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Results for sexually transmitted infections

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Author: Zakaria, Dianne

Title: Rates of Reported Sexually Transmitted Infections since Admission to Canadian Federal Prison and Associated Incarceration Characteristics and Sexual Risk-Behaviours

Summary: Previous research indicates that Canadian federal inmates, particularly women, are a high-risk group for sexually transmitted infections (STIs), but information about incarceration characteristics and sexual behaviours most strongly associated with these infections in correctional systems is sparse. To address this and other deficiencies in the literature, in 2007 the Correctional Service of Canada (CSC) conducted the National Inmate Infectious Diseases and Risk Behaviours Survey (NIIDRBS), a self-administered paper questionnaire completed by a large sample of Canadian federal inmates (n = 3,370). This report presents NIIDRBS data on the rate of reported STIs since admission to Canadian federal prison. Further, it examines associations between reporting an STI since admission and several incarceration characteristics and sexual behaviours. The overall rate of at least one reported STI since admission to federal prison was 158 per 10,000 person-years served. Comparisons across sub-groups revealed elevated rates in women and Aboriginal males. Specifically, the rate of reporting an STI since admission was 4.5 times greater in women than men (669 vs. 150 per 10,000 person-years) and 1.6 times greater in Aboriginal males than non-Aboriginal males (222 vs. 136 per 10,000 person-years). Among men, several incarceration characteristics and in-prison sexual behaviours were associated with reporting an STI since admission to federal prison. First, the odds of reporting an STI were about two times greater among males in maximum security compared to males in minimum security. Second, after serving a total of eight years cumulatively, the odds of reporting an STI among males appeared to consistently increase over time, plateauing after 14 years. After serving more than 16 years, the odds of reporting an STI had increased by a factor of 1.8 relative to those serving two years or less. Last, the odds of reporting an STI were approximately five times greater among males reporting exchange-sex (i.e., a transaction involving the exchange of sex for money, works, rigs, drugs or goods) compared to those who did not. Only 1.8% of the male population, however, reported this high-risk activity during the past six months in prison. Among recently sexually active women, reporting an STI since admission was associated with only one in-prison sexual behaviour. Specifically, those reporting an STI since admission were 1.6 times more likely to have unprotected sex with a casual partner than those not reporting an STI (56% vs. 35%). With respect to community sexual behaviours, only one remained significantly associated with reporting an STI since admission among men: the odds of reporting an STI were about 3.4 times greater among those reporting sex with males compared to those who did not. Among women, several sexual behaviours in the community were significantly associated with reporting an STI since admission. First, the odds of reporting an STI were approximately three times greater in those reporting sex with females compared to those who did not. Second, the odds of reporting an STI were approximately 2.4 times greater among those being paid for sex compared to those who were not. Last, the odds of reporting an STI were 85% lower among those reporting unprotected sex with a regular partner compared to those who did not. This last finding is counterintuitive. Unprotected sex is generally considered a risk-factor for STIs but our finding indicates it is protective. Although further research is necessary to validate this finding, it does reinforce the importance of distinguishing between unprotected sex with casual partners and regular partners. Presently, all of the identified sexual risk-behaviours are screened for in the intake health status assessment at CSC. Healthcare professionals can use this assessment to identify individuals at elevated risk for STIs while incarcerated and thus more likely to benefit from regular STI testing at CSC. Since cumulative time served and security level were also associated with an increased risk of reporting an STI since admission among men, education, screening and testing needs to continue beyond admission, particularly among high-risk subgroups, and access to harm-reduction items (i.e., condoms, dental dams, and lubricant) needs to be monitored across security levels. The primary limitations of this research arise from the cross-sectional design of the NIIDRBS and its reliance on self-report. To overcome these limitations, it may be useful in future research to test all inmates using biosamples (e.g., urine tests) at admission and regular follow-ups to maximize the accuracy of estimating the date of infection and recalling risk-behaviours.

Details: Ottawa: Correctional Service of Canada, 2010. 60p.

Source: Internet Resource: Research Report 2010 NÂș R-196: Accessed April 16, 2012 at: http://www.csc-scc.gc.ca/text/rsrch/reports/r196/r196-eng.pdf

Year: 2010

Country: Canada

URL: http://www.csc-scc.gc.ca/text/rsrch/reports/r196/r196-eng.pdf

Shelf Number: 124983

Keywords:
Inmates, Sexual Behaviors (Canada)
Sexually Transmitted Infections