Collaborating for Health: Summer STD Screening in An Urban Setting

Background: In 2007, Washington DC ranked 6^th and 14^th among counties and independent cities in rates of chlamydia and gonorrhea infections, respectively.  In response to these epidemics, the District’s HIV/AIDs, Hepatitis, STD, TB Administration (HAHSTA) began its successful School-based STD Screening Program during the 2007/2008 academic year.

Objectives: To describe an innovative adolescent screening effort for Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC) infections during an urban summer youth employment program (SYEP).

Methods: During the summer of 2009, the HAHSTA employed two screening models. First, an information booth was erected and voluntary urine-based screening was offered in adjacent rest rooms during the 2-day orientation at the DC Convention Center.  Second, 30 peer leaders were trained to provide an interactive sixty minute STD/HIV prevention presentation throughout the summer at SYEP youth work sites and voluntary urine-based screening was offered on-site immediately following. Disease Intervention Specialists ensured appropriate treatment. Six community-based organizations and other governmental agencies were part of the entire effort.

Results: Of the ~25,000 youth that participated in the SYEP, ~10,000 attended the orientation, 863 (8%) submitted urine specimens, and 100 (11.5%) tested positive for CT, GC or both. During the second model, peer leaders presented to 1227 youth (at >30 sites), 782 (63.7%) of whom submitted urine specimens, and 75 (9.5%) tested positive for CT, GC or both. Of the youth treated, 70% (121/175), the majority 95 (54%) utilized the public health clinic. 

Conclusions: The high prevalence of asymptomatic infections and known barriers to appropriate healthcare for adolescents highlights the need for innovative adolescent STD screening programs. Both models attributed to public health impact. The large forum had high volume (863) due to testing accessibility while the peer-led had high yield (63%) submitting specimens.

Implications for Programs, Policy, and/or Research: Identifying ways to form collaborative relationships between community partners and government agencies facilitates expanded service delivery despite limited resources.