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Background: To improve rates of Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC) screening among adolescents, the New York City Department of Health and Mental Hygiene (NYCDOHMH) began a CT/GC education, screening and treatment program for public high school students in spring 2006. During the 2008/09 school year, 24,236 students were educated; 11,352 were CT/GC screened.
Objectives: There were two objectives: to describe demographic characteristics and CT/GC screening decisions; and to examine CT/GC positivity by sexual activity.
Methods: All students were asked to confidentially report previous vaginal, oral or anal sex before offering screening. Univariate, bivariate and multivariate logistic regression analyses were performed to assess relationships between sex, race/ethnicity, age, sexual activity and screening status; and the relationship between positivity and sexual activity.
Results: Students who screened were more likely to be female (adjusted OR 1.33, p<0.01), sexually active (aOR 5.18, p<0.01), >19 years (aOR 1.61, p<0.01), and Hispanic (aOR 1.09, p<0.01). Overall, 64.5% (7326/11352) students reporting sexual activity were screened vs. 19.7% (2241/11352) who denied sexual activity. CT/GC positivity was 5.9%, with females having higher rates than males (8.1% [469/5,756] vs 3.5% [198/5,596]). CT/GC positivity for sexually active students was similar to that of students not responding to the question (7.2%, 526/7326) vs. (6.1%, 109/1785). Students who reported no previous sex had a CT/GC positivity of 1.4% (32/2241).
Conclusions: Students who do not respond to questions about sexual activity are as likely to test positive as those who report sexual activity. Among those screened, females have high CT/GC positivity.
Implications for Programs, Policy, and/or Research: Screening programs should emphasize that previous sex is a reason for screening, but should extend screening to all. Programs should expect higher rates of screening among older students, so should target this population.