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  • Title: Sexually transmitted diseases in females in a juvenile detention center.
    Author: Bell TA, Farrow JA, Stamm WE, Critchlow CW, Holmes KK.
    Journal: Sex Transm Dis; 1985; 12(3):140-4. PubMed ID: 3929406.
    Abstract:
    Of 37 female adolescent prostitutes and 63 other females held in the King County, Washington, juvenile detention facility, 81 (81%) complained of vaginal discharge, and only eight (8%) had no genitourinary symptoms. The prevalence of genital infections among prostitutes and nonprostitutes was similar. Neisseria gonorrhoeae was found in 18 (18%) of 98 detainees tested, and Chlamydia trachomatis was found in 17 (20%) of 86 detainees tested; either organism was found in 27 (32%) of 85 tested for both organisms. Also, 38 (48%) of 80 tested had trichomoniasis. No detainees had syphilis. Sixty-seven (68%) of 98 responding detainees used no contraception. Such populations deserve the attention of public programs for control of sexually transmitted diseases and for family planning. The medical staff of the King County, Washington, juvenile detention facility attempts to evaluate all new detainees within 72 hours of admission to the facility (or sooner if a history of genitourinary symptoms is elicited when they are questioned on admission about their health). In 1981 100 females who had received no antimicrobial agents in the month prior to examination and who were detained for more than 24 hours and available for comprehensive examinations were selected for this study of the prevalence of sexually transmitted diseases in females in a juvenile detention center. The procedure for examining these young women was identical to that used in the Seattle-King County Harborview Medical Center clinic for sexually transmitted diseases (STDs). It included a medical history, a speculum examination of the vagina and cervix, and a bimanual examination of the uterus and adnexa. Complete data were not available for all 100 female detainees. The mean age of those studied was 15.2 +- 1.3 years; 66% were white, 30% were black, 1% was Asian or Pacific Islander, and 3% were of other ethnic groups. None were married. 37 of the 100 females were known or strongly suspected by the medical staff to be prostitutes. The median number of reported sexual consorts during the month prior to detention was 3 for prostitutes and 1 for other detainees. 68% of the 98 responding detainees used no contraception; 23% used foam and/or condoms, and 8% used oral contraceptives. Volunteered or elicited symptoms related to the genitourinary system did not significantly differ between prostitutes and other detainees. The most common symptom, abnormal vaginal discharge, was present in 81% of the detainees. Only 8 had no genitourinary symptoms. None of the conditions sought differed significantly in prevalence between prostitutes and other detainees. Of detainees appropriately tested, 18 (18%) of 98 were found to be infected with N. Gonorrhoeae and 17 (20%) of 86 with C. Trachomatis. Trichomoniasis was diagnosed in 38 (48%) of 80 detainees examined for it; bacterial vaginosis was diagnosed in 23 (25%) of 92 detainees. Vulvovaginal candidiasis was diagnosed in 6 detainees, herpes genitalis in 2, vulvar warts in 4, and scabies in 1. Of 61 young women tested, none had a reactive serologic test for syphilis. Recovery of either N. gonorrhoeae or C. Trachomatis was not significantly associated with complaints of vaginal discharge. Users of barrier methods were less likely to have C. trachomatis than were those not using contraception. Otherwise, there was no statistically significant associations between the presence of N. gonorrhoeae or C. trachomatis and contraceptive method.
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