TY - JOUR
T1 - Street-based STD testing and treatment of homeless youth are feasible, acceptable and effective
AU - Auerswald, Colette L.
AU - Sugano, Eiko
AU - Ellen, Jonathan M.
AU - Klausner, Jeffrey D.
N1 - Funding Information:
The research described in this article was conducted with support from the National Institute of Child Health and Development (K-23, HD 0149003), the University of California at San Francisco Research Evaluation and Allocation Committee, and the University of California at San Francisco Committee on Research (PI: C. Auerswald) and the Health Resources and Services Administration Title IV/Ryan White Funds (site: Larkin Street Youth Services). We thank our research staff who recruited, tested and treated youth, including Mirriam Rafiq, Eddie Cruz, Brooke Lober, Rondia Crawford, Jennifer Hecht, and Renol Ratchford, and our staff anthropologist, Ben Hickler. We also owe a debt of gratitude to the SFDPH Division of STD control for their support, particularly Lyn Fischer, Sharon Byrd, and Kate Scott. The research would not have been possible without the collaboration of those who provide services to our target population, particularly Larkin Street Youth Services and the Haight-Ashbury Youth Outreach Team. Nancy Padian contributed invaluable advice to the project. Moni Zafar provided critical space for the drafting of the manuscript. Finally, we are most grateful to the youth who participated in our project.
PY - 2006/3
Y1 - 2006/3
N2 - Purpose: Current Centers for Disease Control (CDC) guidelines recommend that sexually transmitted disease (STD) screening measures for high-risk populations such as homeless youth prioritize testing in out-of-clinic settings and incorporate new approaches to STD eradication, such as field-delivered testing and treatment and patient-delivered partner therapy (PDPT). Our non-medically trained research staff offered field-based STI testing, field-delivered therapy, and PDPT to homeless youth in the context of a longitudinal study. Methods: A total of 218 ethnically diverse (34% female) 15-24-year-old homeless youth recruited from street sites in San Francisco completed an audio computer-administered self-interview survey and provided a first-void urine sample for testing for chlamydia (CT) and gonorrhea (GC). Youth testing positive were offered field-delivered therapy and PDPT. A random subset of 157 youth was followed prospectively, of whom 110 (70%) were interviewed and 87 (55%) retested at six months. Results: At baseline, 99% of youth in the study consented to STI testing, of whom 6.9% and .9% tested positive for CT and GC, respectively. Ninety-four percent of positive youth were treated, 50% within one week. The incidence rate for CT was 6.3 per 100 person-years (95% confidence interval [CI]: 1.3-18.4) and for GC was 4.2 per 100 person-years (95% CI: .5-15.2). None of the youth treated by study staff and tested six months later (n = 6) had CT or GC on follow-up testing (95% CI: 0-131.3). Conclusions: Field-delivered testing and field-delivered therapy are feasible, acceptable and effective interventions for the diagnosis and treatment of STDs in homeless youth. These measures along with PDPT may decrease rates of subsequent reinfection.
AB - Purpose: Current Centers for Disease Control (CDC) guidelines recommend that sexually transmitted disease (STD) screening measures for high-risk populations such as homeless youth prioritize testing in out-of-clinic settings and incorporate new approaches to STD eradication, such as field-delivered testing and treatment and patient-delivered partner therapy (PDPT). Our non-medically trained research staff offered field-based STI testing, field-delivered therapy, and PDPT to homeless youth in the context of a longitudinal study. Methods: A total of 218 ethnically diverse (34% female) 15-24-year-old homeless youth recruited from street sites in San Francisco completed an audio computer-administered self-interview survey and provided a first-void urine sample for testing for chlamydia (CT) and gonorrhea (GC). Youth testing positive were offered field-delivered therapy and PDPT. A random subset of 157 youth was followed prospectively, of whom 110 (70%) were interviewed and 87 (55%) retested at six months. Results: At baseline, 99% of youth in the study consented to STI testing, of whom 6.9% and .9% tested positive for CT and GC, respectively. Ninety-four percent of positive youth were treated, 50% within one week. The incidence rate for CT was 6.3 per 100 person-years (95% confidence interval [CI]: 1.3-18.4) and for GC was 4.2 per 100 person-years (95% CI: .5-15.2). None of the youth treated by study staff and tested six months later (n = 6) had CT or GC on follow-up testing (95% CI: 0-131.3). Conclusions: Field-delivered testing and field-delivered therapy are feasible, acceptable and effective interventions for the diagnosis and treatment of STDs in homeless youth. These measures along with PDPT may decrease rates of subsequent reinfection.
KW - Adolescent
KW - Chlamydia
KW - Gonorrhea
KW - Homeless youth
KW - Screening: Incidence
KW - Sexually transmitted diseases
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U2 - 10.1016/j.jadohealth.2005.09.006
DO - 10.1016/j.jadohealth.2005.09.006
M3 - Article
C2 - 16488817
AN - SCOPUS:32644471740
SN - 1054-139X
VL - 38
SP - 208
EP - 212
JO - Journal of Adolescent Health
JF - Journal of Adolescent Health
IS - 3
ER -