Dear Correctional Colleagues:

This month's issue focuses on sexually transmitted diseases (STDs) in jails. STD control is an issue in its own right as well as a measure to prevent the spread of HIV.

Correctional health care professionals can provide an effective service for society in helping control STDs. People who have been convicted of a crime have higher rates of medical conditions that similarly involve risk taking, including STDs. A few years ago it was reported that 24% of Chicago's new syphilis cases were diagnosed at the Cook County Jail. Similarly, 13% of Florida's syphilis cases were identified by correctional facilities. Working together with public health departments, we can design programs that can be among the most effective ways to diagnose STDs in our communities. As those cases are reported and as partners/contacts are contacted by public health departments and treated, control of STDs can be greatly advanced.

We should be screening all our incoming inmates to diagnose and treat patients with STDs. Screening should be tailored to the population being served. Not all systems need to do lab tests for all diseases, but we don't know that until we look. Although our systems try to minimize sexual activity within our facilities, it does occur. Assuring the absence of STDs at least prevents disease transmission. Since it has been shown that the presence of STDs facilitates HIV transmission, control of STDs is also an HIV preventive measure.

STD control in corrections must involve close collaboration with public health departments. This is an area that state and local health departments have specialized in for decades. They have staff trained to interview patients with STDs and to locate their sexual partners. Their staff, clearly identified as health department officials, can sometimes get histories that correctional staff cannot (since inmates may not believe that the information they tell us won't be used against them). This collaboration is a win-win for society. If you don't already know your health department colleagues, get to know them now!

After reading this issue, you will have a better understanding of the epidemiology, diagnosis, and treatment of four STDs commonly found in jail settings: syphilis, gonorrhea, chlamydia and herpes.

Dr. Lester Wright
New York State Department of Corrections

Back to the HEPP Report September 2003 contents page.