Urine-Based Screening of Adolescents in Detention to Guide Treatment for Gonococcal and Chlamydial Infections

Abstract

Objectives: To determine the utility of urine-based ligase chain reaction assays for Neisseria gonorrhoeae and Chlamydia trachomatis in (1) the acceptability of such testing to adolescent detainees, (2) the potential use of these tests for identifying asymptomatic infections, and (3) the effectiveness of this approach for ensuring treatment of infected adolescents.Design: Cross-sectional screening and verification of treatment for infected cases.Subjects: Adolescents admitted to a short-term juvenile detention center.Main Outcome Measures: Neisseria gonorrhoeae and C trachomatis infection rates, and timing and location of treatment for infected patients.Results: Refusal rate was 1.5%. Of 263 participants, 46 (17.5%) were female subjects. Chlamydia trachomatis infections were identified in 28.3% of the female and 8.8% of the male subjects. Neisseria gonorrhoeae infections were present in 13.1% of the female and 2.8% of the male subjects. Overall, 37 participants (14%) were positive for N gonorrhoeae, C trachomatis, or both, only one of whom had symptoms. Almost 70% (25/36) of asymptomatic infected subjects were treated within 28 days of screening. A treatment was documented in 36 of the 37 infected youth, including 20 who were followed up and treated after release from the detention center, by 6 months after testing. Conclusion:Urine ligase chain reaction tests were effective for identifying and guiding treatment of unsuspected N gonorrhoeae and C trachomatis infections in teenagers admitted to a short-term detention center where traditional swab specimens may be difficult to obtain.

Emergency department screening for asymptomatic sexually transmitted infections

“…This rate is comparable to rates of asymptomatic infection among previously examined sexually active populations. [8][9][10][11][12][13][14][15] Urine-based screening was easy to integrate into emergency department service delivery and was well accepted by the emergency department client population.…”

“…[9][10][11][12][13] More than 40% of participants reported a history of STIs, which proved to be a significant risk marker for current infection. Because asymptomatic infection may persist over long periods, number of sex partners in the previous year was a more sensitive marker for infection than number of partners in the previous 3 months.…”

“…6,7 Previous screening studies have demonstrated high prevalence rates of asymptomatic chlamydial infection in family planning centers, adolescent health facilities, detention centers, school-and community-based clinics, and military settings. [8][9][10][11][12][13][14][15] The emergency department represents another health care access site for identifying persons with asymptomatic STIs. Many persons at risk for STIs use emergency departments as a primary source of health care.…”

Do Religious and Control Cognitions Predict Risky Behavior? II. Development and Validation of the Sexual Risk Behavior-related God Locus of Control Scale for Adolescents (SexGLOC-A)

“…The inconsistency of these findings may be due in part to the fact that most studies have relied on small samples (e.g., Oh et al, 1998;O'Leary, Jemmott, Goodhart, & Gebelt, 1996;Pendergrast, DuRant, & Gaillard, 1992) and varying operational definitions of risk behavior. However, other reasons for these contradictions may be the exclusive focus on internal/external control cognitions, and on general rather than domain-specific LOC.…”

Risk and prevalence of treatable sexually transmitted diseases at a Birmingham substance abuse treatment facility

“…In turn, these simplified specimen collection procedures now permit highly sensitive [1][2][3][4] testing for treatable sexually transmitted diseases (STDs) in nonclinical sites and at other locations of convenience where at-risk persons might congregate. [5][6][7][8] A growing literature supports the association between drugs (including alcohol) and high-risk sexual behavior. [9][10][11][12] Most of these studies, however, focused on persons who were actively using drugs.…”