfection (in days)and reinfection was the censored variable. Statistical analyses were completed using Stata Version 17® and Microsoft Excel®. Results: The EMR for 6543 residents over the five year period were reviewed; 5954 (91%) were males, 2251 (34%) were Black, and 529 (8%) were Latin X; mean (±SD) age at admission was 15.9 (±1.4) years; 2499 (38%) were admitted more than once. Residents completed 15169 and 15175 chlamydia and gonococcal tests respectively; 1214 (8%) and 295 (1.9%) were positive respectively. Missed opportunities for testing were- 4243 (chlamydia) and 4241( gonorrhea). Of the 2499 residents admitted more than once, 2316 (93%) were males; and 242 (10.4%) of readmitted males had a reinfection compared with 23 (12%) of the 189 females readmitted. The mean (±SD) time to reinfection was 220 (±221) days for males and 194 (± 225) for females. A statistically positive trend was found for gonorrhea and chlamydia positivity re-infection and the odds of being reinfected over time was statistically significant (p < 0.01).
Conclusion: There was a high readmission rate among youth at this urban JTDC. Reinfection with chlamydia and gonorrhea was high ( above 10%) for both genders. Educational programs on STIs for incarcerated youth should be provided. The availability of transitional healthcare clinics for youth, might prove beneficial for STI prevention and treatment.
