Background:
Urine-based testing for chlamydia (CT) has improved public health access to hard-to-reach populations. Since 1998, young men incarcerated in some state and local detention facilities in Washington and Oregon have received urine-based testing by EIA or LCR for chlamydial infection as a part of the Region X Infertility Prevention Projects’ expansion efforts.

Objectives:
To estimate the prevalence of CT among incarcerated adolescent males tested with urine-based enzyme immunoassay (EIA) and ligase chain reaction (LCR).

Methods:
Urine CT test records from 1998–2000 for 7,666 incarcerated males from nine state and seven local juvenile detention facilities in Oregon and Washington were analyzed. Prevalence, chi-square tests for trend, and univariate predictors of infection were calculated using SPSS 8.0.

Results:
Overall prevalence was low—3.3% (253/7,666); 98% of males tested were asymptomatic. Chlamydia prevalence varied by facility type and test:5.2% among males tested at local juvenile detention using LCR; 4.0% among males tested at state facilities using LCR; 2.8% among males tested at local detention centers using EIA; and 2.1% at state facilities using EIA. Prevalence also varied by age.

Conclusions:
Chlamydia prevalence among incarcerated males is generally low, especially at state facilities, reflecting the difference in the likelihood of exposure between long-term and short-term detention. Higher positivity was found at sites using LCR, in part because of increased sensitivity.

Implications for Programs:
Given the lack of opportunity for sexual contact with an infected female population, the low prevalence of infection among males in state juvenile detention should be expected. Further efforts at reducing CT among males should focus on local detention centers where there is rapid population turnover.

Implications for Research:
Given the low prevalence of CT infection among younger incarcerated males (less than 15 years of age) and those housed in state facilities, research evaluating selective screening approaches might be beneficial.

Measurable Learning Objectives:
Participants will be able to describe the correlates of and differences in CT prevalence among young males incarcerated in state and local juvenile detention centers in Oregon and Washington and assess the role of facility type in these differences.

Presenting Author Contact Information:
D. Scott LaMontagne / Research Associate, Center for Health Training, 1809 7th Avenue, Suite 400, Seattle, WA98144. / Phone 206-447-9538 / slamontagne@jbacht.com