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Trends in sexually transmitted infection diagnoses among people in prison in England, 2018-2023: analysis of surveillance and pilot seroprevalence data

Qudsia Enayat (UK Health Security Agency, London, UK)
Kate Yorke (Health Equity and Inclusion Health, UK Health Security Agency, London, UK)
Dolores Mullen (UK Health Security Agency, London, UK)
Alireza Talebi (UK Health Security Agency, London, UK)
Steve Willner (UK Health Security Agency, London, UK)
Jon Dunn (UK Health Security Agency, London, UK)
Sum Yee Chan (Central and North West London NHS Foundation Trust, London, UK)
Joseph Heskin (Chelsea and Westminster Hospital NHS Foundation Trust, London, UK)
Katy Sinka (UK Health Security Agency, London, UK)
Stephanie J. Migchelsen (UK Health Security Agency, London, UK)
Hamish Mohammed (UK Health Security Agency, London, UK)
Chantal Edge (UK Health Security Agency, London, UK)

International Journal of Prison Health

ISSN: 2977-0254

Article publication date: 25 December 2024

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Abstract

Purpose

People in prison face a disproportionate risk of sexually transmitted infections (STIs), but there is a paucity of evidence on trends in STIs in prisons in England. This study aims to describe trends in chlamydia test-positivity and syphilis prevalence by using two different methodologies in prison settings.

Design/methodology/approach

This study used routinely collected chlamydia surveillance data reported by all primary diagnostic laboratories in England from 2018 to 2022 to identify tests undertaken in prisons. Separately, this study used data from a pilot syphilis serology pilot study of four prisons in England. A descriptive analysis was undertaken to describe chlamydia test-positivity and syphilis seroprevalence by demographic characteristics.

Findings

Between 2018 and 2022, the number of chlamydia tests carried out in prisons increased by 2.0% (17,177–17,514) whilst the number of positive diagnoses decreased by 12.0% (957–840). The overall test-positivity in 2022 was 4.8% (840/17,514) which was marginally lower than that of the community; test-positivity was highest in 15–19 year-olds. Overall, syphilis prevalence was 3.9% (43/1064). Prevalence was highest in the women’s prison site at 6.4% 27/398). The range in male prison sites was between 0.5% and 3.5%.

Originality/value

Use of two methods enabled us to better understand the burden of STIs in a vulnerable population. Chlamydia test positivity was marginally lower than community levels but still indicated a high burden of infection, in particular for the 15–24 age group. Syphilis prevalence was high across all age groups in prisons, highlighting the need for more systematic assessment of STIs in prisons to allow for earlier identification and treatment of infections.

Keywords

Acknowledgements

The authors would like to thank Dr Michael Rayment, Consultant at Chelsea and Westminster NHS Foundation Trust, for his contributions to this paper.

Citation

Enayat, Q., Yorke, K., Mullen, D., Talebi, A., Willner, S., Dunn, J., Chan, S.Y., Heskin, J., Sinka, K., Migchelsen, S.J., Mohammed, H. and Edge, C. (2024), "Trends in sexually transmitted infection diagnoses among people in prison in England, 2018-2023: analysis of surveillance and pilot seroprevalence data", International Journal of Prison Health, Vol. ahead-of-print No. ahead-of-print. https://doi.org/10.1108/IJOPH-11-2023-0073

Publisher

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Emerald Publishing Limited

Copyright © 2024, Emerald Publishing Limited

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