{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T04:05:22Z","timestamp":1777953922701,"version":"3.51.4"},"reference-count":12,"publisher":"BMJ","funder":[{"DOI":"10.13039\/100000025","name":"National Institute of Mental Health","doi-asserted-by":"publisher","award":["DP2DA063100"],"award-info":[{"award-number":["DP2DA063100"]}],"id":[{"id":"10.13039\/100000025","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Sex Transm Infect"],"accepted":{"date-parts":[[2026,4,5]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The syphilis epidemic in the USA has expanded dramatically into new populations, but the overlap with prison populations is unknown. The objective of this analysis was to describe trends in syphilis diagnosis among people incarcerated and released from a state prison system.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was a cohort study of people released from prison in Washington state between 2010 and 2022. Linking prison rosters to Washington surveillance data, we calculated the rate of syphilis diagnosis between 2013 and 2023 when individuals were inside and outside of prison and compared it to the general population of Washington state.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>The rate of syphilis diagnosis increased substantially both in prison (36 per 100\u2009000 person-years in 2013 to 274 in 2022, rate ratio vs general population 1.3 in 2013 to 2.1 in 2023) and out of prison (8 in 2013 to 887 in 2023, rate ratio vs general population 0.3 in 2013 to 6.4 in 2023) over time.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interpretation<\/jats:title>\n                    <jats:p>From 2013 to 2023, the rate of syphilis diagnosis among those incarcerated in prison in Washington changed from similar to the general population to being significantly greater. Opt-out syphilis testing and treatment in prisons should be included in prison guidelines and accreditation standards.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/sextrans-2026-056934","type":"journal-article","created":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T17:20:52Z","timestamp":1777915252000},"page":"sextrans-2026-056934","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Characterising the rate of syphilis diagnosis among people incarcerated in state-level prisons: a cohort study in Washington state 2013\u20132023"],"prefix":"10.1136","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5477-9660","authenticated-orcid":false,"given":"Steven","family":"Erly","sequence":"first","affiliation":[{"name":"Office of Infectious Disease, Washington State Department of Health, Olympia, Washington, USA"},{"name":"Department of Epidemiology, University of Washington School of Public Health, Seattle, Washington, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Silas","family":"Hyzer","sequence":"additional","affiliation":[{"name":"Office of Infectious Disease, Washington State Department of Health, Olympia, Washington, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lara B","family":"Strick","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Washington, Seattle, Washington, USA"},{"name":"Washington State Department of Corrections, Tumwater, Washington, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alonso","family":"Pezo-Salazar","sequence":"additional","affiliation":[{"name":"Washington State Department of Corrections, Tumwater, Washington, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zo\u00eb","family":"Senter","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Washington, Seattle, Washington, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Helen E","family":"Jack","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Washington, Seattle, Washington, USA"},{"name":"Washington State Department of Corrections, Tumwater, Washington, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2026,5,4]]},"reference":[{"key":"2026050410202906000_sextrans-2026-056934v1.1","unstructured":"Centers for Disease Control and Prevention . Sexually Transmitted Infections Surveillance 2024 (Provisional) Atlanta: U.S. Department of Health and Human Services. 2025. Available: https:\/\/www.cdc.gov\/sti-statistics\/annual\/index.html"},{"key":"2026050410202906000_sextrans-2026-056934v1.2","doi-asserted-by":"crossref","unstructured":"Schmidt R , Carson PJ , Jansen RJ . Resurgence of Syphilis in the United States: An Assessment of Contributing Factors. Infect Dis (Auckl) 2019;12. doi:10.1177\/1178633719883282","DOI":"10.1177\/1178633719883282"},{"key":"2026050410202906000_sextrans-2026-056934v1.3","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2022.15322"},{"key":"2026050410202906000_sextrans-2026-056934v1.4","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1097\/OLQ.0000000000002110","article-title":"The Role of Jail Testing in the Public Health Response to Syphilis in King County, Washington","volume":"52","author":"Buck","year":"2025","journal-title":"Sex Transm Dis"},{"key":"2026050410202906000_sextrans-2026-056934v1.5","doi-asserted-by":"crossref","first-page":"542","DOI":"10.1097\/OLQ.0000000000002178","article-title":"Syphilis Screening and Treatment at a Large Urban Jail","volume":"52","author":"Sola-Odeseye","year":"2025","journal-title":"Sex Transm Dis"},{"key":"2026050410202906000_sextrans-2026-056934v1.6","doi-asserted-by":"crossref","first-page":"336","DOI":"10.1177\/10783458251371357","article-title":"Screening, Diagnosis, Treatment, and Prevention of Sexually Transmitted Infections","volume":"31","year":"2025","journal-title":"J Correct Health Care"},{"key":"2026050410202906000_sextrans-2026-056934v1.7","unstructured":"Centers for Disease Control and Prevention . Screening Recommendations and Considerations Referenced in Treatment Guidelines and Original Sources: U.S. Department of Health and Human Services. 2024. Available: https:\/\/www.cdc.gov\/std\/treatment-guidelines\/screening-recommendations.htm"},{"key":"2026050410202906000_sextrans-2026-056934v1.8","doi-asserted-by":"crossref","first-page":"602","DOI":"10.1097\/OLQ.0000000000001023","article-title":"Sexually Transmitted Infections Detected During and After Incarceration Among People with Human Immunodeficiency Virus: Prevalence and Implications for Screening and Prevention","volume":"46","author":"Krieger","year":"2019","journal-title":"Sex Transm Dis"},{"key":"2026050410202906000_sextrans-2026-056934v1.9","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1097\/OLQ.0000000000000224","article-title":"Test positivity for chlamydia, gonorrhea, and syphilis infection among a cohort of individuals released from jail in Marion County, Indiana","volume":"42","author":"Wiehe","year":"2015","journal-title":"Sex Transm Dis"},{"key":"2026050410202906000_sextrans-2026-056934v1.10","first-page":"811","article-title":"HIV screening of male inmates during prison intake medical evaluation - Washington, 2006-2010","volume":"60","author":"Strick","year":"2011","journal-title":"Morb Mortal Wkly Rep"},{"key":"2026050410202906000_sextrans-2026-056934v1.11","first-page":"282","article-title":"STI Case Definitions in Effect During 2023 Center for Disease Control and Prevention, 2023 10\/2024","volume":"115","author":"Erly","year":"2025","journal-title":"Rep Group Adv Psychiatry"},{"key":"2026050410202906000_sextrans-2026-056934v1.12","doi-asserted-by":"crossref","first-page":"282","DOI":"10.2105\/AJPH.2024.307911","article-title":"Real-Time Linkage of Public-Facing Jail Registers and Syphilis Testing and Treatment Monitoring Data, Washington State, 2023\u20132024","volume":"115","author":"Erly","year":"2025","journal-title":"Am J Public Health"}],"container-title":["Sexually Transmitted Infections"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/sextrans-2026-056934","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T17:20:54Z","timestamp":1777915254000},"score":1,"resource":{"primary":{"URL":"https:\/\/sti.bmj.com\/lookup\/doi\/10.1136\/sextrans-2026-056934"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,4]]},"references-count":12,"alternative-id":["10.1136\/sextrans-2026-056934"],"URL":"https:\/\/doi.org\/10.1136\/sextrans-2026-056934","relation":{},"ISSN":["1368-4973","1472-3263"],"issn-type":[{"value":"1368-4973","type":"print"},{"value":"1472-3263","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,4]]}}}