STOP CHLAMYDIA PROGRAM Gloria Jones, BSN, Public Health Nurse 550 S. Peoria Avenue, Tulsa, OK 74120 www.ihcrc.org

Initiating & Integrating CT Screening Activities into: Tulsa metro area: 86,000 Indian people Clinic patients: 15,000 per year Tulsa Public Schools has largest Indian pupil population in U.S. Comprehensive health services: Medical Dental Optometry Behavioral Health Health Education

Chlamydia Program Challenges .1% of patients lost to follow-up, due to unreliable phone number or address PHN makes three attempts for tracking & treating STIs Phone call Certified letter Home visit, leaving business card and need for follow-up appointment Uncooperative condom use by partners 2006 prior STI = 14 (averaging 2 to 5 re-exposures per qtr) 2007 prior STI = 17 (averaging 2 to 5 re-exposures per qtr) Anonymous and multiple partner encounters Contacts ineligibility for IHS services PHN refers partners to their closest health department

Chlamydia Program Enhancements To promote timely treatments of STI’s a systemized approach is established PHN enters daily all pap results in a Stop Chlamydia & STI log book Lab ensures all positive Chlamydia results are sent to the PHN for patient tracking, DOT treatment, partner management & PHIDDO reporting Intensive case management resulted in 99.9% of cases tracked & treated within 10 days of STI lab collection Quarterly PHN checks with pharmacy’s Azithromycin distribution list & performs chart audits for missed reported cases

Stop Chlamydia! Data Newly developed Stop Chlamydia Project Quarterly Reports Provide routine analysis of project-level screening outcomes Can be used to evaluate and better target screening efforts

Chlamydia Positivity Among Females by Age Group, Indian Health Care Resource Center of Tulsa, Inc. 2006 High positivity among youth No positivity found in older age groups Data could inform more effective targeting of services Shift resources currently used to screen older groups to then screen increased numbers of at-risk groups

Chlamydia Positivity Among Females by Age Group, Indian Health Care Resource Center of Tulsa, Inc. 2007 Increase in high positivity among 15-19 year olds (8.8 to 20.2)s Slight increase in positivity found in 20-24 year olds (10.5 to 12.0) Slight decrease in positivity of 25-29 year olds (4.8 to 3.5) Slight increase in positivity in 30 to 65+ age groups due to improved screening efforts

Practical, Consistent & Efficient Keys to Preventing Chlamydia in Indian Country: Intensive case management Networking with health care providers, lab personnel, local & State Health Departments Continuous demographic updating of patient’s phone & address each visit Accessible screening & treatment services targeting the at risk age groups Distribution of STI/Prophylactic education

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