Chlamydia and Gonorrhea Prevalence and Treatment in Detained Youths: Strategies for Improvement.

Purpose: Adolescents and young adults have the highest prevalence of sexually transmitted infections (STIs), accounting for more than 50% of all reported infections. An especially high-risk group includes adolescents in juvenile or correctional facilities.

Methods: This retrospective analysis was conducted at the only juvenile detention facility in the State of Hawai'i from 2014 to 2017. Adolescents aged 12-17 years were offered STI screening and/or presumptive treatment at the time of medical evaluation.

Results: Of 2,208 adolescents offered voluntary testing, 461 males and 372 females agreed to be tested for Chlamydia trachomatis and Neisseria Gonorrhea. Acceptance did not vary by age; females chose testing more often than males (67.4% vs. 27.8%; p < .0001). Females were also more likely to accept presumptive treatment (22.8% vs. 8.8%; p < .0001). In tested youth, STIs were prevalent in 24% of females and 10% of males. Before leaving the detention facility, only half the STIs in females and only 39% of male STI infections had been treated.

Conclusions: There was a high prevalence of STIs in both males and females admitted to this juvenile detention facility, with fewer than half the documented infections being treated before discharge. This indicates a need for universal and timely testing to allow the treatment of those infected. If for whatever reason rapid testing cannot be obtained, presumptive treatment offers a pragmatic approach to treatment and infection control.