Screening High-Risk Adolescent Males for Chlamydia trachomatis Infection

Abstract

Background and Objectives: Reported case data suggest that few men are being tested for Chlamydia trachomatis (CT) infection (female:male reported case ratio is >5:1) partially because men seek preventive health 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 whether urine specimens could be obtained from high-risk teen males in the field using a peer teen outreach approach. Goals: Identify teen males infected with CT and provide treatment and partner management services. Study Design: Prevalence survey of 261 teen males and a program cost evaluation. Results: During the 6.5-month study period (Dec 15, 1995 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 were CT positive. The cost per specimen obtained and per CT infection identified was $103 and $1,677, respectively. The annual cost for adding a peer teen outreach service to an existing STD program using existing staff and adding 1.2 full-time equivalents of outreach time is approximately $25,000. Conclusion: Peer teen outreach and in-field collection of urine specimens appear to be an acceptable alternative for screening teen males for CT and should be further evaluated in other communities.