(P89) CHLAMYDIA AND GONORRHEA SCREENING AND TREATMENT AMONG UNACCOMPANIED CHILDREN IN THE CARE OF THE U.S. OFFICE OF REFUGEE RESETTLEMENT — UNITED STATES, JANUARY 1, 2021–DECEMBER 31, 2023

Background:
During 2021–2023, an average of 120,000 Unaccompanied Children (UC) were referred to the Office of Refugee Resettlement (ORR) each year. UC are a uniquely vulnerable group of minors (aged <18 years) with no lawful immigration status and no guardian to assume custody at the time of U.S. entry. While in ORR custody, UC receive an initial medical exam (IME) and those reporting sexual activity are screened for sexually transmitted infections (STIs) including chlamydia and gonorrhea. This report describes sexual activity, chlamydia and gonorrhea screening, test-positivity, and treatment rates among UC.

Methods:
Children’s health data is stored on a web-based platform called the UC Portal. Data on reported sexual activity, chlamydia and gonorrhea test results, and CDC-recommended treatments were queried for all children in ORR custody who received an IME during January 1, 2021–December 31, 2023. Simple percentages were calculated to assess the following proportions: children reporting sexual activity, sexually active children receiving chlamydia and gonorrhea tests, positive results among those screened, and children with a positive test receiving recommended treatment while in ORR care.

Results:
During 2021–2023, 324,310 children were admitted to ORR and received an IME; 21.1% (n=68,331) reported sexual activity. Among minors reporting sexual activity, 93.9% were aged 15–17 years and 59.6% were male. Nearly all sexually active minors were screened for chlamydia (97.9%) and gonorrhea (97.7%); 8.9% (n=5,926) of screened minors were diagnosed with chlamydia and 0.5% (n=355) with gonorrhea. Almost all minors diagnosed with infection were treated while in ORR care (chlamydia: 97.6%; gonorrhea: 95.5%).

Conclusion:
The test-positivity of chlamydia and gonorrhea among children in ORR care is comparable to rates reported in prior studies for American youth, ranging from 3.7%–10% for chlamydia and 0.3%–0.5% for gonorrhea. ORR is successful in screening and treating this vulnerable population for chlamydia and gonorrhea infections.