HIGH PREVALENCE OF SYPHILIS DETECTED THROUGH A JAIL SCREENING-PROGRAM- A POTENTIAL PUBLIC-HEALTH MEASURE TO ADDRESS THE SYPHILIS EPIDEMIC

Background: In june 1990, a syphilis initiative was undertaken to help control New York's most extensive syphilis epidemic since the 1940s. Methods: To evaluate the usefulness of syphilis screening in local jai ls, we reviewed demographic and syphilis screening data from a county jail in an area with a high prevalence of syphilis that has routinely tested incoming inmates.Results: Of 12 685 inmates, 9797 (77%) were sc reened for syphilis, and 321 (3.3%) had a positive test result; 258 (8 0%) of the positive results were confirmed. Data were available for 24 4 of the inmates with a confirmed positive result: 162 (67%) had newly diagnosed syphilis (overall rate, 1.6%), 112 of whom had early syphil is; 50 (20%) had been previously treated for syphilis; and 32 (13%) we re unavailable for follow-up. Of 162 inmates with newly diagnosed syph ilis, 122 (75%) were treated in jail, and 40 were treated after their release from jail. The median time from screening to treatment was 17 days. The median jail stay was 45 days for inmates who were evaluated for treatment vs 5 days for those who were unavailable for follow-up. Conclusions Screening inmates for syphilis was a productive public hea lth measure, as inmates accounted for 20% of the county's syphilis mor bidity. Given the high prevalence of syphilis among inmates and the in ability to reach them for treatment after release, strategies are need ed to rapidly screen and treat inmates before their release from jail.