Sexually Transmitted Diseases, Drug Use, & Risky Behavior among Miami-Dade County Jail Detainees

Article excerpt

The findings in this report focus on test results of more than 600 detainees housed in Miami-Dade County jails between October 1999 and February 2000. This article also analyzes the relationships between sexually transmitted diseases (STDs) and various factors such as race/ethnicity, age and gender within the detainee population. Finally, it analyzes the relationship between rates of detainee drug use and STDs.

Background

Miami-Dade County, Pa., is an area where large numbers of individuals are carrying STDs, particularly among the county's jail detainee population. Additionally, many of these cases are asymptomatic and even the carrier may not be aware that he or she suffers from an STD. In 1998, Jack Wroten, director of the Bureau of Sexually Transmitted Disease and Control for Florida's Department of Health, met with officials from Miami-Dade County's Health Department and Department of Corrections on the need to screen jail detainees for STDs. At that meeting, it was agreed that screening detainees was a major priority in the effort to address the spread of STDs in the county. The Center for Disease Control in Atlanta provided funding for the screening and last October, officials at Miami's principal male and female jail facilities began recording results of detainees. These records form the core of the statistics in this report.

This project was made possible by the gracious cooperation of the correctional, medical and administrative staff of the Miami-Dade County jail system. One of the largest in the country, the Miami-Dade County jail system encompasses seven major facilities, which process approximately 100,000 detainees per year. Funding support was provided through the Centers for Disease Control and Prevention and the Florida Department of Health. Local administrative, surveillance and field services support was provided by the Miami-Dade County Health Department.

Conducting the survey

Pertinent data about detainees, such as age, race/ethnicity and gender, were entered into a logbook kept at the jail facility. Detainees then were asked to take two voluntary tests to determine if they have an STD: the Ligase Chain Reaction (LCR) test for gonorrhea and chlamydia, and the Rapid Plasma Reagent (RPR) test for syphilis. For detainees who agreed to these tests, results then were entered into the logbook and sent to the Bureau of Sexually Transmitted Diseases in Tallahassee, Fla.

There was no selection of respondents for this survey; all jail detainees who agreed were tested for syphilis, gonorrhea and chlamydia. Even detainees who refused testing were part of the survey, since their refusals also were noted in the report.

Purpose of Survey

The purpose of this study was for public health officials as well as the community at large to get an idea of the extent of STDs among the detainee population and, with this information, strive to thwart the spread of STDs, particularly by individuals who are otherwise asymptomatic. The data compiled by this screening will help public officials in their battle to eradicate STDs.

Raid Plasma Reagent

The RPR test is a blood test to detect syphilis. Those testing positive (or "reactive") have syphilis, while negative ("nonreactive") tests suggest that they do not have syphilis. The LCR test is a urine test given to determine if a patient has gonorrhea and/or chlamydia. While none of the detainees refused to take the LCR test, a substantial portion (13 percent) refused to take the RPR; while LCR tests rely on urine samples, RPR tests require blood samples, to which detainees presumably are more reluctant to submit.

RPR Results

In general, asymptomatic detainees are not required by law to submit to the RPR test. The state has the right to compel a detainee to submit to this test only in cases in which the a detainee shows physical signs of having an STD, or if he or she reported to have had sexual contact with an individual known to have an STD. …