Screening sexually active adolescents for Chlamydia trachomatis: what about the boys?

Abstract

Objectives: We sought to determine the effectiveness of a systems-based intervention designed to increase Chlamydia trachomatis (CT) screening among adolescent boys.

Methods: An intervention aimed at increasing CT screening among adolescent girls was extended to adolescent boys (14-18 years). Ten pediatric clinics in a health maintenance organization with an ethnically diverse population were randomized. Experimental clinics participated in a clinical practice improvement intervention; control clinics received traditional information on screening.

Results: The intervention significantly increased CT screening at the experimental sites from 0% (baseline) to 60% (18-month posttest); control sites evidenced a change only from 0% to 5%. The overall prevalence of CT was 4%.

Conclusions: Although routine CT screening is currently recommended only for young sexually active women, the present results show that screening interventions can be successful in the case of adolescent boys, among whom CT is a moderate problem.

FIGURE 1—

Urine-based Chlamydia trachomatis screening rates among sexually active male adolescents. Note. Error bars indicate 95% confidence intervals. Participants were categorized as sexually active by means of an anonymous survey conducted after their routine checkups.