ABSTRACT
In 1998, treatment completion was low among chlamydia and gonorrhea cases reported to the San Francisco Department of Public Health and assigned for treatment follow-up. To improve treatment completion among growing numbers of chlamydia and gonorrhea cases, the department implemented field-delivered therapy (FDT), a single-dose, directly observed therapy protocol for uncomplicated chlamydial and gonococcal infections. After the protocol was implemented in March 1999, the proportion of cases completing treatment increased significantly, from 61.8% in 1998 to 81.0% in 2000. The greatest increases in treatment completion were observed for females and individuals younger than 20 years old. FDT is an effective, feasible, and convenient way to reach and treat individuals who are unlikely to return for chlamydia and gonorrhea treatment.
Subject(s)
Anti-Bacterial Agents/administration & dosage , Chlamydia Infections/drug therapy , Directly Observed Therapy/standards , Gonorrhea/drug therapy , Public Health Administration , Adolescent , Adult , Child , Chlamydia Infections/diagnosis , Chlamydia Infections/epidemiology , Clinical Protocols , Female , Gonorrhea/diagnosis , Gonorrhea/epidemiology , Humans , Male , Mass Screening , Risk Factors , San Francisco/epidemiology , United States/epidemiologyABSTRACT
BACKGROUND: Previous school-based studies in cities with a high prevalence of chlamydia found a substantial prevalence of chlamydial infection among students. GOAL: The goal was to determine the feasibility and acceptability of chlamydia and gonorrhea screening in San Francisco high schools. STUDY DESIGN: Sexually transmitted disease (STD) education and screening were conducted at four high schools. Students provided basic demographic information and urine specimens for chlamydia and gonorrhea ligase chain reaction testing. RESULTS: Among 283 asymptomatic females screened, 3.9% had chlamydia and 0.7% had gonorrhea. The prevalence of chlamydia was 1.5% among females <16 years of age and 4.6% among females >or=16 years of age. Only 0.8% of asymptomatic males (3/381) had chlamydia, and none had gonorrhea. CONCLUSION: STD screening was both feasible and acceptable in San Francisco high schools. STD screening in high schools should be prioritized as follows: (1) chlamydia screening over gonorrhea screening, (2) female screening over male screening, and (3) screening of older students (juniors and seniors) over screening of younger students.
