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Background: Despite decades of Chlamydia trachomatis (Ct) screening sexually active women < 25 years, Ct rates have not decreased for African American (AA) women and remain 22 times higher than among White women. It is likely that untreated men are serving as a reservoir, thus innovative approaches to seek, test and treat men for STDs are needed. The purpose of this study was to compare respondent driven sampling (RDS) vs. venue-based sampling (VBS) for yield and Ct+ rate.
Methods: Sexually active men who have sex with women, aged 15-25, were recruited from high-poverty neighborhoods in New Orleans, LA using RDS or VBS (e.g. barbershops, basketball courts, etc.). Women were included in the RDS sampling in order to facilitate male recruitment. Participants were screened for both Ct and gonorrhea (GC) using NAAT urine tests and completed a brief ACASI survey. Individuals who tested positive were referred to either the STD clinic or a neighborhood pharmacy where treatment was provided free of charge by the study.
Results: Male participants (N=154) were recruited: RDS (n=57) and VBS (n=97). Nearly all (97%) were AA. Median number of female sex partners in the last 2 months was 2.0 (range 0-60) and 2 men (1.3%) had sex with men, 48% had never been tested for STDs and 57% reported that they no access to regular health care. Positivity rates for RDS compared to VBS were Ct (8.9% and 12.6%) and GC (1.8% vs. 2.1%). Of those who were positive for Ct 11/14 (79%) were treated. Of those positive for GC 100% (3/3) were treated.
Conclusions: RDS and VBS yielded high rates of infection among hard-to-reach men and community treatment facilities yielded high rates of treatment. Making testing available in the community has the possibility to effectively find hard-to-reach men in high-risk networks and treat their infections, subsequently breaking the chain of infection.