title: Feasibility and yield of screening urine for Chlamydia trachomatis by polymerase chain reaction among high-risk male youth in field-based and other nonclinic settings. A new strategy for sexually transmitted disease control.
abstract: BACKGROUND
  Inner-city youth are at disproportionate risk for Chlamydia trachomatis infection. Identification of infected individuals is hampered by the often asymptomatic nature of infection and access and utilization barriers to clinic-based screening services. The feasibility and yield of screening urine for C. trachomatis by polymerase chain reaction was studied among high-risk male youth outside traditional clinic settings.
  
  
  METHODS
  As part of a community-level sexually transmitted disease (STD) prevention program among high-risk youth in Denver, outreach workers enrolled subjects, administered questionnaires, and collected first-catch urine samples in nonclinical facility-based and field-based settings. Facility settings consisted of community/recreation centers, high-schools, and an STD/human immunodeficiency virus prevention storefront. Field settings included alleys, parking lots, parks, and residences. Individuals who tested C. trachomatis positive were contacted by program outreach workers and provided with standard treatment and partner notification services.
  
  
  RESULTS
  Over a 20-month period, 486 urine specimens were collected, 32 (6.6%) of which were C. trachomatis positive. Rates were higher for subjects screened in the field than in facility settings (11.9% vs. 4.4%, P < 0.05). Subjects with chlamydial infection were more likely to have had vaginal intercourse in the previous 30 days (adjusted odds ratio: 2.9) and to have been recruited in field settings (adjusted odds ratio: 2.5). Of subjects with chlamydial infection, 31/32 (97%) were treated within a median of 8 days after urine collection.
  
  
  CONCLUSIONS
  Urine chlamydial screening by polymerase chain reaction of sexually active male youth in nontraditional settings appears to be feasible and to provide yields similar to those reported in standard clinic settings. Evaluation of samples easily collected in nonclinic locations holds great promise as an additional strategy for the control of chlamydial infection and other STD among difficult-to-reach populations.
authors.affiliation: Department of Public Health, Denver Health, University of Colorado Health Sciences Center, Denver, USA.
authors.forename: C A
authors.initials: CA
authors.lastname: Rietmeijer
authors.forename: K J
authors.initials: KJ
authors.lastname: Yamaguchi
authors.forename: C G
authors.initials: CG
authors.lastname: Ortiz
authors.forename: S A
authors.initials: SA
authors.lastname: Montstream
authors.forename: T
authors.initials: T
authors.lastname: LeRoux
authors.forename: J M
authors.initials: JM
authors.lastname: Ehret
authors.forename: F N
authors.initials: FN
authors.lastname: Judson
authors.forename: J M
authors.initials: JM
authors.lastname: Douglas
mesh_terms: D000293:Adolescent; D000328:Adult; D001437:Bacteriuria / Q000382:microbiology*; D002692:Chlamydia trachomatis / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D016133:Polymerase Chain Reaction; D012017:Referral and Consultation; D012749:Sexually Transmitted Diseases / Q000517:prevention & control*