Philadelphia High School STD Screening Program

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Philadelphia High School STD Screening Program

• Declining Disease Prevalence
• After 4 Years of Screening

Lenore Asbel, Melinda Salmon, C. Victor Spain,
Christa Seidman, Mindy J Perilla, Martin
Goldberg
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Background

• Adolescents disproportionately affected
• 2003 Philadelphia 15-19 year olds
• 43 of CT infections and 31 of GC infections
• Chlamydia rate 6,705 /100,000
• Rate among females 10,256 /100,000
• Gonorrhea rate 1,597 /100,000
• Increased screening throughout the city had begun

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Reported Cases of Chlamydia Philadelphia,
1991-2003
Number of cases
Year
4
High School Screening Pilot Project during the
2001-2002 school year. Health Resource Center
STD Screening (2 schools)
Male Tests Female Tests Total
Total of tests 536 683 1219
Total positives () 28 (5.2) 110 (16.1) 138 (11.3)
Positive for CT only () 26 (4.9) 87 (12.7) 113 (9.3)
Positive for GC only () 0 (0.0) 10 (1.5) 10 (0.8)
Dual Infection () 2 (0.4) 13 (1.9) 15 (1.2)
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How it all works

• Parents notified by school district
• Meet with schools to set up screening
• Educational presentation
• The process
• Each student makes a decision, on their own,
  whether or not to submit a specimen

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Numbers of Students Reached by Philadelphias STD
High School Screening Program
of Persons Year 1(2002-03) Year 2(2003-04) Year 3(2004-05)
AttendingPresentation 30,000 30,000 30,000
Screened 19,713 17,019 16,378
Positive persons Chlamydia GC 1,052 (5.3) 1013 (5.1)94 (0.5) 813 (4.8) 768(4.5)96 (0.6) 680 (4.2) 642 (3.9)75 (0.4)
Treated () 1,051 (99.9) 807 (99.3) 676 (99.4)
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Percent Positive for GC/CT combined by Sex and
Year
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Percent Positive for GC/CT combined by School
Type and Year
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Percent Positive for GC/CT combined within
age-group by year
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Over the first three years

• CT positivity rate among participating high
  school students
• declined from 5.1 in 2002-2003 to 3.9 in
  2004-2005
• GC positivity rate remained fairly stable
• 0.5 to 0.4
• Overall GC/CT infection
• 24 decline in positivity rate
• 35 decline in the number of positive cases

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Preliminary Year 4 Data

• GC/CT infection rates seem to have increased
  slightly from Year 3 though remain less than
  Year 1
• Total positivity in Year 4 4.7
• Female positivity 7.2
• Male positivity 2.4
• Overall testing rates have decreased

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Reported Cases of Chlamydia Philadelphia, 1992 -
2005
Number of Cases
Year
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Rates of Chlamydia per 100,000 Population, by
Age Philadelphia, 1995 2005
Rate per 100,000 population
Year
Rates for 1995 to 1999 calculated with 1990
Census denominator. Rates for 2000 to present
calculated with 2000 Census denominator.
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Conclusions

• High school STD screening program implemented
  successfully with few issues
• The broad-based screening program implemented in
  Philadelphia public high schools was successful
  in finding and treating cases of CT and GC

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Conclusions, continued

• Continuing the program yearly has contributed to
  the declining rates of infection among students.
• Preliminary decreases in testing rates and
  increases in positivity in Year 4 require further
  evaluation.
• High School screening may also have contributed
  to a citywide decline in chlamydia infection
  rates.
• Broad-based screening in a variety of venues
  important

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Many Thanks!!!!!!!

• Screening Staff
• High School Staff and Administrators
• Support Staff
• Martin Goldberg, Melinda Salmon, Caroline Johnson
  
• Vic Spain, Mindy Perilla, Christa Seidman