5159.0: Wednesday, November 15, 2000 - 1:45 PM

Abstract #16231

Missed opportunities for STD detection and treatment in Southern school-based health centers (SBHCs)

Malanda Nsuami, MD, MPH1, Deborah A. Cohen, MD, MPH1, Ladatra S. Sanders, BS1, Bridget N. Brooks, MSPH1, David H. Martin, MD2, and Thomas A. Farley, MD, MPH3. (1) Department of Public Health and Preventive Medicine, Louisiana State University Health Sciences Center, 1600 Canal Street, 9th Floor, New Orleans, LA 70112, (504) 680-9450, mnsuam@lsumc.edu, (2) Department of Medicine, Louisiana State University Health Sciences Center, 1542 Tulane Avenue, New Orleans, LA 70112, (3) State Department of Public Health, New Orleans, LA

Objective: To determine SBHCs’ opportunities of detecting STDs through their encounter with adolescents whose health care utilization is traditionally poor.

Methods: In a school with an on-site SBHC, data were available on students’ utilization of the SBHC for 1995-96, 1996-97 and 1998-99, and students’ participation in a parallel school-based chlamydia and gonorrhea (SBSTD) screening using urine LCR. Students grades 9-12 routinely visiting the SBHC were compared with students tested for STD through the SBSTD screening.

Results:    

Visited SBHC 
Tested in SBSTD
p value
1995-96 M (n=379)                F  (n=409)
61.7% 65.5%
61.2% 46.7% 
 0.88 0.000
1996-97 M (n=397)                F  (n=450)
67.8% 74.4% 
58.7% 55.6%
0.01 0.000
1998-99  M (n=365)                 F  (n=394)
55.1% 64.5%
69.0% 70.3%
0.001 0.08

Males vs. females rates of STD were 7.3% and 13.6% in 1995-96 (p=0.03), 5.2% and 11.2% in 1996-97 (p=0.02), and 4.8% and 9.1% in 1998-99 (p=0.05).

Conclusions: Overall, the SBHC would have screened significantly more females if a urine sample was purposefully collected from each student who routinely visited the center between 1995 and 1999. With higher STD rates among females, more cases would probably have been detected through such integrated SBHC STD screening than actually were through the SBSTD screening. This demonstrates that opportunities for identifying the two most common bacterial STDs among adolescents in the US are still being missed in spite of the current availability of noninvasive, highly sensitive diagnostic tools for disease detection.    

Learning Objectives: Participants will be able to assess the extent to which opportunities for early chlamydia and gonorrhea detection and treatment are being missed in spite of the availability of noninvasive diagnostic tests and the potential for a high response from adolescent high school students

Keywords: Adolescents, STD

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

The 128th Annual Meeting of APHA