Relative efficiency of chlamydia screening in non-clinical settings in two California counties

Abstract

We examined the relative efficiency of non-clinical sites to screen for chlamydia in youth and young adults. Chlamydia screening targeting youth (under 30 years of age) was performed at non-clinical sites in high-morbidity neighbourhoods of two California counties. Venues were subdivided into community outreach, schools, parenting centres and drug treatment/correctional facilities. Relative efficiency was estimated with multivariate Poisson regression using incidence of chlamydia per person-hours labour adjusting for strategy and county. Among the 1514 youths screened, the overall prevalence of chlamydia was 5.5%. By venue, the highest prevalence was in drug treatment/correction facilities at 11.1% followed by parenting centres at 6.3%, community outreach at 4.9% and schools at 4.6%. Drug treatment/correctional facilities were the most labour time efficient at 9.9 person-hours per chlamydia case. Schools and parenting centres had the lowest cost per screen at 0.9 person-hours per screen. Adjusted relative labour time efficiency (chlamydia cases per paid person-hour) was significantly higher in schools, 2.0 (95% confidence interval [CI] 1.0–4.2), parenting centres, 3.2 (95% CI 1.6–6.6) and drug treatment/correctional facilities, 2.9 (95% CI 1.0–7.8), compared with community outreach. In conclusion, parenting centres and drug treatment centres and correctional facilities are the most efficient venues for chlamydia screening.

Bacterial Sexually Transmitted Disease Screening Outside the Clinic—Implications for the Modern Sexually Transmitted Disease Program

“…40 A program conducted in collaboration with the family court screened more than 1500 adolescents on probation for chlamydia and gonorrhea and overall positivity of 8.4% with 96% of newly identified infections treated. 33 Mobile van, 30 community outreach, 32 and college campus–based screenings 31 also identified significant burdens of infection (Table 2). In a large sample of community-based organization-sponsored syphilis screening activities in 5 states, more than 11,000 tests were conducted, identifying 48 new syphilis diagnoses (0.4%).…”

Reaching Youth With Out-of-Facility HIV and Reproductive Health Services: A Systematic Review

“…Twenty-one studies describing results of out-of-facility delivery of health services to youth or populations including youth were excluded (Table 1) [27,30,33,[35][36][37][38][39][40][41][42][43][44][45][46][47][48][49][50][51][52]; 15 studies were excluded because none of this review's outcomes of interest were measured in those studies. Another three were excluded because the studies did not meet eligibility based on this review's age-ofsubjects criteria.…”

The Ballseye programme: a mixed-methods programme of research in traditional sexual health and alternative community settings to improve the sexual health of men in the UK

“…155 Buhrer-Skinner et al 164 calculated a cost per test carried out for outreach clinics in Australia but did not include staff time, transport and set up costs. Morris et al 165 calculated the costs associated with two Californian youth programmes but did not include additional time associated with volunteer input. Detailed costings were also provided by a study evaluating the cost-effectiveness of a multifaceted community intervention to increase screening in Stockholm.…”