Screening for sexually transmitted infections among economically disadvantaged youth in a national job training program

Purpose: To evaluate results of screening for syphilis, gonorrhea, and chla mydia among youth in a federally funded job training program. Methods: Data were evaluated from medical records of 12,881 randomly select ed students in 54 U.S. job training centers during 1996. The intake medical evaluation includes serologic testing for syphilis. The policy was for fem ales to receive a pelvic examination with gonorrhea and chlamydia testing a nd for males to be first screened with a urine leukocyte esterase (LE) assa y, with follow-up gonorrhea and chlamydia testing for those with positive L E results. Results: Adjusting for our sampling strategy, among females, an estimated 9 .2% had a positive chlamydia test, 2.7% a positive gonorrhea test, and 0.4% had a positive syphilis test. Gonorrhea and chlamydia rates among females were highest in African-American followed by Native American students. Chla mydia infection was most common in younger women less than or equal to 17 y ears of age. An estimated 0.1% of males had a positive syphilis test, and 4 .8% of males a positive urine LE test. Of 103 LE-positive males tested for gonorrhea and chlamydia, only 27 (26%) had a positive test for one of these STDs. Conclusions: Our study supports routine screening of adolescents for gonorr hea and chlamydia, including those youth from socioeconomically disadvantag ed backgrounds. Because individuals from such backgrounds may not regularly interact with traditional clinical health care systems, screening and trea tment should be offered in alternative settings, such as the job training p rogram described in this study. (C) Society for Adolescent Medicine, 2001.