Chlamydia Screening and STD Education For High-risk Teens: A Peer Outreach Program C. Leah, L. Jackson, K. Guzman, A. Arroyo, D. Borntrager, R. Gunn Health and Human Services Agency, San Diego, CA Centers for Disease Control and Prevention, Atlanta, GA

The Problem: High CT prevalence among teens High risk teens/young adults Limited access to health services, tx Poor health care seeking behavior Especially teenage boys Bring CT and GC screening services to non-clinical sites

Community Testing and Outreach Program Teen-peer program design: Provide STD education Target youth 12–24 years of age in the STD high-risk area of San Diego, CA Urine screening at non-clinical sites

Non-Clinical Sites: Recovery Centers Probation Schools Juvenile Detention Adolescent Pregnant/Parenting Program Group Homes Homeless Shelter Boys and Girls Clubs Teen Drop-in Centers

Presentation 1 hour interactive presentation STD information: Bacterial, Viral, Parasites, Prevention Post-presentation knowledge/behavior survey Urine testing for CT/GC

Test Results Procedures: Result card Call-in for results Teens with positive test results are followed by field staff Free treatment provided Partner notification services

Year Presentations Year# Pres.# SitesParticipants Total

Year Screening Results Testing Eligible Tested No. (%) CT Pos. No. (%) GC Pos. No. (%) Total Positive No. (%) Male (52)17 (2.5)3 (0.4)20 (3.0) Female (46)29 (11.0)4 (1.5)32 (12.0) Total: (50)46 (4.9)7 (0.7)52 (5.5)

Partner Notification Results YearTotal Positive Named at least 1 partner No. of Partners Named Total522430

Named Partners No. of partners No. TestedNo. Infected/TX Preven. Tx Unlocatable/ Refused Exam (39%) 149

Knowledge and Behavior Survey Initiated June question Anonymous STD knowledge Chlamydia screening history Urine test today?

Survey Results (1) Completion rate: 80% ; N=569 Heard of all STDs covered before today? All/Most = (72%) What new information did you learn today? CT can cause infertility (49%) Asymptomatic infections (45%) STD HIV link (45%)

Survey Results (2) Had a CT Test in Last 12 Months?: TotalCT Test Before No. (%) Past 12 mo. No. (%) Pos. Test No (%) Male28589 (31)72 (81)5 (7) Female15492 (60)73 (79)9 (12) Total: (41)145 (80)14(8)

Survey Results (3) Are you planning to take the urine test today? TotalYes No. (%) Male (37) Female16884 (50) Total (42)

Survey Results (4) No, Not sure - Taking urine test today? TotalRecently Tested % Think Not at Risk for STD % Havent Had Sex % Male148(38)(32)(14) Female70(46)(19)(21) Total218(40)(28)(17)

Conclusions Peer-based education and screening can: Reach a considerable number of high-risk adolescents Identify new CT and GC infections Partner services limited in identifying partners- 40% named no partners Partners identified had 39% infection prevalence.

Program Cost: Peer Educator (24 hrs/wk) - $12,000 Mileage Laboratory Treatment STD brochures/condoms In-kind – supervision, CDI staff Annual Program Cost - $22,000

Recommendations: Continue and expand program Explore ways to get partners of infected teens treated Increase screening acceptance rates Peer educators are a valuable component of a STD Program