Background: Sensitive urine tests have substantial public health promise for detection and control of gonorrhea and chlamydia. Urine-based testing is more acceptable than existing tests for screening asymptomatic patients in private practice clinics.
Methods: As part of a community-oriented STD prevention program, lab tests for urine samples were offered free to medical providers at a young men's clinic and a general practice ambulatory care network located in Northern Manhattan. From June through November 2000, a period that coincided with the introduction of urine screening, we tracked results of 639 urine tests. Of these, 386 were for patients ages 12-35.
Results: Most samples were from asymptomatic patients, 77% of all patients and 83% among patients 12-35. Fifty-two samples tested positive for chlamydia and 3 for gonorrhea. All but 8 positive samples were from patients under 36. Chlamydia incidence was equal for males, 11.6%, and females 11.4%. Among this younger group 64% of the chlamydia cases came from asymptomatic patients.
Conclusion: These findings offer encouraging support for the public health benefits of STD urine testing in private practice clinics. We observed a rapid increase in physician STD screening behavior following the introduction of urine testing, which in turn resulted in a dramatic increase in early detection of STDs. These results underscore the high level of undetected chlamydia in both asymptomatic males and females in the study community. In further research, we plan to evaluate provider and patient interventions intended to stimulate STD screening in sexually active, but asymptomatic populations (including cost-effectiveness analyses).
Learning Objectives: 1. The participant will be able to assess the value of LCR urine screening for chlamydia and gonorrhea detection in asymptomatic adolescents and young adults. 2. The participant will be able to describe the rates of asymptomatic gonorrhea and chlamydia in an urban community at high risk for STDs.
Keywords: STD, Surveillance
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.