Background: Rates of reported Chlamydia trachomatis (CT) and Neisseria gonorrhea (GC) infection among New York City (NYC) teens are higher than nationwide. To address this, the NYC Health Department visits public high schools to provide free CT/GC education, screening, and treatment. Students can opt out of screening. We sought to identify predictors of screening acceptance.
Methods: Analysis was limited to students who received STD education while aged 14-19 during the 2013-2014 school year. Using adjusted logistic regression, predictors of screening acceptance included two questions assessing pre-education knowledge of STD testing/treatment barriers in NYC, sex, race/ethnicity, and age (continuous). Students were excluded from analysis if they had missing data for either STD knowledge question.
Results: Of the 5,820 students educated, 1,696 (29.1%) were excluded due to missing data (7% of screeners, 44% of non-screeners). Of the 4,124 students included in the analysis, 53% (n=2,181) accepted screening. The overall CT/GC prevalence was 5.5% (female 7.6%, male 3.4%, χ2=18.6, p<0.001). Students had lower odds of screening if they knew parental consent was not required for STD services (AOR=0.3, 95% CI: 0.3-0.4, p<0.001) or they knew free STD services were available in NYC (AOR=0.6, 95% CI: 0.5-0.7, p<0.001). Students were more likely to screen if they were male (referent=female, AOR=1.4, 95% CI: 1.2-1.6, p<0.001) and less likely if they were white (referent=Black, AOR=0.5, 95% CI: 0.3-0.9, p=0.03). Older age was associated with screening (AOR=1.8, 95% CI: 1.7-1.9, p <0.001).
Conclusions: Some students may not have accepted screening because they knew they could screen outside school. Although CT/GC prevalence was higher among female than male students, female students were less likely to accept the screening. High levels of missing data among non-screeners may have impacted findings. Sexually active students, especially females, should be encouraged to screen with the school-based program despite availability of screening elsewhere.