Participation in a School-Based Sexually Transmitted Disease Screening Program

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Abstract
A school-based chlamydia screening program was offered repeatedly in three Louisiana public high schools in an effort to expand sexually transmitted disease screening services for adolescents. To describe participation of a fixed cohort of students to elucidate the impact of screening on chlamydia prevalence. Five opportunities for chlamydia testing were offered in 3 schools during 3 school years (1995-1996, 1996-1997, 1997-1998). Only students with parental consent could be tested. Students consistently enrolled during the 3 years (n = 1475) were included in this analysis. During the 3 school years, parental consent was cumulatively obtained for 1443 students (97.8%), and 1305 students (88.5%) were tested at least once. Of those tested, 81.1% tested more than once. The prevalence of Chlamydia trachomatis infection at first test among students who tested more than once was 1.8% for males and 7.7% for females. Among students tested only once, 6.2% of males and 12.7% of females had chlamydial infection. Among students tested more than once, no significant difference in C trachomatis prevalence was associated with repeat screenings. Incidence rates per 1000 person-months were 4.3 (2.2, males; 7.1, females; P < 0.0001). Reinfections explained only 5.6% of all incident cases. The documented high response from both parents and students to this school-based chlamydia screening program offers great promise for sexually transmitted disease control among adolescents. Overall, C trachomatis prevalence was two times higher among students testing only once than among those testing more than once. Routine and continued availability of school-based chlamydia screening programs can potentially reduce the burden of disease among adolescents.