Reaching Adolescents

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• Reaching Adolescents
• Michigans Infertility Prevention Screening
  Project

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Oakland County Screening Pilot Project

• Initiated 12/00
• gt7000 adolescents/young adults screened
• 52 males, 48 females
• One-on-One Computerized Sexual Questionnaire
• Risk Reduction Education
• Urine-Based Testing
• Single Dose Treatment

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Screening Sites

• Juvenile Detention
• Jail (lt24 y.o)
• School Based Clinic
• Alternative High School
• Runaway Shelter
• Residential/ Treatment Facility
• Juvenile Drug Court

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Race/Ethnicity
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Number of LifetimeSexual
Partners
Mean Number of Partners
Overall Female (5) Male (10)
Age
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Comparison of SitesChlamydia Positivity

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Positive for ChlamydiaSymptoms
17
83
Males Females
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Comparison of SitesGonorrhea Positivity

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Positive for GonorrheaSymptoms
32
68
Males Females

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Total of Positive Infections By Race
Chlamydia Gonorrhea
1
3
18
18
81 79
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Pen-based Computers

• Data entry at time of client contact
• Uploaded directly into database
• Time saving
• no data entry
• no missing data
• Data can be analyzed at individual sites

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School Sites
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Expansion of Adolescent Screening Sites - 8
School Based Clinics






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Clinical Practice

• Change in eliciting risk behaviors
• Expanded from Are you sexually active? to
  Have you ever had sex?
• Males ease in screening with urine test
• Females entry into reproductive health
• Screening the females that come to clinic for a
  variety
• of reasons.
• Can follow up with pelvic/pap after urine test
• Re-screening
• Students testing positive to return to clinic in
  3-4 months

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Comparison of School ClinicsChlamydia
Positivity9/05 - 4/06
Male 18 Female 15

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Comparison of School ClinicsGonorrhea
Positivity9/05- 4/06
Males 4 Females 4
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Chlamydia Positivity -Primary Reason for Clinic
Visit

47 of the infections would have been missed -
only tested STD requests
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Partner Referral

• 46 students referred by partner
• 74 had no symptoms
• 47 of these students positive for either
• chlamydia or gonorrhea
• Benefits of overall program
• non-invasive testing
• clinic on school grounds easy access
• importance of informing partners

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Race BreakdownOverall and with Chlamydia
Infection
Overall
Positive for CT
8
5
19
12
71 81
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Juvenile Detention and Correctional Settings

• Unique opportunities

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Expansion of Adolescent Screening Sites 7 County
Detention Facilities







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At-Risk Population Time Out from the Community

• Ideal time to offer screening
• Non-invasive test, easy sell
• Offered at time of admission or during
• mandatory physical
• Less costly than untreated complications
• P.I.D. treatment 2000/ detainee
• By screening/ treating prior to release help stem
  the spread of infection in the overall community

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Comparison of Chlamydia Positivity Detention
2005
Male 9
Female 17

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Comparing Adolescent Venues
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Comparison of Chlamydia Positivity 9/05
3/06
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Comparison of Gonorrhea Positivity 9/05 3/06
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• Presented by Shana E. Cash M.P.H.
• Program Manager
• Health Care Education Training Inc.
• Project Coordinator
• Lynda K. Byer R.N., M.S.
• Oakland County Childrens Village
• byerl_at_co.oakland.mi.us
• 248/ 452-9188