Ex-Offender Data Show High Risk of Sexually Transmitted Infections After Release

The American healthcare system may be missing an opportunity to curtail sexually transmitted infections in communities, according to a new study of offenders following release from the justice system.

Researchers at Indiana University School of Medicine and Regenstrief Institute presented findings at the STI & AIDS World Congress in Vienna, Austria, July 14-17, 2013, showing that individuals released from the justice system have a high risk of contracting an sexually transmitted infection within the first year.

Sarah E. Wiehe, MD, associate professor of pediatrics at IU School of Medicine and an affiliated scientist at the Regenstrief Institute, said studies have shown that criminal offenders have a high rate of sexually transmitted infections when entering the justice system and that communities with a high percent of incarcerations also have an increased number of STI cases.

The analysis using existing justice system and public health data by the IU researchers also shows that ex-offenders had a high risk of contracting a sexually transmitted infection within the first year of release. That risk was particularly high for those released from the juvenile system, she said.

Wiehe and colleagues worked with the Marion County (Indiana) Courts, the Marion County Health Department, the Indianapolis Metropolitan Police Department and the Indiana Department of Corrections to track 260,000 youths and adults who had interaction with the justice system through arrest, jail, juvenile detention, juvenile prison or adult prison from 2000 to 2008.

Wiehe said that of those who tested positive for sexually transmitted infections from 2000 to 2008, 16 percent contracted the infection within the first 365 days of release from the justice system. That incidence rate includes:

- 10 percent from adult prison
- 13 percent from jail
- 10 percent of those arrested but not jailed or imprisoned
- 26 percent from juvenile prison
- 22 percent from juvenile detention

"The one-year time period following release from the justice system represents a high-impact opportunity to reduce the sexually transmitted infection rates at a population level. Even modestly successful efforts to reduce post-incarceration STI and STI risk could have substantive effects on community STI burden across infection types," Wiehe says.

This research, funded by a National Institute of Allergy and Infectious Diseases grant (R21AI084060), is the first of a series the IU investigators hope to pursue. Other Indiana University investigators contributing to this research are J. Dennis Fortenberry, MD, MS, Matthew C. Aalsma, PhD, and Marc B. Rosenman, MD.

Wiehe says the next phase of research will be looking at the rates and effect of sexual transmitted infection related to ex-offenders in the community, followed by a review to see whether racial disparities in the justice system correlate to similar disparities in sexual transmitted infection rates.