Community-based seek, test and treat intervention to reduce Chlamydia trachomatis among Black youth in New Orleans, Louisiana: an implementation study protocol

Abstract: Chlamydia trachomatis (Ct) is the most commonly reported bacterial sexually transmitted infection (STI) in the USA with over 1.8 million cases each year. Ct can cause genital symptoms, pelvic inflammatory disease and infertility and can amplify HIV risk. African Americans (AAs) are seven times more likely than White Americans to be infected. The Centers for Disease Control and Prevention recommends screening sexually active women under 25 years of age and men in high prevalence populations, yet many young people are not screened. We hypothesise that screening AA youth in the community will reduce Ct rates in the community in a feasible and cost-effective manner.

Methods and analysis: This implementation study will test 2322 AA youth aged 15–26 years in Orleans Parish, Louisiana, for genital and pharyngeal Ct and Neisseria gonorrhoeae (GC), syphilis and HIV. Individuals who test positive for genital Ct, genital GC or pharyngeal Ct will be offered expedited index and partner treatment for themselves and up to five sexual partners. Those who test positive for HIV, syphilis or pharyngeal GC will be referred to partnering clinics for treatment. The study will include two visits: baseline for all and 3 month rescreening for those who tested positive for Ct or genital GC at baseline. Using Medicaid data, we will compare the rate of Ct among women in the intervention parish with those in control parishes over the study period. Secondary aims will examine feasibility of mailing home testing kits, uptake of partner treatment and cost-effectiveness. We will track how many participants accept testing, expedited treatment for themselves and their partners, peer referral and how much the programme costs using time motion analyses.