STEP UP: NYC DOHMH STD School Screening Progress Meighan Rogers, MPH IPP Region II Mtg December, 2007.

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Presentation transcript:

STEP UP: NYC DOHMH STD School Screening Progress Meighan Rogers, MPH IPP Region II Mtg December, 2007

Background  Chlamydia – most commonly reported bacterial STD nationwide and in NYC (almost 40,000 cases – 2006)  Disproportionately affects adolescents  Chlamydia and gonorrhea (CT/GC) usually asymptomatic Up to 96% of men and women with CT have no symptoms  Both infections easily cured with antibiotics

NYC Chlamydia Cases by Age and Sex, 2006 AgeNumber of Cases FemalesMalesBoth yrs yrs9,3802,77312, yrs9,4594,27813, yrs4,5432,6727, yrs2,0241,4153,439 All other Ages 2,5281,7414,269 TOTAL28,28812,94541,233

Behavioral Factors FemalesMales Grade Sexually Active Sexually Active 9 th 34%48% 10 th 43%52% 11 th 46%55% 12 th 58%59% All grades43%52% Youth Risk Behavior Survey of approximately 7,000 students, NYC 2005 % of NYC High School Students Who Have Ever Had Sexual Intercourse:

DOE & DOHMH Collaboration  Spring 2006 pilot – 5 schools, private grant  Expansion:  Educated 11,298 students (46 sites)  Tested 5420 (48%)  Total positivity 4.8% overall (n=262)  Treated 99% of students  Expansion:  Goal: Educate 30,000 NYC students, test ~15,000  Focus on high morb neighborhoods  Less focus on school-based health center (SBHC) schools

How Does STEP UP Work?  Education: 20-minute education presentation  Voluntary Testing: Students receive brown paper bag with urine cup, contact info sheet, and call-back card All students complete paperwork All students are brought to bathrooms for voluntary testing  Treatment and counseling: Conducted at schools, with DOHMH staff/SBHC staff

Screening Materials

Results Current School Year

NYC Program August 2007 – November 2007Totals # of Schools/Programs Reached 25 # Students Attending Presentations ~7,000 # Students Tested3479 (50.0%) Total Positive CT/GC (%) CT = 250 (7.2%) GC = 22 (0.64%) Coinfections = 7 (.20%) Treated (%)92.5%

Testing Results STD Testing: Of the 7000 educated… Of the n=272 infections…

CT/GC Positivity Results, by sex * Difference between males & females significant at p<.0001

CT/GC Positivity by age, sex

Testing and results, by race Students Tested, by race Students Testing Positive, by race

Does Having an SBHC Significantly Affect CT/GC Positivity? * Results significant at p<.05

Treatment Rates and Partner Follow Up  Treatment rate: 93% (n=245/265); remainder undergoing follow-up  Locatable partner info elicited from 86 patients (total partners n=101)  Of partners elicited, 53% (53/101) have been treated, others being followed

Acknowledgments  Sophie Nurani, STEP UP team, Steve Rubin, Susan Blank, Kristen Harvey, Julie Schillinger, Robin Recant  Roger Platt, Julia Choe - School Health/NYC DOHMH  NYC Dept of Education colleagues  School-based health center partners  School administrations and students Contact information: Meighan Rogers: