Routine screening for chlamydia at colleges essential

College freshmen under the age of 20 at several colleges in the southeastern U.S. were almost 70 percent more likely to test positive for chlamydia than students between 20 and 24 years of age, according to findings by Adelbert James, PhD, MPH, senior associate in the Department of Gynecology and Obstetrics at Emory University School of Medicine.

Dr. James will present results of his data analysis at the 2006 National STD Prevention Conference in Jacksonville, Fla. His effort is the first regional evaluation of chlamydia prevalence on college campuses.

The screening, conducted by student health centers in April 2004, included 789 students (263 freshmen), who were screened voluntarily for chlamydia at 10 colleges in Alabama, Georgia and Mississippi. Due in part to the participation of several historically black colleges, the majority of participants were African American (80.2 percent), with more than half of the students screened being female (57 percent). The average age of participants was 21.7.

While chlamydia prevalence in all students tested was 9.7 percent, prevalence among the 263 freshmen was 13 percent. Dr. James, who directs the Centers for Disease Control and Prevention (CDC)-sponsored Region IV Infertility Prevention Project, says it is critical for student health centers to provide chlamydia screening and treatment services. He says it is just as important to educate college freshmen and other students about STD risks and prevention strategies.

"The CDC recommends that women under the age of 25 who is sexually active and engages in unprotected sex be tested for chlamydia," he says. "This is very important, because chlamydia causes ectopic pregnancies and infertility in young women; it is asymptomatic in 80 percent of women and 50 percent of men. It's especially important for college students, many of whom exhibit high risk sexual behavior and don't use condoms very often. It's imperative that they protect themselves."

Typically, student health centers only provide chlamydia testing and treatment to students with symptoms of the disease.

"These findings underscore the importance of providing chlamydia education, screening and testing services to all students, with efforts targeting freshmen, in particular," Dr. James says. "Since our initial findings, a few colleges have begun routine screening for chlamydia."

The project intends to expand annual monitoring of chlamydia prevalence on college campuses. In order to better determine whether freshmen are arriving at school with infection or becoming infected at college, the project may begin measuring prevalence at the start of the school year rather than in the spring. This will help determine whether additional chlamydia outreach and prevention programs should be focused on high school students, as well as college freshmen.