The Prevalence of Chlamydia Infection in Youth Offenders in HMP/YOI Holloway June 2003 – June 2005
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Transcript of The Prevalence of Chlamydia Infection in Youth Offenders in HMP/YOI Holloway June 2003 – June 2005
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The Prevalence of Chlamydia Infection in Youth Offenders in HMP/YOI Holloway
June 2003 – June 2005
THERESA BURNS, SEXUAL HEALTH ADVISERWomen’s Health Clinic, HMP/YOI Holloway & Marlborough Clinic, Royal Free Hospital
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Methodology• Health Adviser led session.
• Working with the support of unit officers who often helped with
recruitment to the study.
• Evening sessions held on Young Offenders Unit during association time (time for women to take baths, domestic chores and to mix with each other for 11/2 hrs each evening).
• Limited space allowing for privacy. Interviews held in places such as dining room and TV room.
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Methodology
• Opportunistic testing – approaching individuals and explaining who I was and why I was there.
• Administered questionnaire.
• Chlamydia urine NATT.
• Total number of patients = 289
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Aims of Study
• To determine the prevalence of chlamydia infection and associated lifestyle risk factors in young women from the Young Offenders Unit in HMP Holloway.
• To raise awareness of chlamydia in this vulnerable group.
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Age Range
0102030405060708090
32 68 80 81 27
age 17 age 18 age 19 age 20 age 21
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0255075
100125150175200225250275300
77.1% 10.4% 5.9% 8.0% 6.6%
white mixed black caribbean black (other) other
Ethnicity
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Educational History
020406080
100120140160
3.8% 43.2% 47.7% 5.2%
none <3yrs < 5yrs current
Since age 11, how many years did you spend in full-time education?
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Drug Use part I
0
50
100
150
200
250
300
10.4% 85.5% 18.3% 35.0% 45.0%
none tobacco Rx'd alcohol hash
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Drug Use Part II
020406080
100120140
16.3% 12.5% 17.7% 41.2% 25.3% 17.3%
Ecstasy Amphetamine CocaineCrack Heroin (smoked) Heroin (injected)
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Current Sexual Partners
0
50
100
150
200
250
90.7% 2.30% 4.70% 2.30%
RMP > RMP RFP other
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Age of First Sexual Experience
01020304050607080
9 yrs 10 yrs 11 yrs 12 yrs 13 yrs14 yrs 15 yrs 16 yrs 17 yrs 18 yrs
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Commercial Sex Work
53 (18.4%) of the 289 women interviewed admitted at some time being involved in the commercial sex industry.
This was mainly to support their own and their partner’s drug use.
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Number of Sexual Partners
THE LAST THREE MONTHS PRIOR TO COMING INTO PRISON
0
20
40
60
80
100
120
140
160
180
0 1 2 3 4 5+ 10+ 20+ 50+ 100+
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Condom Use
• 56 (19.8%) of women interviewed reported a condom was used at last intercourse.
• 122 (43%) reported that they never used condoms.
• 122 (43%) reported occasional use.
• 40 (14.1%) reported 100% condom use.
0
20
40
60
80
100
120
140
19.8% 43.0% 43.0% 14.1%
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Contraception
020406080
100120140160180
54.4% 22.3% 15.2% 5.3% 2.8%
none condom pill depo other
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Pregnancy
0
10
20
30
40
50
60
13.3% 31.8% 31.2% 23.7%
Pregnant Birth Miscarriage TOP
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Previous STI Infection
05
101520253035404550
21 47 9 18 3 2 4 1
GC CHLAMYDIA TV HPV STS HEP B HEP C HIV
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Chlamydia Results
• Verbal results after one week, hard copy after a fortnight
• Positive results given to women either on the unit or in the clinic. If transferred to another prison, that health care unit contacted and told of the need for treatment. If released, letter sent if address was available.
• Appointment in the Women’s Health Clinic within 48 hours for treatment and an offer of full sexual health screen including HIV, hepatitis B and C if indicated.
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Partner Notification• Difficult due to woman's circumstances:
in prisonlimited contact with the outside worldphone calls listened intoall mail is read by unit officers before posting
• Women often refused to contact partners due to worries over:
Possible violenceConfidentialityEmbarrassment
• Provider referral offered, only possible in a small number of cases
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Results
• Prevalence of chlamydia infection was 12.2%.
• All the young women who took part in this research were offered an appointment for a full sexual health screen.
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Results
No association with a chlamydia diagnosis- age- drug and alcohol use- sex worker- educational history- social history
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Recommendations
• Chlamydia testing offered to all women admitted to the Youth Offender Unit
• Educational session to raise awareness
• Assertiveness training around condom use
• Targeted health promotion programmes
• Multi agency working i.e. drug services