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Background: From 2002-2009, the STD Control Program of the Philadelphia Department of Public Health (PDPH) has run the Philadelphia High School STD Screening Program (PHSSSP), which offers annual, voluntary, urine-based Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC) screening at public high schools.
Objectives: Describe trends of CT and GC positivity in the PHSSSP over 7 years.
Methods: All valid screening tests submitted to the PHSSSP from the 2002-2009 school years were included in the analysis. Relationships between percent of students testing positive (“positivity”) and factors including sex, age group, school type, and race/ethnicity are described. Multivariable analysis including timing of annual screenings was conducted to create adjusted associations with positivity.
Results: In total, 112,968 tests were performed. There were 5,585 positive results (4.9% positivity), of which 97.8% were treated. Overall positivity decreased from 5.3% in Year 1 to 4.2% in Year 3; however, by Year 7, positivity had returned to baseline levels (5.3%). Between Year 3 and Year 7, female positivity increased from 6.4% to 7.7%. This trend was seen despite a 33.9% decrease in number of tests performed in Year 7, as compared to Year 1. Male positivity remained relatively constant (~2.5% +/- 0.2%) over the seven years. In every year, male positivity increases with age; however, female positivity has never shown this trend. Females have around the same positivity from 15 to 19 years of age.
Conclusions: The PHSSSP has been successful in detecting and treating adolescents with STD and has provided insight into trends among large, successive cohorts of adolescents. CT and GC positivity remains high among students who test.
Implications for Programs, Policy, and/or Research: PDPH will continue PHSSSP and has initiated several strategies to address student- and school-level sexual health needs. Additionally, further insight into which students are actually testing is desired.