STD screenings should be offered to all students, regardless of sexual activity

Han JS. J Adolesc Health. 2011;doi:10.1016/j.jadohealth.2010.12.006.

Regardless of reported sexual activity, all adolescents should be screened for sexually transmitted infections, according to a new study conducted in New York City public high schools.

Results of a study by Jessica S. Han, MSc, and colleagues at the New York City Department of Health and Mental Hygiene, and CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, indicate that black, older adolescent females are most likely to test positive for Chlamydia trachomatis and Neisseria gonorrhoeae.

A significant number of students who did not answer the sexual activity question but chose to screen for chlamydia and gonorrhea had a positive result. Therefore, the researchers wrote, “school screening programs should offer screening to all students regardless of reported sexual activity.”

Chlamydia and gonorrhea are the two most commonly reported bacterial STIs in the United States. Adolescents and young adults aged 15 to 24 years have the highest rates of these STIs.

Similar to many other US cities, the New York City school system offers STI education, screening and treatment, specifically targeting chlamydia and gonorrhea.

From 2006 to 2009, investigators educated 57,418 students and screened 27,353 students for the two STIs; 1,736 (6.3%) students reportedly had chlamydia or gonorrhea. Females were more likely to test positive (8.9%), report black race (8.3%) and be aged 16 years or older (6.6%-9.7%). The study results revealed that screening rates were 70.6% for sexually active students; 27.9% for students who were not sexually active; and 47.3% for students who did not respond to the questionnaire. Positivity rates for the two STIs were 7.2%, 1.4% and 6.1%, respectively.

The investigators used univariate, bivariate and multivariate logistic regression analyses to assess relationships between sex, age, race/ethnicity, sexual activity and screening status. The relationship between positive STI and sexual activity was also evaluated.

“Findings from this study indicate that chlamydia is a common STD among young people, particularly young females, and emphasize that routine chlamydia/gonorrhea screening for all sexually active adolescents and young adults is extremely important in clinical settings,” Han told Infectious Diseases in Children. “Population-based STD screening programs should offer chlamydia/gonorrhea screening to all students, regardless of their self-reported sexual history, but emphasize that previous sex is a risk factor, and they should target older adolescents and females.”

Disclosure: The funding source for this project is the New York City Department of Health and Mental Hygiene.

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