NEW YORK, (Reuters Health) -- High school students have a high rate
of sexually transmitted diseases (STDs), with 3 million US teens becoming
infected each year. But school-based screening and treatment can reduce the
number of teen boys infected with STDs such as chlamydia, according to results
of a new study.
Dr. Deborah A. Cohen of the Louisiana State University Medical Center and
colleagues from there and from the Louisiana Office of Public Health, both in
New Orleans, ran a 3-year voluntary screening program in three urban high
schools, and looked at the rate of infection of two STDs -- chlamydia and
gonorrhea. Five additional schools were used as comparison schools for the first
2 years, and then added to the screening program for the third year.
In the original three schools, students in grades 9 through 12 were
offered free screening twice a year, and each year over half of them
participated. Overall, about 83% were screened at least once. For the schools
with health clinics, fewer than 5% of parents refused to let their children be
screened. For schools without health clinics, about 10% refused.
Over all eight schools and all 3 years, 6.2% of boys and 11.5% of girls
tested positive for chlamydia, with numbers nearly doubling between grades 9 and
12. Gonorrhea did not vary across grades, but 1.2% of boys and 2.5% of girls
tested positive. Yet, over 90% of these students reported no symptoms of
infection.
The screening program seems to have made a difference for boys -- by the
fifth screening, the rate of chlamydia infection dropped about 50% compared to
the original rate and compared to the rate in the control schools. Among girls,
the rate of chlamydia infection dropped from 12.1% at the first screening to
7.3% halfway through the program, but then climbed back up to 10.3% at the fifth
screening. Cases of gonorrhea decreased over time for both boys and girls.
Writing in the December issue of the journal Pediatrics, Cohen and her
team suggest several reasons for the difference in effectiveness between boys
and girls. Females, they note, may be more susceptible to infection. Also, girls
are more likely to date older boys who may not be in school to get screened, and
who are more likely to pass on infections.
"Our program indicates that school-based STD-screening programs are
feasible and acceptable, and, over time, have the potential to reduce STDs," the
authors conclude. Noting that "most cases of chlamydia and gonorrhea are
asymptomatic in both males and females," they emphasized that "screening
programs will be the only way to identify the majority of cases."
