Comparison of Opt-In Versus Opt-Out Testing for Sexually Transmitted Infections Among Inmates in a County Jail

Raees A Shaikh; Kari A Simonsen; Anne O'Keefe; Mary Earley; Mark Foxall; K M Islam; Austin Person; Cole Boyle; Uriel Sandkovsky; Ruth Margalit

doi:10.1177/1078345815600447

Comparison of Opt-In Versus Opt-Out Testing for Sexually Transmitted Infections Among Inmates in a County Jail

J Correct Health Care. 2015 Oct;21(4):408-16. doi: 10.1177/1078345815600447. Epub 2015 Aug 18.

Authors

Raees A Shaikh¹, Kari A Simonsen², Anne O'Keefe³, Mary Earley⁴, Mark Foxall⁴, K M Islam⁵, Austin Person⁶, Cole Boyle⁵, Uriel Sandkovsky⁷, Ruth Margalit⁵

Affiliations

¹ Department of Health Promotion, Social and Behavioral Health, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA raees.shaikh@unmc.edu.
² Department of Pediatrics, Division of Infectious Diseases, University of Nebraska Medical Center, Omaha, NE, USA.
³ Douglas County Health Department, Omaha, NE, USA.
⁴ Douglas County Department of Corrections, Omaha, NE, USA.
⁵ Department of Health Promotion, Social and Behavioral Health, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA.
⁶ College of Medicine, University of Nebraska Medical Center, Omaha, NE, USA.
⁷ Department of Internal Medicine, Division of Infectious Diseases, University of Nebraska Medical Center, Omaha, NE, USA.

PMID: 26285597
DOI: 10.1177/1078345815600447

Abstract

A majority of jails in the United States rely on an opt-in (voluntary) rather than opt-out (universal) approach to testing for sexually transmitted infections (STIs). This study compares an opt-out approach at intake to opt-in testing during incarceration and estimates the prevalence of common STIs among jail inmates. Data derive from a universal intake pilot testing program (n = 298) and an established, student-led voluntary testing program (n = 1,963), respectively. The adjusted prevalence as well as the odds of testing positive for chlamydia were significantly higher in the opt-out program (p = .025 and .008, respectively) than the opt-in program but not for gonorrhea (p = .402 and .300, respectively). These results demonstrate the potential public health benefit of implementation of universal STI testing of jail inmates.

Keywords: jail; opt-in; opt-out; sexually transmitted infections; testing.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Chlamydia Infections / diagnosis
Chlamydia Infections / epidemiology
Female
Gonorrhea / diagnosis
Gonorrhea / epidemiology
Humans
Male
Mass Screening / methods*
Prevalence
Prisoners / statistics & numerical data*
Prisons*
Risk Factors
Sexual Behavior
Sexually Transmitted Diseases / diagnosis*
Sexually Transmitted Diseases / epidemiology*
Socioeconomic Factors
United States