CDC-Funded California Program Achieves High Rates of Chlamydia Screening in High School Health Centers; Highest Infection Rates Found Among African-American Teens

Previous studies have shown that young women aged 15 to 19 have the highest rates of chlamydia infection in the country, and CDC recommends that all sexually active women age 25 and under be screened for chlamydia every year (and more frequently if they are at high risk for infection).

A new study led by Rebecca Braun of the California Family Health Council examined the effectiveness of a chlamydia screening program in California high school-based health centers (SBHCs). The researchers analyzed data from the CDC-funded Educational Partnerships to Increase Chlamydia Screening (EPICS) program at seven SBHCs in rural and urban California. The program provides funding, training, and technical assistance to encourage greater chlamydia screening among at-risk teens.

The researchers examined data from 1,321 sexually active adolescent girls who attended the SBHCs seeking contraceptive or STD services between July 2006 and June 2007.

Overall, almost nine in 10 teens (89.7%) attending the health centers were screened, and chlamydia was diagnosed in 6.5 percent of those screened. This positivity rate is more than double the U.S. Department of Health and Human Services' Healthy People 2010 goal of three percent positivity for adolescents and young adults. Young black women (94.1%) and women identifying as "other race" (93.3%) were more likely to be screened than young white women (84.6%). In addition, young black women, Asian women, and women identifying as "other race" were more likely to test positive for chlamydia (9.6%, 6.5%, and 7.5%, respectively) than white women (1.7%). Older adolescents were also more likely to test positive for chlamydia: teens aged 13 to 14 had lower infection rates (3.2%) than those aged 15 to 17 years (6.0%), and those aged 17 to 19 years (6.4%).

The researchers are optimistic that the data will help California health officials focus screening and risk-reduction counseling on those most at risk, especially young African American women and older adolescents. Given the success of this program in reaching at-risk teens, the researchers also recommend that other states consider implementing confidential school-based chlamydia testing and treatment programs as a part of providing comprehensive reproductive health care services to adolescents.

Oral Abstract B8c -- To Screen or Not to Screen -- Maximizing Chlamydia Screening of Adolescent Females in School Based Health Centers in California. In: 2008 National STD Prevention Conference, Chicago, Ill., March 10-13, 2008.