Overcrowding can increase the risk of disease transmission, such as that of SARS-CoV-2 (COVID-19), within United States prisons. The number of COVID-19 cases among prisoners is higher than that among the general public, and this disparity is further increased for prisoners of color. This report uses the example case of the COVID-19 pandemic to observe prison conditions and preventive efforts, address racial disparities for people of color, and guide structural improvements for sustaining inmate health during a pandemic in four select states: California, New York, Illinois, and Florida. To curb the further spread of COVID-19 among prisoners and their communities, safe public health practices must be implemented including providing personal protective equipment (PPE) and testing of staff and inmates, disseminating culturally and language appropriate information regarding the pandemic and preventive precautions, introducing social distancing measures, and ensuring adequate resources to safely reintegrate released prisoners into their communities.
Background: Extragenital testing (rectal and oropharyngeal) of Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) increases the detection of CT/NG infections, compared with genital testing alone. The Centers for Disease Control and Prevention recommends annual extragenital CT/NG screening for men who have sex with men, and additional screenings for women and transgender or gender-diverse individuals if certain sexual behaviors and exposures are reported.Methods: Prospective computer-assisted telephonic interviews were conducted with 873 clinics between June 2022 and September 2022. The computer-assisted telephonic interview followed a semistructured questionnaire that included closed-ended questions on the availability and accessibility of CT/NG testing.Results: Of the 873 clinics, CT/NG testing was offered in 751 clinics (86.0%), and extragenital testing was offered in only 432 clinics (57.5%). Most clinics (74.5%) with extragenital testing do not offer tests unless patients request them and/or report symptoms. Additional barriers to accessing information on available CT/NG testing include clinics not picking up the telephone, disconnecting the call, and unwillingness or inability to answer questions.Conclusions: Despite evidence-based recommendations from the Centers for Disease Control and Prevention, the availability of extragenital CT/NG testing is moderate. Patients seeking extragenital testing may encounter barriers such as fulfilling specific criteria or being unable to access information on testing availability.C hlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) are the most commonly reported sexually transmitted infections (STIs) in the United States, with 1.6 million and 700 thousand reported cases of infection reported in 2021, respectively. 1 Rates of NG (per 100,000 population) have steadily risen 23.0% between 2017 and 2021. 1 Rates of CT (per 100,000 population), on the other hand, seemingly dropped between 2019 and 2020 po-tentially because of underreporting during the COVID-19 pandemic, but increased by 2.9% again in 2021. 1 These rising STI rates disproportionately impact adolescents, young adults, and some racial and ethnic minority groups, such as Hispanic and Black individuals. 2 In addition, there are disparities in STI rates by state.
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