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

https://doi.org/10.1016/S1054-139X(00)00165-8Get rights and content

Abstract

Purpose: To evaluate results of screening for syphilis, gonorrhea, and chlamydia among youth in a federally funded job training program.

Methods: Data were evaluated from medical records of 12,881 randomly selected students in 54 U.S. job training centers during 1996. The intake medical evaluation includes serologic testing for syphilis. The policy was for females to receive a pelvic examination with gonorrhea and chlamydia testing and for males to be first screened with a urine leukocyte esterase (LE) assay, with follow-up gonorrhea and chlamydia testing for those with positive LE 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. Chlamydia infection was most common in younger women ≤17 years 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 gonorrhea and chlamydia, including those youth from socioeconomically disadvantaged backgrounds. Because individuals from such backgrounds may not regularly interact with traditional clinical health care systems, screening and treatment should be offered in alternative settings, such as the job training program described in this study.

Section snippets

Study sample

During 1996, data were abstracted from medical records of currently enrolled students in the U.S. Job Corps, a federally funded Department of Labor job training program for those 16–24 years of age (10). Eligibility criteria for this program include being economically disadvantaged, a high school drop-out or in need of additional training to hold meaningful employment, and free of serious medical or behavioral problems. Of those enrolled in this program during 1995–1996, 78% were high school

Characteristics of study sample

Medical records were abstracted from 12,881 students enrolled at 54 job training centers. Forty-five percent of the sample was female, and 55% male; 49% of the students were African-American, 27% white, 18% Hispanic, 2% Native American, and 2% Asian-Pacific Islander. The median age was 19 years; 54% were between the ages of 18 and 21 years. Thirty-nine percent of students had <10 years of education. Nineteen percent of students came from a town or city of residence with a population of <50,000,

Discussion

Among females enrolled in a job training program for socioeconomically disadvantaged students, an estimated 9.2% had a positive test for chlamydia, 2.7% a positive test for gonorrhea, and 0.4% a positive test for syphilis. Rates for each of these bacterial STDs was highest among African-American students; almost one in every eight African-American women had a positive test for chlamydia. Rates for gonorrhea and chlamydia were next highest for Native American women. Racial/ethnic differences

Acknowledgements

We thank the following people for their assistance and involvement with this project: Sarah Valway and Ida Onorato from the Centers for Disease Control and Prevention; Pat Brothen, Kathryn Como, Clif Gray, Rose Hilk, Ann Johnston, and Jamie Kvittem, who are or were with the Division of Epidemiology, University of Minnesota at the time this study was conducted; Carol Miller from the U.S. Job Corps; Rosita Podberesky, Lura Myers, and Jerri Shaw from Johnson, Bassin & Shaw, and Humanitas; and the

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