Background:
The Maricopa County jail facilities incarcerate over 120,000 arrestees each year. Over 60% are housed for less than 48 hours. This is a high-risk population for STD screening. New screening projects have been implemented to facilitate effective STD interventions.

Objective:
To illustrate new screening approaches enhancing STD interventions.

Methods:
Jail screening strategies were discussed with the Medical Director of the Maricopa County Correctional Health Services and the Health Director of Maricopa County. Activities were implemented after conducting problem-solving meetings and through thepursuit of some outside financial support.

Results:
New jail screening projects:

Holding Tank syphilis screening – prior to the 09/2000 start date fewer than 40 inmates screened in the Holding Tank per month. During the first six months of CY 2001, a monthly average of 2,494 males and 268 females were screened for syphilis in the Holding Tank.

Court ordered syphilis screening for prostitutes – prior to start date no data available for prostitute screening. After the May 2001 start date, an additional 178 females and 10 males were screened during its first two months of operation.

Juvenile Detention Center chlamydia screening (males and females) – male inmates have a 9% rate of positive test findings and females have a 21% rate of positive test findings. Prior to start date, 2/1998, only diagnostic tests were used to test symptomatic inmates. Female chlamydia and gonorrhea screening for adult and teenage inmates – screening will start in January 2002. Update will be listed on poster display.

STAT syphilis testing at the Holding Tank – targeted STAT testing will be initiated in January 2002. STAT testing will promote prompt administration of syphilis treatment prior to the inmate’s release.

Conclusions / Implications for Program/Policy:
STDs are detected when aggressive, innovative screening projects are implemented in the county jail. Syphilis screening at the Maricopa County jails accounts for 27% of the syphilis morbidity in Maricopa County.