Chlamydia Screening in a Charter School: Components of a Successful Infertility Prevention Project Collaboration

Background:
Texas has 241 charter schools with over 60,000 students enrolled. There is limited data on Chlamydia (CT) and Gonorrhea (GC) among male and female students attending charter schools.

Objective:
1) Determine feasibility and methods of CT/GC screening in charter schools; and 2) assess CT/GC positivity among charter school youth

Method:
As a part of the Region VI Infertility Prevention Project (IPP), the Texas IPP collaborated with a central Texas charter high school, People's Community Clinic (PCC) and the Texas Department of State Health Services (DSHS) to design and implement two on-site mass CT/GC screening events. Key elements included: parental consent, pre-event classroom presentations, student consent/assent, counseling as needed pre- and post-testing. Gen-Probe's urine Aptima CT/GC test was used.
Test results were provided face-to-face to all students. Positives were treated and referred for a full STD exam.

Result:
176 students were tested; 56% were male. About half the students attending school on screening dates were tested. Overall CT+ was 10.0% (males 5.1%; females 16.7%); GC+ was 0.6%. Male and female clients were comparable on: race/ethnicity, age, self-reported symptoms; new sex partner (SP), symptomatic SP, monogamous SP; history of CT, GC or other STD. Sex differences were found for multiple SPs in the past 60 days (males 30%; females 16%). The only factor associated with CT+ was young age (16-17 years v. 18+).

Conclusion:
The project demonstrated a high need for STD testing in this student population (CT+ = 10.0%). Additionally, the screening events linked students to other clinic services, such as pregnancy testing and prenatal care.

Implications:
This innovation demonstrated a successful collaboration between public health and school setting as well as affirming the feasibility of outreach to this population.