Participation in a school-based sexually transmitted disease screening program

A school-based chlamydia screening program was offered repeatedly in three Louisiana public high schools in an effort to expand sexually transmitted disease screening services for adolescents.

To describe participation of a fixed cohort of students to elucidate the impact of screening on chlamydia prevalence.

Five opportunities for chlamydia testing were offered in 3 schools during 3 school years (1995-1996, 1996-1997, 1997-1998). Only students with parental consent could be tested. Students consistently enrolled during the 3 years (n = 1475) were included in this analysis.

During the 3 school years, parental consent was cumulatively obtained for 1443 students (97.8%), and 1305 students (88.5%) were tested at least once. Of those tested, 81.1% tested more than once. The prevalence of Chlamydia trachomatis infection at first test among students who tested more than once was 1.8% for males and 7.7% for females. Among students tested only once, 6.2% of males and 12.7% of females had chlamydial infection. Among students tested more than once, no significant difference in C. trachomatis prevalence was associated with repeat screenings. Incidence rates per 1000 person-months were 4.3 (2.2, males; 7.1, females; P < 0.0001). Reinfections explained only 5.6% of all incident cases.

The documented high response from both parents and students to this school-based chlamydia screening program offers great promise for sexually transmitted disease control among adolescents. Overall, C. trachomatis prevalence was two times higher among students testing only once than among those testing more than once. Routine and continued availability of school-based chlamydia screening programs can potentially reduce the burden of disease among adolescents.