Screening for sexually transmitted infections among economically disadvantaged youth in a national job training program.
OBJECTIVE
To evaluate results of screening for syphilis, gonorrhea, and chlamydia among youth in a federally funded job training program.


METHODS
Data were evaluated from medical records of 12,881 randomly selected students in 54 U.S. job training centers during 1996. The intake medical evaluation includes serologic testing for syphilis. The policy was for females to receive a pelvic examination with gonorrhea and chlamydia testing and for males to be first screened with a urine leukocyte esterase (LE) assay, with follow-up gonorrhea and chlamydia testing for those with positive LE results.


RESULTS
Adjusting for our sampling strategy, among females, an estimated 9.2% had a positive chlamydia test, 2.7% a positive gonorrhea test, and 0.4% had a positive syphilis test. Gonorrhea and chlamydia rates among females were highest in African-American followed by Native American students. Chlamydia infection was most common in younger women < or = 17 years of age. An estimated 0.1% of males had a positive syphilis test, and 4.8% of males a positive urine LE test. Of 103 LE-positive males tested for gonorrhea and chlamydia, only 27 (26%) had a positive test for one of these STDs.


CONCLUSIONS
Our study supports routine screening of adolescents for gonorrhea and chlamydia, including those youth from socioeconomically disadvantaged backgrounds. Because individuals from such backgrounds may not regularly interact with traditional clinical health care systems, screening and treatment should be offered in alternative settings, such as the job training program described in this study.
Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis 55455, USA. lifso001@umn.edu
A R
AR
Lifson
L L
LL
Halcón
P
P
Hannan
M E
ME
St  Louis
C R
CR
Hayman
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D002265:Carboxylic Ester Hydrolases / Q000652:urine; D002690:Chlamydia Infections / Q000453:epidemiology / Q000517:prevention & control*; D005006:Ethnicity / Q000706:statistics & numerical data; D005260:Female; D006069:Gonorrhea / Q000453:epidemiology / Q000517:prevention & control*; D006801:Humans; D016018:Least-Squares Analysis; D016014:Linear Models; D008297:Male; D008403:Mass Screening; D015999:Multivariate Analysis; D011203:Poverty; D012111:Residence Characteristics; D017678:Sex Distribution; D013587:Syphilis / Q000453:epidemiology / Q000517:prevention & control*; D014481:United States / Q000453:epidemiology
C021443:leukocyte esterase; D002265:Carboxylic Ester Hydrolases