title: Chlamydia infection in street youth: Need for more aggressive screening programs.
abstract: OBJECTIVE
  To determine, first, the sexual practices among street youth in the Ottawa-Carleton, Ontario region; second, the percentage of street youth who report previous sexually transmitted disease (STD) screening; and third, the rate of previous infection with Chlamydia trachomatis in this population.
  
  
  METHODS
  This prospective street youth pilot study was cross-sectional in design. Street youth aged 15 to 20 years were recruited through a drop-in centre or shelter in Ottawa, Ontario between August and October 1993. Information on demographics, substance use, current sexual practices and STD screening and infection history were obtained through a structured face to face interview and a 75-item questionnaire. Past C trachomatis infection was determined by microimmunofluorescence assay with purified antigens of C trachomatis (serovars A to K), Chlamydia psittaci (avian strain 6BC) and Chlamydia pneumoniae (TW-183 strain).
  
  
  RESULTS
  Ninety-eight per cent of the youth approached participated. Of the 100 street youth (61 males, mean age 17.8 years; 39 females, mean age 17.1 years), 94% were sexually active, with 21% of males and 26% of females having had four or more different sexual partners in the previous year. Only 27% of males and 8% of females reported consistent condom use with all partners all of the time. Thirty per cent of males and 50% of females reported previous STD testing. Of the 100 street youth, 22 (16 males and six females) had had previous C trachomatis infection by serotesting, but only three of 16 (19%) of these males and three of six (50%) of these females reported previous STD testing. None of the 22 recalled previous diagnosis or treatment for any STD.
  
  
  CONCLUSIONS
  These street youth reported a high prevalence of risky sexual behaviour, and this supports the national STD guidelines for targeted screening in this population. The current screening guidelines for C trachomatis in this population do not reach the majority of street youth.
authors.affiliation: Departments of Pediatrics and Medicine, University of Ottawa, and Laboratory Centre for Disease Control, Ottawa, Ontario.
authors.forename: R
authors.initials: R
authors.lastname: Tam
authors.forename: N
authors.initials: N
authors.lastname: Macdonald
authors.forename: S
authors.initials: S
authors.lastname: Feder
authors.forename: L
authors.initials: L
authors.lastname: Giglia
authors.forename: R
authors.initials: R
authors.lastname: Peeling
authors.forename: P
authors.initials: P
authors.lastname: Gully
authors.forename: B
authors.initials: B
authors.lastname: Toye
authors.forename: J
authors.initials: J
authors.lastname: Doherty