To read the full version of this content please select one of the options below:

A cross-sectional evaluation of opt-in testing for sexually transmitted and blood-borne infections in three Canadian provincial correctional facilities: a missed opportunity for public health?

Jennifer Gratrix (Department of STI Services, Alberta Health Services, Edmonton, Canada)
Petra Smyczek (Department of STI Services, Alberta Health Services, Edmonton, Canada)
Lindsay Bertholet (Department of STI Services, Alberta Health Services, Edmonton, Canada)
M.C. Lee (Microbiology Department, DynaLIFE Dx, Edmonton, Canada)
Diane Pyne (Department of Corrections Health, Alberta Health Services, Edmonton, Canada)
Dan Woods (Department of Corrections Health, Alberta Health Services, Edmonton, Canada)
Keith Courtney (Department of Corrections Health, Alberta Health Services, Edmonton, Canada)
Rabia Ahmed (Department of Medicine, University of Alberta, Edmonton, Canada)

International Journal of Prisoner Health

ISSN: 1744-9200

Article publication date: 31 May 2019

Issue publication date: 22 July 2019

Abstract

Purpose

Incarceration provides an opportunity for screening and treatment of sexually transmitted and blood-borne infections (STBBIs) in high-risk groups. The purpose of this paper is to determine positivity rates of STBBI screening within correctional facilities using opt-in strategies and estimate the proportion of admissions tested.

Design/methodology/approach

A cross-sectional, retrospective review of testing data from January 2012 to August 2015 from three provincial correctional facilities located in Alberta, Canada was completed. Analysis variables included STBBI, gender, facility, collection year and age. STBBI-stratified analysis was performed to identify correlates for positivity using univariate and logistic regressions.

Findings

Overall prevalence of chlamydia was 11.2 percent and gonorrhea was 3.5 percent; correlates for both were younger age and facility type. The syphilis prevalence rate was 3.2 percent; correlates included being female, older age, adult facilities, with later years being protective. In total, 14 (0.3 percent) newly diagnosed HIV cases were found, prevalence increased with age. HBV prevalence was 1.7 percent with no significant correlations. Nearly one-tenth (n=422) of those screened for HCV antibody were positive; all variables were significantly correlated. Overall estimates of the proportion of admissions tested by STBBI were low and ranged from 4.8 to 16.1 percent.

Originality/value

This study found high rates of STBBI in correctional facilities and showed that only a small proportion of the population was tested using an opt-in strategy. Shifting to an “opt-out” strategy may be warranted.

Keywords

Acknowledgements

The authors would like to acknowledge the support of Leah Feist to this study and the work of the correctional healthcare staff and the provincial STI nurses.

Citation

Gratrix, J., Smyczek, P., Bertholet, L., Lee, M.C., Pyne, D., Woods, D., Courtney, K. and Ahmed, R. (2019), "A cross-sectional evaluation of opt-in testing for sexually transmitted and blood-borne infections in three Canadian provincial correctional facilities: a missed opportunity for public health?", International Journal of Prisoner Health, Vol. 15 No. 3, pp. 273-281. https://doi.org/10.1108/IJPH-07-2018-0043

Publisher

:

Emerald Publishing Limited

Copyright © 2019, Emerald Publishing Limited