SCREENING HIGH-RISK ADOLESCENT MALES FOR CHLAMYDIA-TRACHOMATIS INFECTION - OBTAINING URINE SPECIMENS IN THE FIELD

Background and Objectives: Reported case data suggest that few men are being tested for Chlamydia trachomatis (CT) infection (female:male re ported case ratio is >5:1) partially because men seek preventive healt h services less frequently than women and, until recently, obtaining a CT specimen from men required a urethral swab, which has low patient acceptability, A study was conducted in San Diego, CA, to determine wh ether urine specimens could be obtained from high-risk teen males in t he field using a peer teen outreach approach. Goals: Identify teen mal es infected with CT and provide treatment and partner management servi ces. Study Design: Prevalence survey of 261 teen males and a program c ost evaluation. Results: During the 6.5-month study period (Dec 15, 19 95 to June 30, 1996) an estimated 1,860 teen males were approached and 261 submitted a urine specimen; 16 (6.1%) were positive by polymerase chain reaction, All positive males were treated with azithromycin, 1 gm, in the field, and 9 female sex partners were treated, 7 of whom we re CT positive. The cost per specimen obtained and per CT infection id entified was $103 and $1,677, respectively, The annual cost for adding a peer teen outreach service to an existing STD program using existin g staff and adding 1.2 full-time equivalents of outreach time is appro ximately $25,000. Conclusion: Peer teen outreach and in-field collecti on of urine specimens appear to be an acceptable alternative for scree ning teen males for CT and should be further evaluated in other commun ities.