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Background:
Crownpoint Hospital serves a rural population in the eastern Navajo Nation. In 2011 we were given funds by the IHS National HIV program for routine HIV screening. After initial difficulties (we have a very low prevalence of HIV in this setting), we decided to use the funds for broader STD screening, as STD rates are known be high in the AI/AN population. We did this with the intent that screening for other more common STDs would generate awareness and concern about HIV as well.Objectives: see prior
Project Description: From July 1st 2011 through September 30th 2011 Crownpoint Hospital initiated a policy of routinely screening all urines from persons aged 16-25 for Chlamydia and Gonorrhea. Anytime a patient submitted a urine sample for any reason (i.e. abdominal pain, pregnancy test, sports physical, etc.) the nurse or provider also ordered Chlamydia and Gonorrhea testing, unless the patient refused. Signs were posted in all hospital toilets notifying patients of this policy and the testing was also discussed during the clinic visit.
Findings: Screening of the teenage population improved during this 3 month trial due to the commitment of the pediatric team. Also screening was done during a prime time for adolescent sports physicals(already submitting urine). Screening for young adults (18-25) proved more challenging.
Conclusions: The screening project overall was a success on many levels. We did improve of overall screening rates for C/GC (54% August 2011 vs. 33% August 2010). It improved nursing staff comfort with discussing STDs, a culturally sensitive issue. It also encouraged patient education and community awareness.
Implications for Programs, Policy, and Research: It was a relatively easy to implement policy, as it only tested urines that were already being submitted for other reasons and required no additional consent. However it was only done at a small facility, and it would be interesting to see research with a larger population.