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The studies included 1.4 million incarcerated individuals in 43 countries, with most conducted in North America (47.1%) and South and Central America (22.3%) and in high-income (64.6%) and middle-income (34.5%) countries. The study authors note that the World Health Organization (WHO) has identified people in prison and other closed settings as one of the key populations in the global response to sexually transmitted and bloodborne infections (STBBIs). Given the high burden of bacterial STI in prisons and other closed settings, understanding their prevalence is critical for refining global estimates and informing testing and treatment practices, to ultimately advance bacterial STI elimination efforts both within and beyond carceral settings." Risky sexual behaviors, poor access to testing Among female adults, the pooled prevalence of chlamydia, gonorrhea, and syphilis was 6.5%, 1.5%, and 5.9%, respectively, among male adults, the corresponding estimates were 4.7%, 0.4%, and 3.7%. The authors say the findings potentially reflect both sexual behaviors that increase the risk of STIs and poor access to bacterial STI testing and treatment in carceral and community settings."