The Howard County Health Department (HCHD) is the local health department for Howard County Maryland. Howard County is located in central Maryland. Howard County has a population of approximately 321,113 residents which are 51% female, 49% male, 62% 19-64 years of age, 25% 18 years and younger, and 13% 65 years and over. The racial/ethnic demographics are approximately 57% White, 20% Black, 19% Asian, 4% Two or More Races, 0.4% American Indian and Alaska Native, 0.1% Native Hawaiian and Other Pacific Islander and 7% Hispanic. The median household income is $115,576. Approximately 6% of persons live in poverty.
Nationally, the rate of sexually transmitted infections (STIs) has increased and disproportionately effects adolescents and young adults ages 15-24. This trend has occurred in Maryland and Howard County. In Howard County the numbers of cases of both chlamydia and gonorrhea have nearly doubled in teens ages 15 and up. In response this growing public health issue, HCHD formed a community partnership with Howard County Public School System (HCPSS), and Maryland Department of Health (MDH) with the goal of launching an awareness campaign to inform high school students about prevention of STIs, risks of STIs and offer free, confidential screening tests and access to treatment. The overall initiative falls within our Teen STI Communication Plan. The initiative utilizes I Want the Kit (IWTK), funded by the MDH and test kits provided by Hopkins University. IWTK provides self-collection STI testing kits that include swabs to test for chlamydia and gonorrhea.
Through the initiative information about the health risks of STIs and how to access free, confidential testing is posted in all high school counseling and nurses' office, school restrooms and locker rooms. Students log into the IWTK website to request a free STI testing kit. The STI testing kits are either mailed to high school nurse's office or to the student's home. Students requesting the test kit and receiving test results remain confidential. Test results are shared with the student, MDH and HCHD as part of state communicable disease reporting laws.
The outcomes of the practice are to implement free, confidential school-based STI testing in HCPSS high schools and have 200 test kits mailed and submitted for STI screening. As of December 12, 2018, 44 kits have been mailed. The initiative is planned for September 25, 2018 through June 30, 2019.
The factors that have led to the success of this initiative included support of partner agency leadership, multiagency partnership, scheduling regular partner meetings to provide project updates and gain input and oversight of project, commitment to address growing public health concern of STIs in adolescents and utilization of data and surveillance to provide the evidence for the need for the initiative and tracking results.
The public health impacts of the practice are policy change on the part of HCPSS to allow STI testing in schools which have led to increased access and availability of STI testing and increased self-efficacy for teens through behavior change, requesting STI test kits and self-testing.
The website for the organization is hchealth.org.