Health officials unveiled a program Wednesday that will target young women in Los Angeles County by offering home delivery of STD testing kits and a text message to alert them when the results are ready online.
"Adolescents traditionally have not used health services the way they need to," said Dr. Jonathan Fielding, the county's public health director. "We need to use media tools and be part of the way people communicate who are that age."
The program expands on a model piloted by Johns Hopkins School of Medicine researchers in Baltimore who conducted a six-month study in 2004 using mail-in tests.
Health officials in Los Angeles County hope their program can curb the alarming spread of gonorrhea and chlamydia. According to the most recent statistics available from the Centers for Disease Control and Prevention, Los Angeles County led the nation in 2007 in reported chlamydia cases at 44,030, and ranked second in the number of gonorrhea cases at 10,063.
Peter Kerndt, director of the county's sexually transmitted disease program, says those numbers are expected to climb upon the program's implementation.
More than half the cases involve women under 25, with many teenage African American girls and Latinas in South Los Angeles, Fielding said. Women under 25 are recommended for testing once a year.
Under the program, women can request testing kits to detect chlamydia or gonorrhea by visiting a Web site or calling a toll-free number, and the kits are then mailed to addresses provided.
To administer the test, women insert a vaginal swab for 10 seconds, seal the swab in a plastic tube and mail it to a testing center. The samples are testable for up to two weeks.
Women can opt to receive a text message alert when their test results are available, which they can check via phone or on the Web. If needed, they are referred to a local clinic for help.
The CDC calls chlamydia a hidden epidemic that affects millions of unwitting women, despite the fact it can easily be cured with antibiotics. Oftentimes, affected women exhibit no symptoms.
It's estimated that 3 million men and women contract chlamydia every year, though health consequences in women can be much more severe, with the disease causing infertility, higher incidence of ectopic pregnancies and other problems.
Privacy needs and wide availability dictate that the Internet is a good approach, especially when dealing with teenage girls, said Dr. Carrie Terrell, director of obstetrics and gynecology at the University of Minnesota.
"Any time we can save people the cost and hassle of an office visit, I think we can improve the screening rates of any STD," Terrell said.
Since 2004, the Baltimore program has screened about 1,800 women and 500 men for chlamydia and gonorrhea, said Dr. Charlotte Gaydos, who leads the program and has studied chlamydia for 20 years.
Similar programs have been implemented in Maryland, Washington, D.C., Denver, West Virginia, and select counties in Illinois.
Gaydos said her program will need funding to continue and to match the level of services provided by Los Angeles County - including receiving results via Internet and text messages to report test results.
The Los Angeles program is funded by $450,000 of local funds and is designed to eliminate clinic waits or costs. There will be 10,000 kits available immediately, and county Supervisor Zev Yaroslavsky said more will be made available when needed.