(P66) SEXUALLY TRANSMITTED INFECTIONS AMONG PEOPLE WHO WERE INCARCERATED, CALIFORNIA PROJECT AREA, 2018-2022

Background:
Disproportionate incarceration of Black/African American and Hispanic/Latinx people due to structural racism and other social determinants of health contributes to sexually transmitted infection (STI) disparities among these populations. Estimating disease burden among incarcerated populations is complex because some correctional facilities have limited testing capacity, short incarceration periods, and limited tools to identify incarcerated people in surveillance systems. We estimated the number of people diagnosed with a bacterial STI while incarcerated and described the demographic characteristics of this population.

Methods:
We identified cases of chlamydia (CT), gonorrhea (GC), early syphilis (ES), and unknown duration/late syphilis (UDLS) among incarcerated people using case reports, geocoding tools, and Perl regular expressions. Incarceration included jail, prison, juvenile, federal, or state forensic psychiatric hospital facilities. Using Pearson’s chi-squared tests, we compared the demographic characteristics of incarcerated people and non-incarcerated people with STIs in the California Project Area (all counties except Los Angeles and San Francisco) from 2018-2022.

Results:
From 2018-2022, 38,598 (4%) of all CA STI cases (n = 1,014,827) were among incarcerated people. There were significantly different (p < 0.0001) distributions of gender, race/ethnicity, and STI diagnosis between incarcerated and non-incarcerated people. Compared to non-incarcerated people, incarcerated populations had fewer CT cases (50% vs 68%); more UDLS cases (17% vs 4%); fewer people who were female (32% vs 56%) or white (14% vs 16%); and more people who were Black/African American (10% vs 9%) or Hispanic/Latinx (28% vs 22%)

Conclusion:
Californians diagnosed with an STI while incarcerated had significantly different demographic characteristics than non-incarcerated Californians with an STI, perhaps reflecting wider demographic differences between incarcerated and non-incarcerated populations. Understanding the unique STI epidemiology among incarcerated populations can support implementation of opt-out STI testing and treatment in correctional facilities, partner services and linkage-to-care upon release, and ultimately reduce STI incidence in high STI morbidity communities.