School Based Screening and Beyond: Expanding Collaborations to Serve Dc's Youth

Background: National guidelines recommend annual chlamydia/gonorrhea screening for women ≤ 25 and consideration of screening young men in high risk settings.  Barriers exist to routine screening of adolescents.

Objectives: To describe implementation of CT/GC screening program in public high schools, including key partnership development.

Methods: Collaborating with DC Public Schools, the STD Bureau began providing in-school screening for CT/GC in 2007. To gain wider support and plan for sustainability, BSTD partnered with key CBOs to assist. By 2009, the program was successfully implemented in all 20 public high schools. BSTD then partnered with the area’s largest primary care provider to collaborate in providing treatment, HIV testing, and pregnancy testing/counseling for adolescents infected with CT/GC.  ISIS, Inc. was a key partner for text messaging.  Screening and treatment data have been collected.  Information on facilitators and barriers to screening success and to maintaining key partnerships has been documented.

Results: For 2010-2011 academic year, 5,427 students participated; 3,463 (64%, range 20-95%) volunteered for testing; 208 (6%, range 3-18%) were infected; 184 (88%) had treatment verified.  A very small proportion of CT/GC infected students were provided HIV and pregnancy testing/counseling.  Facilitators for success were clear, frequent communication with DCPS, school points-of-contact, and partners; supportive principals and teachers; advance scheduling of clinicians.  Barriers were frequent turnover of personnel; lack of communication between POCs and teachers; lack of appropriate school space; decreased funding; and, scheduling miscommunications.

Conclusions: STD screening in schools identifies previously undetected infections.  Collaborating with partners to achieve full implementation is labor intensive but necessary for sustaining screening efforts and expanding offering other important adolescent services.

Implications for Programs, Policy, and Research: School-based screening efforts can be brought to scale, sustained, and even expanded through the inclusion of key community and health partners. Schools are appropriate venues for delivering important adolescent health services.