P015 Introduction of chlamydia and gonorrhea opt-out testing in a short-term correctional facility in alberta, canada. (14th July 2019)

• Record Type: Journal Article
• Authors: Gratrix, Jennifer; Payne, Diane; Smyczek, Petra; Eagle, Lynn; Courtney, Keith; Ahmed, Rabia
• Is Part Of: Sexually transmitted infections. Volume 95(2019)Supplement 1
• Page Start: A88
• Page End: A88
• Publication Date: 2019-07-14
• Subjects: diagnosis -- correctional facility -- Canada; Sexually transmitted diseases -- Periodicals; HIV infections -- Periodicals; 616.951005
• DOI: 10.1136/sextrans-2019-sti.224
• Languages: English
• ISSNs: 1368-4973

Abstract

Abstract : Background: Incarceration provides an opportunity for screening and treatment of STBBI in high-risk groups. The purpose of this study was to evaluate the uptake and outcomes of opt-out screening at time of admission. Methods: Between March and September 2018, all individuals ≤ 30 years admitted to a short-term correctional facility in Alberta, Canada were offered urine nucleic acid amplification test (Aptima Combo 2®, Hologic Inc., Marlborough, MA) for Chlamydia trachomatis (CT) and Neisseria gonorrhea (NG), upon admission. Admission line-lists recorded offering of opt-out testing and reasons for testing non-completion. Laboratory data extracts provided test results by matching collection date with unique patient identifiers. Simple descriptive statistics analysis were completed. Results: A total of 1, 735 (1, 295 males) admissions were recorded, with a median age of 23 years (IQR: 21–25). Most (92.7%; n=1, 608) of individuals were offered opt-out testing; reasons for not offering testing included inability to consent (35.1%; n=39), operational limitations (28.8%; n=32), guardianship issues (10.8%; n=12), other concerns (9.0%; n=10), and missing (16.2%; n=18). Of those offered testing, 32.3% (n=520) consented. Reasons for not consenting included: no perceived risk (35.3%; n= 384), recently tested (16.6%; n=181), deferred testing (13.3%; n=145), declined (11.0; n=120), not sexually active (4.7%; n=51), other (5.9%; n=65), and missing (13.1%; n=142). The positivity rate for CT was 18.0% (n=83) and NG was (12.6%; n=58). Women were more likely to test positive for CT (26.1% vs 15.2%, P=0.008) and NG (21.8% vs 9.3%, P<0.001) than men. Conclusion: Opt-out testing at admission proved to be feasible, although uptake was relatively low, CT and NG positivity rates were high. With the majority of incarcerated individuals in Canada being held in short-term correctional facilities, intensification of screening strategies to an opt-out model is effective for a large number of high-risk individuals. Disclosure: No significant relationships.