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Chlamydial cervical infection in jailed women.

M D Holmes, S M Safyer, N A Bickell, S H Vermund, P A Hanff and R S Phillips

Department of Medicine, Beth Israel Hospital, Boston, Mass. 02215.

OBJECTIVES. The prevalence of Chlamydia trachomatis cervical infection in incarcerated adult women has not been reported. To develop a policy for testing and treatment, we determined the prevalence of and risk factors for chlamydial infection in women in a New York City jail. METHODS. Interviews and cervical cultures for C trachomatis were obtained from 101 consenting female inmates. RESULTS. Positive cultures for C trachomatis were found in 27% of the participants. Mucopurulent cervical discharge and education of 8 years or less were two independent risk factors for infection, but only 63% of the infected women had one or both of these factors. If pelvic tenderness were considered as a third factor, an additional 7% of the infected women would have been identified. CONCLUSIONS. The prevalence of chlamydial infection in this population was as high as that in populations for which presumptive treatment is recommended. Although the optimal policy for detection and treatment of chlamydial infection may vary depending on practical considerations, we suggest that women entering correctional facilities should be screened or offered presumptive therapy for C trachomatis infection.

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