Incidence of STIs among justice-involved youth and use of point-of-care screening to improve health outcomes
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Abstract
BACKGROUND: Sexually transmitted infections (STIs) are becoming more prevalent among the US population. It is estimated that 20% of US residents are living with an STI at any given time, and over half of all newly diagnosed STIs are among youth aged 14-24 years old. Of these youth, justice-involved youth have the highest rates of STIs compared to their same-aged counterparts. These justice-involved youth also have unique health needs compared to their same-age counterparts, since they often lack access to healthcare which leaves them susceptible to untreated illnesses and infections including STIs. Furthermore, justice-involved youth are often released back to the community quickly after being detained, so they do not have the same healthcare access that arrested and detained youth are guaranteed by the constitution. Many barriers exist for STI testing and treatment for justice-involved youth, and the limited time between detainment and release of these youth may be a useful point of intervention for rapid STI testing and possibly treatment.
LITERATURE REVIEW: The literature review for this study is separated into two sections: an overview and an examination of existing literature. The overview explores the two most common STIs among justice-involved youth, as well as their health sequelae. It also explores the health needs of justice-involved youth when compared with the general youth population and the healthcare inequality these youth face which creates barriers to them receiving preventative care. It discusses potential areas for intervention, including the use of detention facilities as places where youth receive healthcare or are connected to healthcare resources. It also discusses best practices for screening and treatment of STIs in detention facilities within an appropriate time span for justice-involved youth.
The examination of existing literature discusses articles about universal screening for STIs in youth detention facilities. It also discusses trends of chlamydia and gonorrhea infections and treatment rates in detained youth, use of point-of-care testing to improve screening and treatment, cost savings from STI testing and treatment, and the efficacy of point-of-care testing as a whole. Together, this examination of existing literature suggests of the demand for universal STI testing in detained youth, and the feasibility of using point-of-care testing to improve both screening and treatment outcomes.
PROPOSED RESEARCH: The proposed study is a multi-site, prospective interventional study in which half of all Massachusetts Department of Youth Services (DYS) facilities will provide universal opt-out STI screening to detained youth using standard testing, and half will provide universal opt-out STI screening to detained youth using rapid testing. The aim of this study is to explore the feasibility of universal rapid STI testing in detained youth, and to determine whether rapid testing will improve treatment rates compared to standard testing in detained youth.
CONCLUSION: The goal of this thesis is to explore the sexual health needs of justice-involved youth, and to understand the barriers to care that leave them susceptible to higher rates of STI infection than their same-age counterparts. The thesis also explores opportunities for interventions that will increase screening and treatment rates in this youth population. This thesis adds to a growing body of literature about reproductive health in adolescents, and highlights the importance of STI testing and treatment to medically underserved juvenile populations in non-traditional healthcare settings.
Description
2024