Reaching Adolescents Michigan’s Infertility Prevention Screening Project

Oakland County Screening Pilot Project Initiated 12/00 >7000 adolescents/young adults screened 52% males, 48% females One-on-One Computerized Sexual Questionnaire Risk Reduction Education Urine-Based Testing Single Dose Treatment

Screening Sites Juvenile Detention Jail (<24 y.o) School Based Clinic Alternative High School Runaway Shelter Residential/ Treatment Facility Juvenile Drug Court

Race/Ethnicity

Number of Lifetime Sexual Partners Mean Number of Partners Age Overall Female (5) Male (10)

Comparison of Sites Chlamydia Positivity %

Positive for Chlamydia Symptoms 17 % 83% Males Females

Comparison of Sites Gonorrhea Positivity %

Positive for Gonorrhea Symptoms 32% 68% Males Females

Total of Positive Infections By Race Chlamydia Gonorrhea 81% 79% 18% 1% 3%

Pen-based Computers Data entry at time of client contact Uploaded directly into database Time saving no data entry no missing data Data can be analyzed at individual sites

School Sites

Expansion of Adolescent Screening Sites - 8 School Based Clinics * * * * * *

Clinical Practice Change in eliciting risk behaviors Expanded from “Are you sexually active?” to “Have you ever had sex?” Males – ease in screening with urine test Females – entry into reproductive health Screening the females that come to clinic for a variety of reasons. Can follow up with pelvic/pap after urine test Re-screening Students testing positive to return to clinic in 3-4 months

Comparison of School Clinics Chlamydia Positivity 9/05 - 4/06 Male 18% Female 15%

Comparison of School Clinics Gonorrhea Positivity 9/05- 4/06 Males 4% Females 4%

Chlamydia Positivity - Primary Reason for Clinic Visit % 47% of the infections would have been missed - only tested STD requests

Partner Referral 46 students referred by partner 74% had no symptoms 47% of these students positive for either chlamydia or gonorrhea Benefits of overall program non-invasive testing clinic on school grounds –easy access importance of informing partners

Race Breakdown Overall and with Chlamydia Infection Overall Positive for CT 71% 81% 19% 12% 8% 5%

Juvenile Detention and Correctional Settings Unique opportunities

Expansion of Adolescent Screening Sites 7 County Detention Facilities * * ** * * *

At-Risk Population – Time Out from the Community Ideal time to offer screening Non-invasive test, easy sell Offered at time of admission or during mandatory physical Less costly than untreated complications P.I.D. treatment $2000/ detainee By screening/ treating prior to release help stem the spread of infection in the overall community

Comparison of Chlamydia Positivity – Detention 2005 Male 9% Female 17%

Comparing Adolescent Venues

Comparison of Chlamydia Positivity 9/05 – 3/06

Comparison of Gonorrhea Positivity 9/05 – 3/06

Presented by Shana E. Cash M.P.H. Program Manager Health Care Education & Training Inc. Project Coordinator Lynda K. Byer R.N., M.S. Oakland County Children’s Village 248/