It’s been almost a year since Cook County stopped trying to test most new jail inmates for sexually transmitted diseases. County Board President Todd Stroger’s administration eliminated the nationally recognized program to cut costs. Public-health experts predicted that ending the screening would leave thousands of STD cases undiagnosed and untreated and that, when inmates got out of jail, they’d take the diseases back to their neighborhoods. New data add weight to those predictions.

On Chicago’s West Side, patients pour in to Mount Sinai Hospital’s emergency department.

MARTINEZ: We have an 18-year-old female, an 18-year-old male.

Behind a counter, health educator Alberto Martínez scans a computer screen that lists each patient in the waiting room. His job is to sit down with everyone from age 15 to 25 for a talk about sexually transmitted diseases.

MARTINEZ: We target that population because of the asymptomatic nature of STDs. A lot of young adults are unaware that they might be infected.

While he has their attention, Martínez also asks patients to urinate in a cup for chlamydia and gonorrhea screening. In a few days, he’ll let the patients know if they’ve tested positive for either type of bacteria.

When Martínez was starting this job two years ago, about 16 percent of the results were positive. The hospital’s Dr. Nancy Glick says that rate has steadily increased.

GLICK: Most recently, 22 percent of those screened were found to have either chlamydia or gonorrhea or both.

The escalation at Mount Sinai mirrors what the Illinois Department of Public Health is seeing throughout the city. Factors such as greater test sensitivity could be at play.

WONG: But the increases could certainly indicate an increase in the true community-wide prevalence of gonorrhea and chlamydia.

Dr. William Wong leads STD prevention for the Chicago Department of Public Health. He and other public-health officials say the increases may stem partly from cuts in STD screening at Cook County Jail over the years.

WONG: A jail screening program can identify a large number of cases and reach a population that is difficult to reach in any other setting.

Dr. Wong says the stakes go beyond gonorrhea and chlamydia. Former inmates with those diseases, he says, are more likely to spread AIDS.

WONG: Bacterial conditions like gonorrhea and chlamydia enhance the transmission of HIV by three to five times.

For most of this year, the county tested male inmates for STDs only if they had symptoms or demanded the care. In October, the city and state helped bring back some testing of inmates without symptoms. This screening reaches about 10 percent of the number of inmates that were reached before the county budget cuts.

Chicago’s public-health department says it would be willing to provide additional staffing for the effort. That might seem like a welcome idea, considering the struggle to balance Cook County’s 2008 budget. But returning to rigorous screening doesn’t seem to be a priority for the county. Dr. Eileen Couture heads the jail’s health services.

COUTURE: The majority of the detainees coming in, they’re here for a short period of time—it might be seven days, maybe ten days—and they leave. We don’t take samples on every person who comes in. There’s no reason to sample everybody who comes in. Now if they complain or they say, “Listen, I want to be tested for an STD,” that’s what we do.

Dr. Couture and other county officials insist they’re doing all they can to protect inmates and the communities they return to.