Young men's preferences for sexually transmitted disease and reproductive health services in San Francisco, California.

We explored STD (sexually transmitted disease) service preferences among 108 African-American adolescent males recruited from a high-morbidity neighborhood. Participants largely preferred to seek care at traditional STD testing venues (86.5%) rather than nontraditional venues. Additionally, most males preferred receiving STD test results from a clinician (61.1%) rather than online (11.1%) or through email or text message (12.0%). These results highlight the need for continued strengthening of traditional public health clinics to ensure capacity to meet young men's health needs and to improve outreach and access to traditional STD services for young men.

Youth united through health education: building capacity through a community collaborative intervention to prevent HIV/STD in adolescents residing in a high STD prevalent neighborhood.

The early detection and treatment of STDs is an effective strategy for slowing the sexual transmission of HIV. The goal of the YUTHE (Youth United Through Health Education) program, a collaborative effort between the San Francisco Department of Public Health (SFDPH) and the University of California, San Francisco, is to increase sexually transmitted disease screening and treatment among adolescents in a neighborhood with a high incidence of STDs in San Francisco. Youth health educators residing in the intervention neighborhood recruited sexually active youth between the ages of 12 and 22 years to participate in the YUTHE program's intervention between January 2001 and May 2002. Sixty-three percent had two or more sexual partners, 47% did not use condoms consistently, and 18% had a history of STDs. When the intervention neighborhood was contrasted with a sociodemographically matched comparison neighborhood results indicate that both females and males in the YUTHE intervention neighborhood were significantly less likely to have Chlamydia trachomatis infection than their counterparts in the comparison neighborhood.

Youth United Through Health Education: community-level, peer-led outreach to increase awareness and improve noninvasive sexually transmitted infection screening in urban African American youth.

PURPOSE: To evaluate the effectiveness of the Youth United Through Health Education (YUTHE) program, a community-level, peer-led outreach program to increase awareness and improve noninvasive sexually transmitted infection (STI) screening in youth residing in the targeted community. METHODS: Sexually experienced youth, aged 12-22 years, anonymously participated in the YUTHE program (a 15-minute encounter, including a risk assessment with feedback and prevention messages). A street- and venue-based intercept approach using a nonequivalent control group design was implemented to evaluate the YUTHE program. RESULTS: YUTHE community respondents were more likely to know that STIs could be asymptomatic (odds ratios [OR] 1.36, 95% confidence interval [CI] 1.08-1.72), know about urine-based STI screening tests (OR 1.34, 95% CI 1.04-1.72), perceive themselves to be at risk for STIs (OR 1.71, 95% CI 1.11-2.62), and worried about acquiring an STI (OR 1.50, 95% CI 1.04-2.18). No other community differences were identified. However, respondents who reported a single contact (OR = 2.12, 95% CI = 1.11-4.03) or multiple contacts (OR 2.78, 95% CI 1.81-4.26) with the YUTHE program were more likely to have been tested for STIs in the previous six months. CONCLUSIONS: We did not accomplish our overall goal of increasing STI screening in our outreach community relative to the comparison community; our findings suggest that a peer-led, street- and venue-based community outreach approach is a feasible means for reaching large numbers of adolescents for STI prevention.

"Street medicine": Collaborating with a faith-based organization to screen at-risk youths for sexually transmitted diseases.

Chlamydia and gonorrhea rates among African American youths in San Francisco are far higher than those among young people of the city's other racial and ethnic groups. A geographically targeted sexually transmitted disease education and screening intervention performed in collaboration with a local faith-based organization was able to screen hundreds of at-risk youths. The screened individuals included friends and sex partners from an extensive social-sexual network that transcended the boundaries of the target population. The intervention also provided an excellent opportunity to practice "street medicine," in which all screening and treatment was effectively conducted in the field.