Objectives: To evaluate sex and age correlates of chlamydia prevalence in incarcerated populations.
Methods: Cross-sectional analysis of chlamydia prevalence by demographic characteristics from incarcerated females and males entering selected juvenile and adult correctional facilities (jails) in the United States in 2005.
Results: A total of 97,681 and 52,485 incarcerated persons aged >/=12 years were screened for chlamydia in 141 juvenile and 22 adult correctional facilities, respectively. Overall, chlamydia prevalence was high in females (14.3% and 7.5%) in both juvenile and adult facilities when compared with that in males (6.0% and 4.6%). The chlamydia prevalence was higher in incarcerated females than in incarcerated males for persons </=35 years, and prevalence was highest among females aged </=25 years (range, 11.3%-15.6%). In juvenile facilities, prevalence did not steadily increase with age in females (12.8% in 12-14 years, 15.1% in 15-17 years, and 14.3% in 18-20 years) whereas in males prevalence steadily increased with age (2.4% in 12-14 years to 8.7% in 18-20 years). In females and males the highest prevalence in juvenile facilities was in incarcerated blacks (18.4% and 9.6%, respectively). In adult facilities, the prevalence was consistently highest in younger detainees: in females it was 15.6% in 18- to 20-year olds compared with 1.5% in those >40 years; in males it was 8.8% in 18- to 20-year olds compared with 1.4% in those >40 years.
Conclusions: The consistently high chlamydia prevalence among females in juvenile facilities and females (</=25 years) in adult facilities supports a screening policy in correctional settings consistent with Centers for Disease Control and Prevention and US Preventive Services Task Force guidelines. Although the prevalence of chlamydia in males is substantial, chlamydia prevalence in females exceeds that of males </=35 years, and thus screening females for chlamydia in these facilities should take priority over screening males.