TY - JOUR
T1 - Sexually Transmitted Infections Detected during and after Incarceration among People with Human Immunodeficiency Virus
T2 - Prevalence and Implications for Screening and Prevention
AU - Krieger, Demi
AU - Abe, Caroline
AU - Pottorff, Alexandra
AU - Li, Xilong
AU - Rich, Josiah
AU - Nijhawan, Ank E.
N1 - Funding Information:
From the *University of Texas Southwestern Medical Center, Dallas, TX; †Department of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas, TX; ‡Department of Internal Medicine and Ep-idemiology, Warren Alpert Medical School of Brown University, Providence, RI; §Division of Infectious Diseases, Department of Inter-nal Medicine, University of Texas Southwestern Medical Center; and ¶Parkland Health and Hospital Systems, Dallas, TX Conflicts of Interest: A.N. receives research funding from Gilead FOCUS program. No other authors had conflicts of interest.
Funding Information:
Sources of Funding: The investigators were supported by the following grants: National Institutes of Health: R01 DA030778 (J.R.), K24 DA022122 (J.R.), K23 AI112477 (A.N.), R34 DA045592 (A.N.), P30 AI042583, CTSA UL1-RR024982.
Publisher Copyright:
© 2019 American Sexually Transmitted Diseases Association. All rights reserved.
PY - 2019/9/1
Y1 - 2019/9/1
N2 - Background Incarceration and human immunodeficiency virus (HIV) are associated with sexually transmitted infections (STIs); however, little is known about STI prevalence among people living with HIV (PLWH) during and after incarceration. Methods Electronic medical records from the Dallas County Jail and community HIV clinics were reviewed to determine the frequency and results of testing for gonorrhea, chlamydia, syphilis, and hepatitis B virus (HBV) among PLWH incarcerated in Dallas County Jail between 2010 and 2013. HIV viral loads (VL) and evidence of STI symptoms and treatment were also collected. Results During 2473 incarcerations, 6 (3%) of 190 tests were positive for gonorrhea, 7 (4%) of 190 for chlamydia, 231 (21%) of 1082 for syphilis, of which 53 (23%) were new diagnoses, and 48 (5%) of 1005 for HBV surface antigen. Among 1631 releases to the community, 808 followed up in community clinics, where 21 (4%) 553 tests were positive for gonorrhea, 23 (4%) of 555 for chlamydia, 150 (19%) of 808 for syphilis, of which 31 (21%) were new diagnoses, and 24 (6%) of 421 for HBV surface antigen. The majority of new STI cases, 51 (80%) of 64 in jail and 43 (77%)of 56 in the community, had a concurrent detectable (>200 copies/mL) HIV VL. Conclusions Testing for gonorrhea and chlamydia was low, particularly in jail, which was attributed to testing protocols. High proportions of PLWH tested positive for syphilis and HBV infection in both settings. The majority of patients with active STIs had a detectable HIV VL. Routine, opt-out screening for STIs for PLWH during and after incarceration has the potential to identify a high proportion of STIs and improve secondary HIV prevention.
AB - Background Incarceration and human immunodeficiency virus (HIV) are associated with sexually transmitted infections (STIs); however, little is known about STI prevalence among people living with HIV (PLWH) during and after incarceration. Methods Electronic medical records from the Dallas County Jail and community HIV clinics were reviewed to determine the frequency and results of testing for gonorrhea, chlamydia, syphilis, and hepatitis B virus (HBV) among PLWH incarcerated in Dallas County Jail between 2010 and 2013. HIV viral loads (VL) and evidence of STI symptoms and treatment were also collected. Results During 2473 incarcerations, 6 (3%) of 190 tests were positive for gonorrhea, 7 (4%) of 190 for chlamydia, 231 (21%) of 1082 for syphilis, of which 53 (23%) were new diagnoses, and 48 (5%) of 1005 for HBV surface antigen. Among 1631 releases to the community, 808 followed up in community clinics, where 21 (4%) 553 tests were positive for gonorrhea, 23 (4%) of 555 for chlamydia, 150 (19%) of 808 for syphilis, of which 31 (21%) were new diagnoses, and 24 (6%) of 421 for HBV surface antigen. The majority of new STI cases, 51 (80%) of 64 in jail and 43 (77%)of 56 in the community, had a concurrent detectable (>200 copies/mL) HIV VL. Conclusions Testing for gonorrhea and chlamydia was low, particularly in jail, which was attributed to testing protocols. High proportions of PLWH tested positive for syphilis and HBV infection in both settings. The majority of patients with active STIs had a detectable HIV VL. Routine, opt-out screening for STIs for PLWH during and after incarceration has the potential to identify a high proportion of STIs and improve secondary HIV prevention.
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U2 - 10.1097/OLQ.0000000000001023
DO - 10.1097/OLQ.0000000000001023
M3 - Article
C2 - 31415042
AN - SCOPUS:85071177282
SN - 0148-5717
VL - 46
SP - 602
EP - 607
JO - Sexually Transmitted Diseases
JF - Sexually Transmitted Diseases
IS - 9
ER -