STD testing policies and practices in US city and county jails

Background and Objectives: Studies have shown that sexually transmitted dis ease (STD) rates are high in the incarcerated population. However, little i s known about STD testing policies or practices in jails. Goal: To assess STD testing policies and practices in jails. Study Design: The Division of STD Prevention developed and distributed an e -mail survey to 94 counties reporting more than 40 primary and secondary ca ses in 1996 or having cities with more than 200,000 persons. State and loca l STD program managers completed the assessment in collaboration with healt h departments and the main jail facilities in the selected counties. Results: Most facilities (52-77%) had a policy for STD screening based only on symptoms or by arrestee request, and in these facilities, 0.2% to 6% of arrestees were tested. Facilities having a policy of offering routine test ing tested only 3% to 45% of arrestees. Large facilities, facilities using public providers, and facilities routinely testing for syphilis using Stat RPR tested significantly more arrestees (P < 0.05). Approximately half of t he arrestees were released within 48 hours after intake, whereas 45% of fac ilities did not have STD testing results until after 48 hours. Conclusion: Most facilities had a policy for STD screening based only on sy mptoms or by arrestee request. Facilities having a policy of routine STD te sting are not testing most of the arrestees, There is a small window (< 48 hours) for STD testing and treatment before release. Smaller jails and faci lities using private providers may need additional resources to increase ST D testing levels. Correctional facilities should be considered an important setting for STD public health intervention where routine rapid STD screeni ng and treatment on-site could be implemented.