STEP UP: NYC DOHMH STD School Screening

Progress

Meighan Rogers, MPH IPP Region II MtgDecember, 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

Age Number of Cases

Females Males Both

10-14 yrs 354 66 420

15-19 yrs 9,380 2,773 12,153

20-24 yrs 9,459 4,278 13,737

25-29 yrs 4,543 2,672 7,215

30-34 yrs 2,024 1,415 3,439

All other Ages

2,528 1,741 4,269

TOTAL 28,288 12,945 41,233

Behavioral Factors

Females Males

Grade Sexually

ActiveSexuallyActive

9th 34% 48%

10th 43% 52%

11th 46% 55%

12th 58% 59%

All grades 43% 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 2006-2007 Expansion:

Educated 11,298 students (46 sites) Tested 5420 (48%) Total positivity 4.8% overall (n=262) Treated 99% of students

2007-2008 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 2007-08School Year

NYC 2006-2007 ProgramAugust 2007 – November 2007 Totals

# of Schools/Programs Reached

25

# Students Attending Presentations

~7,000

# Students Tested 3479 (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…

3%6%

91%

CT positive GC positive CT/ GC co-infected

Of the n=272 infections…

CT/GC Positivity Results, by sex

4.6

10.5

7.7

0

2

4

6

8

10

12

CT

/GC

Po

siti

vity

Male

Female

Overall

* 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: 212-788-4428

mrogers@health.nyc.gov