Background: The prevalence of chlamydial and gonorrheal infections among targeted populations was unclear although high rates of chlamydial infections were consistently reported on Guam. To better understand prevalence among populations at risk, targeted screenings were done among adolescents and young Chuukese on Guam, at the STD Clinic and at nontraditional venues.
Methods: From October 2009 through October 2013, the STD/HIV Program, in collaboration with community partners and CDC, implemented a screening program using Aptima Combo 2 assay (Gen-Probe) self collected vaginal swabs and urine samples to test for Chlamydia and gonorrhea. Patients that tested positive for Chlamydia and/or gonorrhea were treated as recommended by CDC along with their sex partner(s). The prevalence was calculated from data abstracted from STD client records.
Results: From October 10/2009 to October31/2013, 4,727 self- collected tests were administered to clients at selected venues. The overall prevalence for Chlamydia was 25%, and gonorrhea was 3%. Of the 4,727 tests administered 780 (16%) were Chuukese, age group 15-49 and 2,533 (54.5%) were adolescents (15-24 years of age). Among Chuukese, a prevalence of 30% for Chlamydia and 5% for gonorrhea were noted. Among adolescents a prevalence of 25% for Chlamydia and 3% for gonorrhea were noted.
Conclusions: Expanded screenings for Chlamydia and gonorrhea provided solid epidemiological data. By conducting periodic analysis of the data (monthly/quarterly and annually), the STD Program was able to better target program resources and implement strategies to reach populations most at risk. As a result of expanded screenings, the STD Program better understands the prevalence of Chlamydia and Gonorrhea among Chuukese and adolescents. Self-collection of vaginal and urine samples for tests by clients, demonstrated that this testing method reduced missed opportunities by reaching populations who would not have accessed STD services.