Abstract
Objectives
To determine the prevalence of urethral chlamydia and gonorrhea in males in a correctional facility in Ontario, Canada, and to explore risk factors for infection.
Methods
Between June and December, 2009, 500 adult males who had been newly admitted at a correctional facility in southern Ontario completed a survey of risk factors and provided a urine sample for testing. Those who tested positive were treated and their names were provided to the local public health unit for follow-up including contact tracing. Prevalence and 95% confidence intervals were calculated for infection with chlamydia and gonorrhea, respectively, and a multivariable model was used to look at risk factors for infection.
Results
The study population reported high levels of sexual risk behaviours and drug use. The overall chlamydia prevalence was 2.9% (95% CI 1.6–4.8) and the overall gonorrhea prevalence was 0.6% (95% CI 0.1–1.8). Rates were particularly high for chlamydia in younger males, at 16% (95% CI 4.5–36) in 18–19 year olds and 3.7% (95% CI 1.0–9.3) in 20–24 year olds, and for gonorrhea in males aged 20–24 at 1.9% (95% CI 0.2–6.6). A multivariable logistic regression model revealed that though not statistically significant, younger age was associated with infection.
Conclusion
The relatively high prevalence of chlamydia and gonorrhea found in this study suggests that primary and secondary prevention programs should be instituted for males in correctional facilities, in particular among younger inmates. Further research is required to ensure internal and external generalizability of these results, as well as to determine the cost-effectiveness of potential interventions.
Key words: Prisons, chlamydia, gonorrhea, mass screening, prevention and control
Résumé
Objectifs
Déterminer la prévalence de la chlamydiose urétrale et de la gonorrhée dans la population masculine d’un établissement de correction en Ontario, au Canada, et étudier les facteurs de risque d’infection.
Méthode
Entre juin et décembre 2009, nous avons administré un sondage sur les facteurs de risque à 500 hommes adultes nouvellement incarcérés dans un établissement de correction du Sud de l’Ontario et nous leur avons prélevé un échantillon d’urine. Ceux dont le test de dépistage était positif ont été traités, et leurs noms ont été fournis au bureau de santé publique local à des fins de suivi, y compris pour le retraçage des contacts. Nous avons calculé la prévalence et les intervalles de confiance de 95 % pour l’infection à Chlamydia et la gonorrhée, respectivement, et utilisé un modèle multivarié pour examiner les facteurs de risque d’infection.
Résultats
La population à l’étude a déclaré de hauts niveaux de comportements sexuels à risque et de consommation de drogue. La prévalence globale de la chlamydiose était de 2,9 % (IC de 95 %=1,6–4,8), et la prévalence globale de la gonorrhée, de 0,6 % (IC de 95 %=0,1–1,8). Des taux de chlamydiose particulièrement élevés ont été observés chez les jeunes hommes, soit de 16 % (IC de 95 %=4,5–36) chez les 18–19 ans et de 3,7 % (IC de 95 %=1,0–9,3) chez les 20–24 ans, et des taux élevés de gonorrhée ont été observés chez les hommes de 20–24 ans, à 1,9 % (IC de 95 %=0,2–6,6). Selon notre modèle de régression logistique multivariée, la jeunesse était associée à l’infection, mais pas de manière significative.
Conclusion
La prévalence relativement élevée de la chlamydiose et de la gonorrhée observée dans notre étude donne à penser qu’il faudrait instituer des programmes de prévention primaire et secondaire pour la population masculine des établissements de correction, en particulier les jeunes détenus. Il faudrait pousser la recherche pour veiller à la généralisabilité interne et externe de ces résultats et pour déterminer le rapport coût-efficacité des interventions possibles.
Mots clés: prison, chlamydia, gonorrhée, dépistage de masse, prévention et contrôle
Footnotes
Funding: This study was funded by a Resident Research Grant from Physicians’ Services Incorporated Foundation.
Conflict of Interest: None to declare.
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