Master's Project Title:

Statewide STI Testing Day 2017- Community-led Initiatives to Address STI Rates in Vulnerable Populations (Executive Summary)

MCH Student:

J'Mag Karbeah

Date of Defense:

April 28, 2017



Sexually transmitted infection (STI) rates, primary chlamydia caused by Chlamydia trachomatis and gonorrhea caused by Neisseria gonorrhoeaerates in the US have increased dramatically in the past two decades. Since 1994 Chlamydia has comprised the largest proportion of all reported STD cases in the US. In 2015, there were 1,526,658 cases of Chlamydia reported to the Centers of Disease Control and Prevention1. The majority of these cases occur in adolescents 15-242. Chlamydia rates in Minnesota saw a 61% increase from 2005-2015. During this same period, gonorrhea rates increased 8%3. Chlamydia and gonorrhea infections in Minnesota mirror national disparities with teens and young adults, and racial minorities being disproportionately effected by these infections. Recent increases are of particular concern because these infections are asymptotic and if left untreated can cause pelvic inflammatory disease (PID) in women and can lead to infertility and/or ectopic pregnancies later in life4.  Research has shown that screening can dramatically reduce the risk of PID


I worked with Communities Restoring Urban (Youth) Sexual Health (CRUSH), a Minneapolis based community collaborative of youth serving organizations to plan their 3rd annual statewide STI Testing Day. CRUSH was created in response to a 2012 Minnesota Department of Health Report highlighting increasing rates of chlamydia and gonorrhea in adolescent population in the state. In addition to highlighting age disparities, the report also recognized that Minneapolis youth were most impacted and were disproportionately represented, as were youth of color. To address these disparities and to connect young people to sexual health services in their community, CRUSH planned a citywide testing day event in 2015 using the Minneapolis School-Based Clinic’s model for walk-in STI testing. Using this model, CRUSH, along with 18 clinics, planned the first annual testing day and successful tested over 99 youth ages 13-25 for Chlamydia and Gonorrhea. In 2016 CRUSH expanded this event statewide and had over 56 clinics sign-up and administered over 900 STI tests. In 2017 the organization sought to engage more rural providers and increase the overall number of youth tested.

The primary objective of this project was to engage clinic and community partners, new and old in this observance and have them commit to raising awareness of the state’s STI rates, and to increase advocacy, education, testing, and treatment for youth ages 13-25 . This involved reaching out to clinics and youth-serving community organizations throughout the state and encouraging them to participate in this event. Using existing contacts as well as reaching out to the Family Planning Grant Specialists at MDH, over 100 clinics and youth-serving organizations were contacted and invited to participate in this year’s event. Many of these clinics were located in the metro-are and served the populations most effected by STI infections: youth of color and American Indian youth.

The next objective for this project was to work along side members of the CRUSH Statewide STI Testing Day Planning Committee to create promotional materials and publicity for the event. This committee consisted of an interdisciplinary team of public health professionals ranging from federal grant managers; youth program coordinators, to clinic staff who work directly with young people. This committee worked to develop outreach materials for clinics, update and disseminate a toolkit for clinics new to the event, host a webinar for new participants as well as administrate an event evaluation.


Community Restoring Urban (Youth) Sexual Health (CRUSH) is a collaborative of youth serving organizations formed in 2013 with the goal of mobilizing organizations and individuals and communities to eliminate STI infections in Minneapolis through advocacy, education, prevention and treatment. CRUSH believes that youth are an asset to their communities and sexual health care should be made available to all youth regardless of gender, and sexual orientation. Additionally CRUSH believes that parents and caring adults play a vital role in supporting and promoting healthy relationships and sexuality for young people.

Lessons Learned

Fifty plus clinics signed up to participate in the 2017 Statewide STI Testing Day. Clinics from all over the metro-area as well as new rural clinics signed on to participate in this year’s event. The biggest take away from this event is that clinics, both rural and urban understand the importance of increasing awareness and activating youth to take control of their sexual health. To best support health service providers serving youth by publicizing this event and getting financial support from health plans. Clinics have systems in place that allow them to provide free testing services to youth but often find it difficult to provide treatment for youth who test positive. Statewide health plans have shown interest in support this initiative by publicizing it in their newsletters but could significantly impact this event by subsidizing the costs of treatment services. As this event continues to grow and more young people seize this opportunity, treatment options were made available to them in addition to testing and educational information. Although our primary stakeholders were clinics, having health plans participate more actively in this project and increase it’s reach and effectiveness.


CRUSH’s work to date has shown that clinics and community partners are enthusiastic about increasing the access that young people have to sexual health services and STI testing. Additional support and publicity is needed to engage community partners as well as adolescents in combating rising STI rates in Minnesota. To increase awareness of the state STI rates as well as CRUSH’s annual event to increasing testing and treatment for this vulnerable populations the following recommendations should be considered:

  • Develop and leverage relationships with state health plans early in ways that benefit both partners
  • Develop incentives for clinics that are more relevant to their needs
  • Provide financial support to clinics that will allow them provide low-cost treatment to adolescents who test positive for STIs during CRUSH’s Statewide STI Testing Day Event  


CRUSH is a community collaborative comprised of public health professionals and health service providers committed to reducing the rates of STI infections in Minneapolis adolescent populations, and in Minnesota through it’s annual STI testing day. Events like statewide STI testing days raise awareness and allow young people to easily access testing services. CRUSH has accomplished a lot considering how limited its funding is, and could significantly impact STI rates in the state given additional support from other entities.


  1. Centers for Disease Control and Prevention (2015). 2015 Sexually Transmitted Disease Surveillance. Retrived from:
  2. Cuffe, K. M., Newton-Levinson, A., Gift, T. L., McFarlane, M., & Leichliter, J. S. (2016). Sexually transmitted infection testing among adolescents and young adults in the United States. Journal of Adolescent Health58(5), 512-519.
  3. Minnesota Department of Health (2015). 2015 Minnesota Sexually Transmitted Disease Statistics. Retrived from:
  4. Stamm WE. Chlamydia trachomatis infections in the adult. Sexually Transmitted Diseases. 4th ed. New York, NY: McGraw-Hill; 2008. p. 575-606.