Maximizing Opportunities for Chlamydia Screening Among Adolescent Females – A Lesson from School Based Health Centers

Background

Young women account for more than half of all reported chlamydia cases. CDC guidelines suggest annual screening among sexually active women 25 and under; yet only about 50% of adolescents are being screened for chlamydia. Many young women access family planning for non-pelvic examination visits, such as emergency contraception (EC) or pregnancy tests; yet these women often do not receive STD services at the time of their visit. Increasing screening among these women during these time limited visits is an essential chlamydia control strategy.

Objective

To illustrate an effective model of maximizing opportunities for screening among females that access reproductive health services in the School Based Health Center (SBHC).

Methods

In 2008, nine Title X agencies in California partnered with 19 SBHCs in the Educational Partnerships to Increase Chlamydia Screening (EPICS) program, a CDC-funded program, developed by the California Family Health Council's Infertility Prevention Project. SBHCs collected data on all clients served; data included patient demographics, reason for visit, and chlamydia testing information.

Results

SBHCs provided services to 3552 unduplicated, sexually active females. Of these, 3152 females were tested for Chlamydia; a screening coverage of 88.7%. Of females that requested pregnancy tests and EC, 94% and 88%, respectively, were screened; disease was detected among 7.4% and 6.9% of these females, respectively.

Conclusions

The SBHC model effectively provides comprehensive reproductive health care to adolescents using clinical strategies such as identifying opportunities for screening during time limited non-pelvic examination visit types. To improve chlamydia control efforts, this model should be adapted in the general family planning setting.