Background: Sexually active high school students are at risk for chlamydia (CT) and gonorrhea (GC) infection but may not seek testing. The
Objectives: 1) To determine the feasibility of offering CT/GC screening to an entire high school population, and 2) to estimate the prevalence of CT/GC.
Methods: From October-December 2009, teams visited classrooms to provide a brief presentation on CT/GC and an opportunity to test. Students elected in private whether to submit a urine sample. Make-up sessions were held for students initially absent. Confidential results were available online or by phone. STDP clinicians contacted infected students on campus for treatment and partner services.
Results: From an enrollment of 2,096, 1,806 (86%) students heard the presentation and 1,136 (63%) of these accepted testing. Of those tested, 55% were African-American, 44% were Hispanic, and 47% were female, reflecting the school population. Overall CT and GC prevalence was 4.1% and 0.4%, respectively. All GC cases were among females. Prevalence of any infection was 7 times higher among African-American females than among Hispanic females, 10.2% (31/305) vs. 1.3% (3/227), with African-American females over age 16 having the highest prevalence of 12.9%. Initially absent students had twice the prevalence of the original group: 7.3% (7/96) vs. 3.9% (41/1040). All of the positives were treated.
Conclusions: The overall prevalence of CT was high among students tested in this high school population, with highest morbidity found among African-American females. Gonorrhea prevalence was low in females and not found in males
Implications for Programs, Policy, and/or Research: School screening programs can be an effective method of detecting and treating CT/GC in high risk adolescents. Particular efforts should be made to reach African-American females and absent students.