RESUMO
Juvenile detention settings provide an important venue for addressing the health-related needs of adolescent populations, who often have high rates of sexually transmitted diseases (STDs) and concomitant drug use. This study examines factors associated with methamphetamine use and risky sexual behaviors among 539 incarcerated female adolescents between ages 12-18 years with an STD diagnosis. Data were obtained from interviews with detainees receiving STD case management services within a California juvenile detention facility in January 2006-June 2007. High-risk behaviors characterized the sample, such as low use of condoms consistently (43.3%), prior STD infection (25%), pregnancy history (26%), arrest charge for prostitution or drug use (23%), and a history of prostitution (18%). Half of the sample reported weekly alcohol or drug use; most commonly used drugs were marijuana (37%), alcohol (21%), and methamphetamine (16%). In multivariate analysis, African Americans had a lower odds of methamphetamine use (odds ratio [OR] = .163) compared with whites. Detainees who reported inconsistent condom use had over twice the odds of methamphetamine use (OR = 2.7) compared with consistent condom users. In addition, those who reported alcohol use had twice the odds of methamphetamine use (2.0). There was a significant interaction between Latina ethnicity and having an arrest charge for drugs or prostitution; Latinas who had this charge had over 11 times the odds of using methamphetamine compared with those with other arrest charges (OR = 11.28). A better understanding of the relationship between drug use and sexual risk behaviors of STD-positive incarcerated female adolescents can inform the development of appropriate corrections and community-based interventions serving this segment of high-risk adolescents.
Assuntos
Metanfetamina/efeitos adversos , Prisioneiros/estatística & dados numéricos , Comportamento Sexual/estatística & dados numéricos , Infecções Sexualmente Transmissíveis/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adolescente , Alcoolismo/epidemiologia , Alcoolismo/etnologia , California/epidemiologia , Criança , Feminino , Humanos , Abuso de Maconha/epidemiologia , Abuso de Maconha/etnologia , Fatores de Risco , Trabalho Sexual/etnologia , Trabalho Sexual/estatística & dados numéricos , Comportamento Sexual/etnologia , Transtornos Relacionados ao Uso de Substâncias/etnologia , Sexo sem Proteção/etnologia , Sexo sem Proteção/estatística & dados numéricosRESUMO
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.
Assuntos
Infecções por Chlamydia/epidemiologia , Chlamydia trachomatis , Delinquência Juvenil , Programas de Rastreamento , Prisões/estatística & dados numéricos , Adolescente , Adulto , Distribuição por Idade , Criança , Infecções por Chlamydia/diagnóstico , Estudos Transversais , Feminino , Política de Saúde , Humanos , Masculino , Programas de Rastreamento/métodos , Prevalência , Prisioneiros , Distribuição por Sexo , Estados Unidos , Adulto JovemRESUMO
BACKGROUND: Juvenile detention centers offer public health practitioners an opportunity to gain access to large numbers of adolescents at risk for chlamydia and gonorrhea. GOAL: To describe the prevalence and coinfection of chlamydia and gonorrhea among adolescents in 14 US juvenile detention centers from 1997 to 2002. STUDY: We calculated the prevalence of chlamydia and gonorrhea in males and females, stratified by race/ethnicity, age group, and site. We also calculated the proportion of adolescents with chlamydia that were coinfected with gonorrhea and the proportion of those with gonorrhea that were coinfected with chlamydia. RESULTS: The prevalence of chlamydia was 15.6% in 33,619 females and 5.9% in 98,296 males; gonorrhea prevalence was 5.1% in females and 1.3% in males. Of females with gonorrhea, 54% were coinfected with chlamydia, and 51% of males with gonorrhea were coinfected with chlamydia. CONCLUSIONS: Chlamydia and gonorrhea prevalence was very high in females in all project sites. In males, chlamydia prevalence was high in some areas; however, gonorrhea prevalence was substantially lower. These prevalence data justify screening for chlamydia and gonorrhea among female adolescents in juvenile detention centers nationally.