A Cross-Sectional, Retrospective Evaluation of Opt-Out Sexually Transmitted Infection Screening at Admission in a Short-Term Correctional Facility in Alberta, Canada

J Correct Health Care. 2022 Dec;28(6):429-438. doi: 10.1089/jchc.21.08.0079. Epub 2022 Dec 7.

Abstract

Incarcerated populations experience higher rates of sexually transmitted infections (STIs) than the general population, alongside inconsistent testing strategies. In response, universal opt-out STIs (chlamydia, gonorrhea, syphilis, and HIV) screening was implemented at admission in a short-term correctional facility in Alberta, Canada, for individuals ≤35 years. A cross-sectional, retrospective evaluation of testing outcomes between March 2018 and February 2020 was completed. Descriptive statistics were used to stratify STIs by gender, age group, and date for univariate analysis. Despite low uptake (31.2%), opt-out screening resulted in high positivity rates (14.9%, 10.8%, 29.5%, and 0.3%, respectively) and treatment completion (93.7%) while capturing a high proportion (52.6%) of asymptomatic cases. Opt-out screening at admission is feasible and can improve STI testing in high-risk individuals experiencing incarceration in Canada.

Keywords: HIV; STI; adults; correctional facilities; opt-out.

MeSH terms

  • Alberta / epidemiology
  • Chlamydia Infections* / diagnosis
  • Chlamydia Infections* / epidemiology
  • Chlamydia Infections* / prevention & control
  • Correctional Facilities
  • Cross-Sectional Studies
  • Gonorrhea* / diagnosis
  • Gonorrhea* / epidemiology
  • Gonorrhea* / prevention & control
  • HIV Infections* / diagnosis
  • HIV Infections* / epidemiology
  • Humans
  • Mass Screening / methods
  • Retrospective Studies
  • Sexually Transmitted Diseases* / diagnosis
  • Sexually Transmitted Diseases* / epidemiology
  • Sexually Transmitted Diseases* / prevention & control
  • Syphilis* / diagnosis
  • Syphilis* / epidemiology
  • Syphilis* / prevention & control