Background: Over the past 10 years, the Philadelphia High School STD Screening Program has screened 126,053 students, and identified 8,089 CT/GC infections, ensuring treatment for 98%. Given these large numbers, a substantial population of at-risk adolescents probably participates in the program at least once during high school. As a means of identifying strategies to decrease CT/GC positivity in this group, we wanted to learn about behaviors associated with infection.
Methods: Standardized interviews were given to all infected students receiving in-school CT/GC treatment in 2009-2012. Similar interviews were given to students testing negative who called in for test results in 2011-2012. Separate multivariate logistic models for males and females were computed using significant bivariate variables, including those who met vs. who did not meet partners at a particular venue.
Results: 1,489 positive and 318 negative students were interviewed. Risks for females included black race (AOR 2.27, CI 1.1-4.6), history of arrest (AOR 2.26, 1.2-4.2), higher partner number (AOR 1.75, 1.1-2.9), meeting partners in their neighborhood (AOR 1.92, 1.29-2.86), and particularly meeting partners in venues other than their own school, neighborhood, or through friends (“all other”, AOR 9.44, 3.7-24.1). For males, risks included early sexual debut (AOR 1.99, 1.2-3.3) and meeting partners at “all other” (AOR 2.76, 1.2-6.4). For males, meeting partners through friends was protective (AOR 0.63, 0.41-0.96). Meeting partners at their own school was protective for both sexes (males AOR 0.33, 0.20-0.55, females AOR 0.65, 0.44-0.96).
Conclusions: The risk of infection incurred by the same behaviors is different for male vs. female adolescents; however, partner meeting place is significantly associated with infection in both. Reasons for this are unknown but may be associated with partner age or risk of a given partner network. Prevention messages aimed at limiting partner meeting place may help curb transmission of CT/GC in this population.