title: A Novel Public Library-Based Sexually Transmitted Infection Screening Program for Younger High-Risk Groups in Omaha, Nebraska, USA.
abstract: Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) are the two most commonly reported sexually transmitted infections (STIs) in the United States (U.S.) and Douglas County, Nebraska has STI rates consistently above the U.S. average. The Douglas County Health Department (DCHD) developed an outreach CT and NG screening program in public libraries to address the problem beyond the traditional STI clinic setting. This study evaluates the effectiveness of the program and identifies factors predictive of CT and NG infections. A retrospective review of surveys of library patrons and DCHD traditional STI clinic clients who submitted urine tests for CT and NG from June 2010 through April 2014 was done. Chi square, Fisher exact, Student's t tests, univariate and multivariate logistic regression were conducted. A total of 977 library records and 4871 DCHD clinic records were reviewed. The percent positive was lower in the library than in the traditional clinic for CT (9.9 vs. 11.2 %) and NG (2.74 vs. 5.3 %) (p = 0.039 and p < 0.001, respectively). Library clients were more likely to be 19 years and younger (OR 6.14, 95 % CI: 5.0, 7.5), Black (OR 3.4, 95 % CI: 2.8, 4.1), and asymptomatic (OR 12.4, 95 % CI: 9.9, 15.5) compared to traditional clinic clients. The library STI screening program effectively reaches a younger, asymptomatic, and predominantly Black population compared to a traditional health department clinic site.
authors.affiliation: Division of Infectious Diseases, Department of Pediatrics, University of Nebraska Medical Center, Omaha, NE, USA. shirley.delair@unmc.edu.
authors.forename: Shirley F
authors.initials: SF
authors.lastname: Delair
authors.affiliation: Department of Biostatistics, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA.
authors.forename: Elizabeth R
authors.initials: ER
authors.lastname: Lyden
authors.affiliation: Douglas County Health Department, Omaha, NE, USA.
authors.forename: Anne L
authors.initials: AL
authors.lastname: O'Keefe
authors.affiliation: Division of Infectious Diseases, Department of Pediatrics, University of Nebraska Medical Center, Omaha, NE, USA.
authors.forename: Kari A
authors.initials: KA
authors.lastname: Simonsen
authors.affiliation: Douglas County Health Department, Omaha, NE, USA.
authors.forename: Sherri R
authors.initials: SR
authors.lastname: Nared
authors.affiliation: Douglas County Health Department, Omaha, NE, USA.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Berthold
authors.affiliation: Department of Epidemiology, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA.
authors.forename: Shinobu
authors.initials: S
authors.lastname: Watanabe-Galloway
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D007990:Libraries; D008297:Male; D008403:Mass Screening; D008485:Medical Audit; D009329:Nebraska; D011633:Public Facilities; D012189:Retrospective Studies; D012749:Sexually Transmitted Diseases / Q000652:urine*; D055815:Young Adult
keywords: Chlamydia trachomatis; Health disparity; Neisseria gonorrhoeae; Sexual health; Sexually transmitted infections