OBJECTIVES: The purpose of this study was to determine the feasibility and usefulness of rapid screening and immediate presumptive treatment for sexually transmitted diseases among arrestees at a county jail. METHODS: The rapid plasma reagin test (for syphilis) and the urine leukocyte esterase test (for urethritis) were used in establishing routine screening and presumptive treatment for sexually transmitted diseases among arrestees. RESULTS: Of 4757 arrestees screened, 82 (1.7%) had untreated syphilis, and, of 4174 male arrestees screened, 541 (13%) had a positive leukocyte esterase test. The syphilis prevalence rate was higher among women than among men (3.1% vs 1.5%), and the rate was higher among Blacks than among Whites (2.3% vs 0.7%). Although leukocyte esterase test positivity was higher among persons reporting a urethral discharge (57% vs 12%), 88% of persons with a positive test result did not report such symptoms. CONCLUSIONS: The program described here has reached persons with sexually transmitted diseases who are unlikely to use traditional health care services and thus are likely to remain untreated. Rapid screening and treatment for sexually transmitted diseases among arrestees is feasible and should be considered in areas with high sexually transmitted disease rates.

In pursuing the research and development discussed in this report, the assistance of Messrs.

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The Gen-Probe PACE 2 assay is useful for screening young males in this jail setting and is more accurate for detecting Chlamydia trachomatis compared with Neisseria gonorrhoeae.

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