By Darryl Fears and Nelson Hernandez
Washington Post Staff Writers
Wednesday, August 5, 2009; A01
D.C. school officials are planning to offer tests for sexually transmitted diseases to all high school students in the coming school year, expanding a pilot program that uncovered a significant number of infected children.
The program conducted last year at eight high schools found that 13 percent of about 3,000 students tested positive for an STD, mostly gonorrhea or chlamydia, according to the D.C. Department of Health.
The expansion places D.C. public schools in the vanguard of a growing number of urban school districts that test adolescents for STDs. About 12,000 students attend public high schools in the District.
STDs are of particular concern to AIDS activists because they increase the risk of contracting HIV. The testing program was hailed in a report being released Wednesday by the D.C. Appleseed Center for Law and Justice as a positive step in the city's effort to arrest its growing AIDS rate, which is the highest in the nation and is considered an epidemic. Half of the city's cases of chlamydia and gonorrhea are among adolescents.
The program, which has been discussed by the D.C. school board, requires students to attend a lecture about STDs, but they can opt out of providing a urine sample for the test. All 50 states and the District allow minors older than 12 to be screened for STDs without parental consent.
"The program tells us that a lot of students in the public school system are engaging in unsafe sex," said Walter Smith, executive director of D.C. Appleseed, which advocates for more AIDS outreach and education in the schools. "If 13 percent of these students are testing positive for STDs, those same kids could get HIV. A lot needs to be done to get the message out to the schools . . . and this very high STD rate is an indication that what we've been doing is not effective."
In a 2007 study by the D.C. public school system, 60 percent of high school students and 30 percent of middle school students reported having had intercourse. Twenty percent of the high school students said they had had sex with four or more partners, and 12 percent of the middle school students said they had had three or more partners.
The D.C. schools first offered the tests two years ago at two charter schools. Health department workers presented a lecture on STDs to groups of 20 to 30 students in grades 9 through 12; none of the students was younger than 15. After the lecture, students were invited to submit urine samples for chlamydia and gonorrhea testing at a health department laboratory.
Of 987 students who attended the lectures, 68 percent submitted urine specimens, according to a report. Of those students, 9 percent tested positive for at least one STD.
Test results were provided confidentially by telephone, and the city paid for treatment at the school or an STD clinic. Students who decided to be treated by a family physician were responsible for their own payments. Students were counseled about STDs and HIV prevention, were given notification cards to inform partners of the positive diagnosis and were encouraged to share the results with their parents.
In the past school year, the program was modified and expanded to eight high schools: Ballou, Banneker, Anacostia and Dunbar high schools, Moore Academy and Choice Academy, and two charter schools, Rock Creek Academy and High Road Academy. In those schools, a 45-minute lecture was given, followed by a question-and-answer period, officials said.
Chad Ferguson, deputy chief of youth engagement for the D.C. schools, said the tests are administered by taking groups of 15 to 20 students at a time to the restroom area. The students are given paper bags containing urine collection cups and enter bathroom stalls. Once they get in the stalls, they can choose whether or not to provide urine samples. All the students return the paper bags, so other students do not necessarily know who did or did not provide a sample. Students provide a password and then call in a week later to get their result and treatment, if necessary.
The D.C. testing program is a near copy of a Philadelphia program that began in 2002. In the 2004-05 school year, 30,000 students in 53 high schools attended presentations, and 16,000 submitted specimens for testing, according to a report by the Philadelphia Department of Health. More than 4 percent tested positive for chlamydia, gonorrhea or both.
School systems in New York, Chicago, New Orleans and Baltimore, among others, either perform screening for sexually transmitted diseases or are preparing to begin pilot programs. In Baltimore, no parental consent is required. In New York, parents can elect to not have their child tested. In New Orleans, a parent must give consent for a child to take the test.
"We have Third World statistics in terms of our HIV issues, and from the HIV perspective, we do need to find a way to identify students so that we can help them," said William Lockridge, a member of the State Board of Education representing Ward 8.
But he said parents need to be involved. "Right now, if you play sports in a public school, you have to get permission from your parents. If you take a field trip, you have to get permission from your parents. Why would it be any less for this? . . . Only if the parent gives the consent upfront would I do this."
D.C. Council member David A. Catania (I-At Large) offered a different viewpoint. "This isn't necessarily intended to comfort adults," said Catania, who chairs the health committee. "I don't think you turn a blind eye and pretend these problems don't exist."
Catania said he has not heard much community opposition to the testing. "In this regard, I find our population to be extremely secure," he said. "I'm not condoning this behavior. I don't think young people are equipped for the consequences of engaging in sex, but the fact is that they do."
Chlamydia is the most commonly reported disease in the United States, according to the Centers for Disease Control and Prevention. More than 1.1 million new cases were reported in 2007, up from 1 million the previous year.
Because the condition is mainly asymptomatic, most cases of chlamydia go undiagnosed. The CDC estimates that there are actually about 2.8 million new cases of chlamydia in the country each year, indicating that more than 1 million are undiagnosed. Symptoms include an inflamed pelvis and chronic pelvic pain, similar to symptoms for gonorrhea.