SCREENING FOR GONORRHEA AND CHLAMYDIA BY DNA AMPLIFICATION IN ADOLESCENTS ATTENDING MIDDLE SCHOOL-HEALTH CENTERS - OPPORTUNITY FOR EARLY INTERVENTION

Goal: To determine prevalence and incidence of Neisseria gonorrhoeae ( GC) and Chlamydia trachomatis (CT) infection and assess risk factors p redictive for such infections in a middle school-based clinic sample. Study Design: 170 female students and 43 male students making 256 and 47 visits, respectively, greater than or equal to 30 days apart, in ur ban middle school clinics for primary care screening, reproductive hea lth, or illness/injury were routinely asked to provide urine specimens for GC and CT ligase chain reaction testing if sexually active in the preceding 3-month period. Information regarding prior sexually transm itted diseases, reason for visit, and sexual risk behaviors was obtain ed, Results: GC: 11.4% of female student and 2.1% of male student test s were positive, Incidence was 34.0 cases/1,000 person months (95% Con fidence interval [CI]: 19.5-67.5), Median time to first positive and r epeat positive test was 4.6 and 2.6 months, respectively. For CT: 16.4 % of female student and 2.1% of male student tests were positive. Inc idence was 57.5 cases/1,000 person months (95% CI: 35,2-93.8), Median time to first positive and repeat positive CT test was 6.0 and 4.8 mon ths, respectively. Assessed risk factors failed to specify a candidate screening population. Conclusion: These data suggest that all sexuall y active adolescent girls in this high risk setting should be offered testing for GC and CT at least twice per year, regardless of;age or ot her sexual risk behaviors and that STD control efforts in high risk mi ddle schools should be encouraged.