1. NYC DOHMH BSTDC School-Based Education, Screening and Treatment Pilot Program Meighan Rogers, MPH Bureau of STD Control, NYC DOHMH Region II IPP Meeting, May 31-June 1, 2006

2. Background  Chlamydia and gonorrhea (CT/GC) largely asymptomatic  Untreated infection can cause: - Infertility - Increased risk of HIV transmission - Pelvic inflammatory disease - Tubal scarring - Ectopic pregnancy  Chlamydia cases, NYC, 2004: - 34,101 total - 10,084 (29.5%) among 15-19 year-olds  NYC Youth Risk Behavior Survey, 2005, N=7,058: - Approximately 50% of all students reported sexual intercourse

3. Planning Fall 2005  Funded for high school education, screening, treatment pilot (~$85,000)  Observed Philadelphia high school screening January-March 2006  Negotiated school selection with Bureau of School Health and Department of Education (DOE)  Secured IRB review/approval – DOE, DOHMH  Secured parental support  Opt-out passive parental consent  Presentations at parent association meetings

4. Pilot Program Goals  Educate 2,500 NYC students about - CT/GC - Access to sexual/reproductive healthcare  Offer urine-based CT/GC tests  Treat all students diagnosed with CT/GC in school  Notify and treat locatable partners  Provide disease prevention messages

5. Screening Materials

6. Summary Statistics – Education and Testing Total N=2003 STD Education 30% 70% InstructedAbsent N=1395 STD Testing - of the 1395 Educated 38% 62% Did Not TestTested Total N=1395 N=860

7. CT/GC Positivity by Sex, by School 1.1 6.9 4.4 12.5 4.8 6.8 2.5 8.2 0 2 4 6 8 10 12 14 Percent Positive School 1School 2School 3Overall Male % Female %

8. 0 0.88 1.1 6.3 0 4.1 7.6 7.3 12.5 8.3 0 9.1 0 2 4 6 8 10 12 14 Under 1515161718Over 18 Age Percent Positive Male Female CT/GC Positivity by Age, by Sex

9. Treatment / Partner Elicitation  N= 46 students tested positive (44CT/2GC) - 45 treated - 1 refused treatment  N= 43 partners elicited 8 treated in school 14 treated at clinic or private doctor 15 not locatable 6 currently undergoing field follow up  N= 29 students/partners underwent testing and/or treatment at a BSTDC clinic

10. Looking Ahead 2005-06 school-year  Conduct project at 2 more schools (1 Brooklyn/1 Bronx)  Complete project evaluation 2006-07 school-year  Educate/offer screening to 10,000 NYC public high school students (~20 high schools, and 3-5 summer schools)  Include larger schools in higher morbidity areas with fewer resources  Enhance CT/GC testing capacity at school-based health centers

11. Thank You!  BSTDC Project Staff  Bureau of School Health  Department of Education  Public High School Staff  District Public Health Offices For further information, please contact: Meighan Rogers (212) 788-4428 mrogers@health.nyc.gov

12. Phildalephia High School Screening Program Positivity Rates by Sex and Year