Accessing College Students: Chlamydia and Gonorrhea Screening in Dorms and Campus Health Centers

Background: University health centers traditionally have lower chlamydia positivity (4.3%) compared to high school clinics (12.8%), detention centers (10.5%) - Region V IPP 2007, although college students are in higher prevalence rates (15-24y.o.) 2008-09 pilot conducted in two Michigan universities, expanding screening in health center and dorms.

Objectives: Determine if dorm screening and universal screening at health centers are effective models to detect infections (increase positivity).  Compare dorm to health center data. 

Methods:   Free urine-based chlamydia/gonorrhea screening was offered in university health centers and dorms on advertised “screening nights”.  Students accessing health centers offered screening regardless of reason for visit.  Multiple freshman and upperclass dorms were utilized.  Brief sexual questionnaire obtained on participants. Positives treated and partner interviewed at health centers.

Results: Michigan Department of Community Health (MDCH) and Oakland County Health Division collaborated on pilot.  Two universities selected: suburban, primarily commuter population; and urban university.  Highest chlamydia positivity found in urban university freshman dorms (15-20% females, 7-10% males).  Freshman positivity higher than upperclass dorms.  Nearly all infections detected in dorms were asymptomatic (>82%).  Dorm screening at suburban university revealed higher chlamydia positivity, younger students, higher percentage of males and African-American students compared to campus health center.  Universal screening in health centers uncovered more than half of infections, other infections diagnosed in students requesting STD services. 

Conclusions: By screening in freshman dorms, asymptomatic infections can be detected, treated, partners notified, decreasing costly complications and overall prevalence on campus. Dorm screening affords access to student population that typically don’t utilize campus health center.  Screening at health centers detects more asymptomatic infections compared to testing models. 

Implications for Programs, Policy, and/or Research: Explore other non-traditional settings to offer screening to adolescents/ young adults who rarely seek health care and are asymptomatic. Expand targeted screening, utilizing dorm and health center data into more colleges and universities.