The prevalence and treatment of chlamydia (CT) and gonorrhea (GC) at school-based clinics (SBCs) requires revisiting. To assess whether clinic type influences CT/GC testing and treatment for minors (individuals 13–17 years of age), our study compared four SBCs with five family planning clinics (FPCs) in the Houston, Harris County metropolitan area of Texas, USA for: (1) the prevalence of CT/GC infection (pre-COVID-19 and during COVID-19); (2) treatment rates at the last positive diagnosis; and (3) the time, in days, from testing-to-diagnosis and testing-to-treatment. Between January 2019 and December 2020, 2439 unique patients (1579 at SBCs, 860 at FPCs) were seen. Of the 1924 tests obtained, 39.2% and 15.9% were positive for CT and GC, respectively. The prevalence of CT and GC at SBCs was similar prior to COVID-19 vs. during the COVID-19 pandemic. SBCs were able to provide treatment significantly faster after diagnosis (mean, 6.07 days; 95% CI, 3.22–8.90; 94.7% were within 30 days) than FPCs (mean, 17.60 days; 95% CI, 10.15–25.12; 84.7% were within 30 days) (p = 0.0257). This comparison within our large clinic system, with consistent clinical management protocols, suggests that SBC care may be critical to ensuring optimal sexually transmitted infection management in minors.

This quality-improvement initiative evaluated procedures to increase parental consent for students, 13 to 18+ years old, to access a school-based health clinic that provides primary and reproductive health care in a Hispanic immigrant neighborhood in the U.S. Southwest. Six consent-retrieval procedures were sequentially implemented. Procedures included school registration, competition, hand delivery, PTO meetings, self-consent, and mail. Age, grade, and number of completed consents were calculated and compared. The percentage of students with completed consents increased from 35% to 72%. Lessons learned include increasing the number of completed consents is difficult; however, it is important to increase students’ access to health-care services.

Objectives: To preliminarily compare health care utilization, sexual behaviors, and sexual health outcomes among high school students accessing school-based health centers (SBHCs) vs. non-SBHCs and develop an initial hypothesis on the potential impact of SBHCs. Design: Retrospective chart review. Setting: Three SBHC locations and 5 non-SBHCs locations within an adolescent and young adult health center system in Houston, Texas. Participants: Random sample of 189 high school students receiving care between August 2022 and May 2023 at a SBHC (n = 129) or non-SBHCs (n = 60). Main Outcome Measure: Demographic characteristics, health center utilization patterns, sexual behaviors, and sexual health outcomes, including sexually transmitted infection (STI) testing and results. Results: Students accessing SBHCs were more likely to be male (35.9% vs. 21.7%, P = .03) and Spanish-speaking (24.8% vs. 8.3%, P = .01) compared with students accessing non-SBHCs. Students accessing SBHCs also tended to be uninsured at higher rates (70.3% vs. 54.7%, P = .06), although the difference was not statistically significant. SBHC users were less likely to report having a primary care provider (22.5% vs. 41.7%, P = .01) or being sexually active (30.2% vs. 60.0%, P < .001). No significant differences were observed in STI testing rates or STI outcomes between groups. Conclusions: These preliminary data show that SBHCs serve adolescents with greater structural barriers to health care, including lack of insurance and limited access to primary care. SBHCs can be accessible points of care within schools that address disparities in health care access. Continued investment and expansion of SBHCs may have positive implications strengthen public health systems by improving access to preventive and sexual health services for underserved youth. Further research is needed to explore correlations between student utilization of health care to SBHC access.