Sexually transmitted infections in Brazilian adolescent offenders in correctional facilities

Objective 
To assess the prevalence and risk factors of sexually transmitted infections (STI) among adolescent offenders held in correctional facilities.

Methods 
This quantitative cross-sectional study, carried out in Rio de Janeiro, Brazil, included interviews to collect sociodemographic and clinical data and knowledge about STIs. Rapid tests for detection of syphilis antibodies and HIV infection, and molecular urine tests for chlamydia and gonorrhea were performed. Statistical analysis included STI prevalence estimates and multivariate analysis to identify risk factors.

Results 
A total of 965 adolescents (average age: 16.1 years; 85.1% male) were included in the study. STI prevalence was higher in the female unit than in the male units: syphilis (45.6% vs. 7.7%), chlamydia (34.6% vs. 19.7%), gonorrhea (12.5% vs. 6.0%), and HIV (1.5% vs. 0.4%). The prevalence of “at least one STI” was higher in the female unit compared to the male units (68.4% vs. 27.3%; prevalence ratio 2.51). This high bur den of STIs, which were often asymptomatic, was associated with multiple sexual partners and unprotected sex practices, reflecting important gaps in sex education in this highly vulnerable group who demonstrated limited knowledge on STI risk and prevention.

Conclusions 
This high prevalence of STIs, combined with limited knowledge of prevention, calls for comprehensive strategies associating systematic screening, timely treatment, and sexual health education into the routine activities of socio-educational institutions.