24 results
Search Results
2. Sexual behaviour, sexually transmitted infections and attitudes to chlamydia testing among a unique national sample of young Australians: baseline data from a randomised controlled trial.
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Kang, Melissa, Rochford, Arlie, Skinner, S. Rachel, Mindel, Adrian, Webb, Marianne, Peat, Jenny, and Usherwood, Tim
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SEX customs ,CHLAMYDIA infections ,SEXUALLY transmitted disease risk factors ,SEXUAL intercourse ,MEDICAL informatics ,RANDOMIZED controlled trials - Abstract
Background Chlamydia infection is the most common notifiable sexually transmitted infection (STI) in Australia and mostly affects young people (15 - 25 years). This paper presents baseline data from a randomised controlled trial that aimed to increase chlamydia testing among sexually active young people. The objectives were to identify associations between sexual behaviour, substance use and STI history and explore attitudes to chlamydia testing. Methods This study was conducted in cyberspace. Study recruitment, allocation, delivery of interventions and baseline and follow up data collection all took place online. Participants were 16 - 25 years old and resided in Australia. Substance use correlates of sexual activity; predictors of history of STIs; barriers to and facilitators of chlamydia testing were analysed. Results Of 856 participants (79.1% female), 704 had experienced penetrative intercourse. Sexually active participants were more likely to smoke regularly or daily, to drink alcohol, or to have binge drunk or used marijuana or other illicit substances recently. Risk factors for having a history of any STI were 3 or more sexual partners ever, 6 or more partners in the past 12 months, condom non-use and being 20 years or older. Almost all sexually active participants said that they would have a chlamydia test if their doctor recommended it. Conclusions Sexually active young people are at risk of STIs and may engage in substance use risk behaviours. Where one health risk behaviour is identified, it is important to seek information about others. Chlamydia testing can be facilitated by doctors and nurses recommending it. Primary care providers have a useful role in chlamydia control. [ABSTRACT FROM AUTHOR]
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- 2014
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3. Pay-it-forward gonorrhea and chlamydia testing among men who have sex with men and male STD patients in China: the PIONEER pragmatic, cluster randomized controlled trial protocol
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Marley, Gifty, Tan, Rayner Kay Jin, Wu, Dan, Wang, Tong, Sun, Murong, Sheng, Qilei, Holly, Margaret Elizabeth, Hlatshwako, Takhona Grace, Wang, Cheng, Tang, Weiming, Ramaswamy, Rohit, Yang, Ligang, Luo, Danyang, Sylvia, Sean S., Gray, Kurt, Van Duin, David, Zheng, Heping, and Tucker, Joseph D.
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- 2023
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4. Mathematical modeling study of school-based chlamydia screening: potential impact on chlamydia prevalence in intervention schools and surrounding communities
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Rönn, Minttu M., Dunville, Richard, Wang, Li Yan, Bellerose, Meghan, Malyuta, Yelena, Menzies, Nicolas A., Aslam, Maria, Lewis, Felicia, Walker-Baban, Cherie, Asbel, Lenore, Parchem, Sarah, Masinter, Lisa, Perez, Ernestina, Gift, Tom L., Hsu, Katherine, Barrios, Lisa C., and Salomon, Joshua A.
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- 2020
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5. The characteristics of patients frequently tested and repeatedly infected with Chlamydia trachomatis in Southwest Limburg, the Netherlands
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Wijers, Juliën N. A. P., Dukers-Muijrers, Nicole H. T. M., Hoebe, Christian J. P. A., Wolffs, Petra F. G., and van Liere, Geneviève A. F. S.
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- 2020
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6. Community engagement on-site rapid test for chlamydia and gonorrhea among men who have sex with men: a pioneering study in Guangzhou, China.
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Lin, Xiao-Xin, Meng, Si-Yan, Ke, Wu-Jian, Zhang, Xiao-Hui, Wang, Liu-Yuan, Liao, Yu-Ying, Liu, Han, Zhao, Pei-Zhen, Liang, Chun-Mei, Chen, Hui-Ru, Long, Hai-Ying, Yang, Bin, and Yang, Li-Gang
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Background: Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) infections are prevalent among men who have sex with men (MSM) in China. However, compared to syphilis and HIV, the testing rate for chlamydia and gonorrhea remains low. The purpose of this pilot study was to evaluate the feasibility for conducting rapid nucleic acid test for chlamydia and gonorrhea in MSM community-based organizations (CBO).Method: We recruited our participants through an MSM CBO where free HV and syphilis testing were routinely provided. We collected data including social-demographic background, sexual history, chlamydia and gonorrhea testing history, and reasons for accepting this on-site rapid testing. Urine and/or anorectal swab samples were collected and tested for chlamydia and gonorrhea on-site and the testing results were delivered in about 1.5 h. Positive cases received on-site free treatment.Results: From August 2020 to October 2020, 634 MSM visited the CBO for syphilis and HIV testing and 158 (158/634, 24.9%) accepted the on-site chlamydia and gonorrhea rapid test, 135 were finally enrolled. The positive rate fo chlamydia was 16.3% (22/135) and 3.0% (4/135) for gonorrhea, respectively. Only 19.3% participants had previously undergone chlamydia and gonorrhea testing and 68.9% (93/135) participants reported that they had heard of gonorrhea, 47.4% (64/135) had heard of chlamydia. The main reason for testing was "free for charge" (66.2%), followed by "convenient, 'shorter waiting time" (45.2%) and "had high-risk sexual behavior recently" (16.3%).Conclusions: This pilot study showed that the chlamydia and gonorrhea infection rate remains high among MSM, while the testing rate was low. On-site rapid testing is feasible and potentially preferred by MSM. [ABSTRACT FROM AUTHOR]- Published
- 2022
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7. Uptake and correlates of chlamydia and gonorrhea testing among female sex workers in Southern China: a cross-sectional study.
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Zhao, Pei Zhen, Wang, Ya Jie, Cheng, Huan Huan, Zhang, Ye, Tang, Wei Ming, Yang, Fan, Zhang, Wei, Zhou, Ji Yuan, and Wang, Cheng
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SEX workers ,CHLAMYDIA ,GONORRHEA ,CONDOMS - Abstract
Background: Female sex workers (FSW) are highly susceptible to chlamydia and gonorrhea infection. However, there is limited literature examining their testing uptake to date. This study aimed to assess the uptake and determinants of chlamydia and gonorrhea testing among FSW in Southern China.Methods: A cross-sectional study with convenience sampling was performed in five cities in Southern China. Data on socio-demographic characteristics, sexual behaviors, chlamydia and gonorrhea testing, and the utilization of health care services from participants were collected through face-to-face interviews. Univariate and multivariable logistic regressions were used to determine factors associated with chlamydia and gonorrhea testing, respectively.Results: Overall, 1207 FSWs were recruited, with the mean age of 30.7 ± 6.8 years and an average number of clients of 7.0 (4.0-10.0) per week. 65.4% participants constantly used condoms with clients during the past month. Only 7.5 and 10.4% had been tested for chlamydia and gonorrhea in the last year, respectively. Multivariable analysis indicated that FSW who worked at low tiers (adjusted Odds Ratio (aOR) = 2.36, 95%CI:1.23-10.14), had more clients in the last month (aOR = 1.03, 95%CI:1.01-1.05), used condoms consistently (aOR = 1.79, 95%CI:1.12-2.86), had STD symptoms (aOR = 4.09,95%CI:2.62-6.40), had been tested for HIV (aOR = 5.16, 95%CI:3.21-8.30) or syphilis (aOR = 6.90, 95%CI:4.21-11.22) in the last year were more likely to have chlamydia testing. In addition, FSW who had more clients in the past month (aOR = 1.02,95%CI:1.00-1.04), had STD symptoms (aOR = 3.33, 95%CI:2.03-5.46), had been tested for HIV (aOR = 3.94, 95%CI:2.34-6.65) and syphilis (aOR = 3.27, 95%CI:1.96-5.46) in the last year were more likely to have gonorrhea testing.Conclusions: The testing rates of chlamydia and gonorrhea are low among Chinese FSW. Integrating chlamydia and gonorrhea testing into HIV testing promotion programs may help bridge the gap among FSW. [ABSTRACT FROM AUTHOR]- Published
- 2021
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8. Lack of sexual behavior disclosure may distort STI testing outcomes.
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Kumar, Navin, Forastiere, Laura, Zhang, Tiange, Yang, Fan, Li, Katherine T., Tang, Weiming, Tucker, Joseph D., Christakis, Nicholas A., and Alexander, Marcus
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HUMAN sexuality ,MEN who have sex with men ,SEXUALLY transmitted diseases ,RANDOMIZED controlled trials ,CHLAMYDIA ,SEXUALLY transmitted disease diagnosis ,EPIDEMIOLOGY of sexually transmitted diseases ,DISCLOSURE ,CROSS-sectional method ,SOCIAL stigma ,HOMOSEXUALITY ,SEX customs ,DISEASE prevalence - Abstract
Background: Men who have sex with men (MSM) globally have a high burden of curable sexually transmitted infections (STIs). MSM do not frequently receive rectal STI testing because of several barriers, such as not being out (disclosure of sexual behavior). We evaluate whether Chinese MSM select an STI test (rectal vs urethral) appropriate for their sexual behavior (insertive and/or receptive), and the interactions with being out.Methods: This was a secondary analysis of data from a cross sectional MSM survey conducted at a multisite randomized controlled trial (RCT) (December 2018 to January 2019) around uptake of gonorrhea and chlamydia testing among Chinese MSM (N = 431). We collected socio demographics, relevant medical and sexual history, and disclosure of sexual behavior (outness). We estimated the decision to test and test choice, and the extent to which disclosure plays a role in decision making.Results: Among 431 MSM, mean age was 28 years (SD = 7.10) and 65% were out to someone. MSM who indicated versatile sexual behavior and were out to someone had a 26.8% (95%CI = 6.1, 47.5) increased likelihood for selecting the rectal test vs the ure thral test, compared to those versatile and not out. Versatile MSM out to their health provider outside of the study context had a 29.4% (95%CI = 6.3, 52.6) greater likelihood for selecting the rectal STI test vs the urethral test, compared to versatile MSM not out to their health provider.Conclusions: Sexual behavior and outness may affect gonorrhea and chlamydia testing provision. Apart from clinicians, community based efforts may reduce stigma based barriers to testing. [ABSTRACT FROM AUTHOR]- Published
- 2020
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9. Service evaluation of an educational intervention to improve sexual health services in primary care implemented using a step-wedge design: analysis of chlamydia testing and diagnosis rate changes.
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Town, Katy, McNulty, Cliodna A. M., Ricketts, Ellie J., Hartney, Thomas, Nardone, Anthony, Folkard, Kate A., Charlett, Andre, and Dunbar, J. Kevin
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CHLAMYDIA ,SEXUAL health ,DIAGNOSIS of HIV infections ,PRIMARY care ,CONDOM use ,CHLAMYDIA infection diagnosis ,CHLAMYDIA infections ,COMPARATIVE studies ,CONDOMS ,EMPLOYEE orientation ,FAMILY medicine ,RESEARCH methodology ,MEDICAL care ,MEDICAL cooperation ,MEDICAL screening ,PRIMARY health care ,RESEARCH ,RURAL population ,REPRODUCTIVE health ,EVALUATION research ,RANDOMIZED controlled trials ,EVALUATION of human services programs - Abstract
Background: Providing sexual health services in primary care is an essential step towards universal provision. However they are not offered consistently. We conducted a national pilot of an educational intervention to improve staff's skills and confidence to increase chlamydia testing rates and provide condoms with contraceptive information plus HIV testing according to national guidelines, known as 3Cs&HIV. The effectiveness of the pilot on chlamydia testing and diagnosis rates in general practice was evaluated.Methods: The pilot was implemented using a step-wedge design over three phases during 2013 and 2014 in England. The intervention combined educational workshops with posters, testing performance feedback and continuous support. Chlamydia testing and diagnosis rates in participating general practices during the control and intervention periods were compared adjusting for seasonal trends in chlamydia testing and differences in practice size. Intervention effect modification was assessed for the following general practice characteristics: chlamydia testing rate compared to national median, number of general practice staff employed, payment for chlamydia screening, practice urban/rurality classification, and proximity to sexual health clinics.Results: The 460 participating practices conducted 26,021 tests in the control period and 18,797 tests during the intervention period. Intention-to-treat analysis showed no change in the unadjusted median tests and diagnoses per month per practice after receiving training: 2.7 vs 2.7; 0.1 vs 0.1. Multivariable negative binomial regression analysis found no significant change in overall testing or diagnoses post-intervention (incidence rate ratio (IRR) 1.01, 95 % confidence interval (CI) 0.96-1.07, P = 0.72; 0.98 CI 0.84-1.15, P = 0.84, respectively). Stratified analysis showed testing increased significantly in practices where payments were in place prior to the intervention (IRR 2.12 CI 1.41-3.18, P < 0.001) and in practices with 6-15 staff (6-10 GPs IRR 1.35 (1.07-1.71), P = 0.012; 11-15 GPs IRR 1.37 (1.09-1.73), P = 0.007).Conclusion: This national pilot of short educational training sessions found no overall effect on chlamydia testing in primary care. However, in certain sub-groups chlamydia testing rates increased due to the intervention. This demonstrates the importance of piloting and evaluating any service improvement intervention to assess the impact before widespread implementation, and the need for detailed understanding of local services in order to select effective interventions. [ABSTRACT FROM AUTHOR]- Published
- 2016
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10. The acceptability and cost of a home-based chlamydia retesting strategy: findings from the REACT randomised controlled trial.
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Smith, K. S., Kaldor, J. M., Hocking, J. S., Jamil, M. S., McNulty, A. M., Read, P., Bradshaw, C. S., Chen, M. Y., Fairley, C. K., Wand, H., Worthington, K., Blake, S., Knight, V., Rawlinson, W., Saville, M., Tabrizi, S. N., Garland, S. M., Donovan, B., and Guy, R.
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CHLAMYDIA infection treatment ,HOME care services ,MEDICAL care costs ,RANDOMIZED controlled trials ,HETEROSEXUAL men ,HEALTH ,CHLAMYDIA infection diagnosis ,CHLAMYDIA infection prevention ,CHLAMYDIA infections ,CHLAMYDIA trachomatis ,COST effectiveness ,DIAGNOSTIC reagents & test kits ,MEDICAL screening ,PATIENT compliance ,PATIENT satisfaction ,HEALTH self-care - Abstract
Background: Chlamydia retesting three months after treatment is recommended to detect reinfections, but retesting rates are typically low. The REACT (retest after Chlamydia trachomatis) randomised trial demonstrated that home-based retesting using postal home-collection kits and SMS reminders, resulted in substantial improvements in retesting rates in women, heterosexual men and men who have sex with men (MSM), with detection of more repeat positive tests compared with SMS reminder alone. In the context of this trial, the acceptability of the home-based strategy was evaluated and the costs of the two strategies were compared.Methods: REACT participants (200 women, 200 heterosexual men, 200 MSM) were asked to complete an online survey that included home-testing acceptability and preferred methods of retesting. The demographics, sexual behaviour and acceptability of home collection were compared between those preferring home-testing versus clinic-based retesting or no preference, using a chi-square test. The costs to the health system of the clinic-based and home retesting strategies and the cost per infection for each were also compared.Results: Overall 445/600 (74 %) participants completed the survey; 236/445 from the home-testing arm, and 141 of these (60 %) retested at home. The majority of home arm retesters were comfortable having the kit posted to their home (86 %); found it easy to follow the instructions and collect the specimens (96 %); were confident they had collected the specimens correctly (90 %); and reported no problems (70 %). Most (65 %) preferred home retesting, 21 % had no preference and 14 % preferred clinic retesting. Comparing those with a preference for home testing to those who didn't, there were significant differences in being comfortable having a kit sent to their home (p = 0.045); not having been diagnosed with chlamydia previously (p = 0.030); and living with friends (p = 0.034). The overall cost for the home retest pathway was $154 (AUD), compared to $169 for the clinic-based retesting pathway and the cost per repeat infection detected was $1409 vs $3133.Conclusions: Among individuals initially diagnosed with chlamydia in a sexual health clinic setting, home-based retesting was shown to be highly acceptable, preferred by most participants, and cost-efficient. However some clients preferred clinic-based testing, often due to confidentiality concerns in their home environment. Both options should be provided to maximise retesting rates.Trial Registration: The trial was registered with the Australia New Zealand Clinical Trials Registry on September 9, 2011: ACTRN12611000968976. [ABSTRACT FROM AUTHOR]- Published
- 2016
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11. Socioeconomic factors and other sources of variation in the prevalence of genital chlamydia infections: A systematic review and meta-analysis.
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Crichton, Joanna, Hickman, Matthew, Campbell, Rona, Batista-Ferrer, Harriet, and Macleod, John
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CHLAMYDIA ,YOUTH health ,SOCIOECONOMIC factors ,SEXUALLY transmitted diseases ,PUBLIC health ,HETEROGENEITY - Abstract
Background: The success of chlamydia screening programmes relies on their ability to effectively target those with greatest need. Young people from disadvantaged backgrounds may be at greater need for chlamydia screening, but existing evidence on the variation of prevalence with social position is inconclusive. We carried out a systematic review to examine variation in chlamydia prevalence in populations and possible sources of this variation. Methods: Studies were eligible if they reported chlamydia prevalence derived from population-based samples that included young people aged 15-24 years from Europe, North America or Australia. Systematic searches of the following databases were undertaken from their inception to November 2014: MEDLINE, Embase, Web of Science and PsychINFO. There were no restrictions by language or publication date. Independent screening for eligibility and data extraction were carried out by two reviewers. Where possible, data were pooled in a meta-analysis using a random effects model. Heterogeneity was further investigated using meta-regression techniques. Results: Of 1248 unique titles and abstracts and 263 potentially relevant full texts, 29 studies were eligible for inclusion. There was relatively strong evidence that disadvantaged young people had an increased risk of having a chlamydia infection across multiple measures of disadvantage, including lower educational attainment (OR 1.94, 95 % CI: 1.52 to 2.47), lower occupational class (OR 1.49, 95 % CI: 1.07 to 2.08) and residence in deprived areas (OR 1.76, 95 % CI: 1.15 to 2.71) with an overall OR of 1.66 (95 % CI: 1.37 to 2.02). Socioeconomic disadvantage was associated with chlamydia infection in both men and women. There was weaker evidence that prevalence estimates also varied by gender and age. Conclusions: This review provides evidence of a consistent association between socioeconomic disadvantage and higher risk of Chlamydia infection. This association may reflect a number of factors including social variation in engagement with Chlamydia control programmes. Chlamydia screening could therefore reduce or increase health inequalities, depending on service provision and uptake by different socioeconomic groups. [ABSTRACT FROM AUTHOR]
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- 2015
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12. Outreach for chlamydia and gonorrhoea screening: a systematic review of strategies and outcomes.
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Hengel, Belinda, Jamil, Muhammad S., Mein, Jacqueline K., Maher, Lisa, Kaldor, John M., and Guy, Rebecca J.
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GONORRHEA ,MEDICAL care ,MEDICAL screening - Abstract
Background High Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) prevalence have been reported in populations that do not regularly access health centres for sexually transmissible infections (STI) testing. We reviewed current outreach strategies used to increase access to STI testing and their outcomes. Methods We systematically reviewed the literature for English language studies published between 1 January 2005 and 28 January 2011 describing CT and/or NG screening programs in non- clinical outreach settings. Results We identified 25 programs, with the majority occurring in either Australia (32%) or the United States (32%). The most common target groups were young people aged 15-29 years (52%), men who have sex with men (24%) and sex workers (8%). The median CT positivity was 7.7% (Inter Quartile Range [IQR]: 3.0%-11.1%, n=19 programs), and median NG positivity was 2.6% (IQR: 0.0%-8.0%, n=10). The median participation rate was 53% (IQR: 23.9%-81.3%), and a median of 79.6% (IQR: 55.1%-89.4%) of participants were tested, with a median of 100 tests conducted per program (IQR: 65-331, range: 11-1808). Across all settings the participation rate was highest among target groups gathering in community service venues (community centres, parenting centres, homeless shelters) (median=81.4%, n=4), and social venues (sporting venues or bars) (80.4%, n=1). Lower participation rates were found in street/public community areas (median=23.9%, n=3) and sex on premises venues (10.4% and 24.3%, n=2). Conclusions The review indicated that although CT and NG outreach programs reached a relatively small number of people the yield of infections is high. Settings which appear to be more effective at encouraging participation appear to be those within an existing venue, rather than in public areas. [ABSTRACT FROM AUTHOR]
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- 2013
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13. Chlamydia screening in England: a qualitative study of the narrative behind the policy.
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Sheringham, Jessica, Baraitser, Paula, Simms, Ian, Hart, Graham, and Raine, Rosalind
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CHLAMYDIA ,CHLAMYDIACEAE ,MEDICAL screening ,HEALTH policy ,MEDICAL care ,PUBLIC health ,HEALTH & welfare funds - Abstract
Background: The rationale for the English National Chlamydia Screening Programme (NCSP) has been questioned. There has been little analysis, however, of what drove the NCSP's establishment and how it was implemented. Such analysis will help inform the future development of the NCSP. This study used a qualitative, theory-driven approach to evaluate the rationale for the NCSP's establishment and implementation. Methods: Semi-structured interviews with 14 experts in chlamydia screening were undertaken. The interview data were analysed with policy documents and commentaries from peer-reviewed journals (published 1996-2010) using the Framework approach. Results: Two themes drove the NCSP's establishment and implementation. The first, chlamydia control, was prominently referenced in documents and interviews. The second theme concerned the potential for chlamydia screening to advance wider improvements in sexual health. In particular, screening was expected to promote sexual health services in primary care and encourage discussion of sexual health with young people. While this theme was only indirectly referenced in policy documents, it was cited by interviewees as a strong influence on implementation in the early years. However, by full rollout of the Programme, a focus on screening volume may have limited the NCSP's capacity to improve broader aspects of sexual health. Conclusions: A combination of explicit and implicit drivers underpinned the Programme's establishment. This combination may explain why there was widespread support for its introduction and why implementation of the NCSP was inconsistent. The potential to improve young people's sexual health more comprehensively should be made explicit in future planning of the NCSP. [ABSTRACT FROM AUTHOR]
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- 2012
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14. A pragmatic assessment of the relative efficiency of outreach chlamydia screening events conducted in non-clinical settings.
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Bowden1,2,, Francis J., Currie1*,, Marian J., Todkill2,, Muareen, Schmidt3,, Mathias, Webeck3,, Sue, Del Rosario2, Rendry, Bavinton3, Tim, and Tyson1,2, Alexandra
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CHLAMYDIA ,CHLAMYDIACEAE ,MEDICAL screening ,YOUNG adults ,YOUTH ,CLINICS - Abstract
Background: Opportunistic screening for chlamydia in non-clinical settings is becoming more common, but little is known about which settings (or events) offer the best return on investment. We measured the relative efficiency of each screening site and event during the conduct of a chlamydia education and screening outreach program which used a cash incentive to encourage participation (SOC2). Methods: SOC2 staff identified sites and organised events in non-clinical sites where young people were likely to congregate. 16 to 30 years olds were offered chlamydia education and a cash reward of AUD10 if they chose to be screened for chlamydia. Data collected during these activities were used to calculated five measures of efficiency: i) screening yield' (proportion of people providing a sample), ii) proportion of positive tests, iii) 'event screening tempo' (number of screens performed for every hour that screening is offered), iv) 'staff hour screening tempo' (number of screens performed per hour of staff time) and v) 'chlamydia detection tempo' (number of positive tests detected per hour of screening). Results: 3011 people (71% male) were screened during 18 events at 10 venues. Overall 'screening yield' was 43.8% (range: 20-77%) and 1.7% (95% CI: 1.1-3.0) of tests were positive (by event range 1-3%). Overall, the 'event screening tempo' was 23.7 screens per event hour (range 8.0-79.0), the 'staff hour screening tempo' was 6.5 screens per staff hour and the 'chlamydia detection tempo' was 0.4 positive tests per hour (range: 0-1.75). Conclusion: Assessing the efficiency of screening sites and programs should be integral to their conduct. We suggest the use of five measures to enable pragmatic assessment of any screening program. We introduce the terms 'event screening tempo', 'staff hour screening tempo' and 'chlamydia detection tempo' to describe three of these simple measures. [ABSTRACT FROM AUTHOR]
- Published
- 2012
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15. Should young people be paid for getting tested? A national comparative study to evaluate patient financial incentives for chlamydia screening.
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CHLAMYDIA ,MEDICAL screening ,HEALTH risk assessment ,PRIMARY care ,MEDICAL care - Abstract
The article cites a research study that describes incentives used to promote chlamydia screening in Primary Care Trusts (PCTs) in England. It also evaluates their impact on coverage and positivity rate. In order to promote chlamydia screening uptake amongst 15-24 year olds in England, patient financial incentives have been widely used.
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- 2012
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16. Keeping participants on board: increasing uptake by automated respondent reminders in an Internet-based Chlamydia Screening in the Netherlands.
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CHLAMYDIA ,MEDICAL screening ,EMAIL ,RESPONSE rates ,TEXT messages ,PREVENTION - Abstract
The article cites a research study that analyzes the contribution of automated reminders by letter, email and short message service (SMS) on package request and sample return in a Chlamydia screening program among people aged 16 to 29 years in the Netherlands. It is said that an adequate level of participation and the capturing of high-risk groups is used to determine the effectiveness of Chlamydia screening programs.
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- 2012
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17. Young women"s decisions to accept chlamydia screening: influences of stigma and doctorpatient interactions.
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Balfe, Myles, Brugha, Ruairi, O'Donovan, Diarmuid, O'Connell, Emer, and Vaughan, Deirdre
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CHLAMYDIA ,WOMEN'S health ,CHLAMYDIA infection treatment ,MEDICAL screening ,CHLAMYDIACEAE ,MEDICAL care - Abstract
Background: An understanding of the factors that encourage young women to accept, and discourage them from accepting, STI (sexually transmitted infection) testing is needed to underpin opportunistic screening programs for the STI Chlamydia trachomatis (opportunistic screening involves healthcare professionals offering chlamydia tests to people while they are attending health services for reasons that are usually unrelated to their sexual health). We conducted a qualitative study to identify and explore: how young women would feel about being offered opportunistic tests for chlamydia?; how young women would like to be offered screening, and who they wanted to be offered screening by?; and what factors would influence young women's partner notification preferences for chlamydia (who they would notify in the event of a positive diagnosis of chlamydia, how they would want to do this). Methods: Semi-structured interviews with 35 young women between eighteen and twenty nine years of age. The study was conducted in the Dublin and Galway regions of the Republic of Ireland. Young adults were recruited from General Practice (GP) practices, Third Level College health services, Family Planning clinics and specialist STI treatment services. Results: Respondents were worried that their identities would become stigmatised if they accepted screening. Younger respondents and those from lower socio-economic backgrounds had the greatest stigma-related concerns. Most respondents indicated that they would accept screening if it was offered to them, however; accepting screening was seen as a correct, responsible action to engage in. Respondents wanted to be offered screening by younger female healthcare professionals. Respondents were willing to inform their current partners about positive chlamydia diagnoses, but were more ambivalent about informing their previous partners. Conclusions: If an effort is not put into reducing young women's stigma-related concerns the population coverage of Chlamydia screening might be reduced. [ABSTRACT FROM AUTHOR]
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- 2010
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18. Home-based chlamydia testing of young people attending a music festival--who will pee and post?
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Sacks-Davis, Rachel, Gold, Judy, Aitken, Campbell K., and Hellard, Margaret E.
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CHLAMYDIA ,MUSIC festivals ,BACTERIAL diseases ,COMMUNICABLE diseases - Abstract
Background: Chlamydia is most common among young people, but only a small proportion of Australian young people are tested annually. Home-based chlamydia testing has been piloted in several countries to increase testing rates, but uptake has been low. We aimed to identify predictors of uptake of home-based chlamydia testing to inform future testing programs.Methods: We offered home-based chlamydia testing kits to participants in a sexual behaviour cross-sectional survey conducted at a music festival in Melbourne, Australia. Those who consented received a testing kit and were asked to return their urine or vaginal swab sample via post.Results: Nine hundred and two sexually active music festival attendees aged 16-29 completed the survey; 313 (35%) opted to receive chlamydia testing kits, and 67 of 313 (21%) returned a specimen for testing. One participant was infected with chlamydia (1% prevalence). Independent predictors of consenting to receive a testing kit included older age, knowing that chlamydia can make women infertile, reporting more than three lifetime sexual partners and inconsistent condom use. Independent predictors of returning a sample to the laboratory included knowing that chlamydia can be asymptomatic, not having had an STI test in the past six months and not living with parents.Conclusions: A low proportion of participants returned their chlamydia test, suggesting that this model is not ideal for reaching young people. Home-based chlamydia testing is most attractive to those who report engaging in sexual risk behaviours and are aware of the often asymptomatic nature and potential sequelae of chlamydia infection. [ABSTRACT FROM AUTHOR]- Published
- 2010
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19. Interventions for increasing chlamydia screening in primary care: a review.
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Ginige, Samitha, Fairley, Christopher K., Hocking, Jane S., Bowden, Francis J., and Chen, Marcus Y.
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CHLAMYDIA ,PRIMARY care ,SEXUALLY transmitted diseases ,PELVIC inflammatory disease ,MEDICAL care - Abstract
Background: Despite guidelines recommending opportunistic chlamydia screening of younger women, screening rates in some countries remain low. Our aim was to review the evidence for specific interventions aimed at increasing chlamydia screening rates in primary care. Methods: A Medline search was conducted for controlled trials that assessed the effectiveness of interventions aimed at improving chlamydia screening rates in primary health care settings. The Medline search was done for studies in English published prior to December 2005 using the following key words: chlamydia, screening, intervention, primary care and GPs. In addition, the references cited in the articles were reviewed. Studies in English published prior to December 2005 were reviewed. Results: Four controlled studies met the inclusion criteria - 3 were randomized studies and one was not. Strategies to increase screening rates included the use of educational packages targeting primary care physicians and the correction of barriers to screening within clinic systems. In 3 studies, the intervention was associated with an increase in screening rates of between 100% and 276% (p < 0.04). In the fourth study, the intervention was associated with a significant attenuation in declining screening rates over time (4% versus 34% decline, p = 0.04). Conclusion: There are only a limited number of randomized or controlled studies that demonstrate improved chlamydia screening of younger women in primary care. [ABSTRACT FROM AUTHOR]
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- 2007
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20. Project LifeSkills - a randomized controlled efficacy trial of a culturally tailored, empowerment-based, and group-delivered HIV prevention intervention for young transgender women: study protocol
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Matthew J. Mimiaga, Sari L. Reisner, Lisa M. Kuhns, Robert Garofalo, and Katie B. Biello
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Male ,Gonorrhea ,Psychological intervention ,HIV Infections ,law.invention ,Health Risk Behaviors ,Study Protocol ,0302 clinical medicine ,5. Gender equality ,Randomized controlled trial ,law ,Medicine ,030212 general & internal medicine ,Young adult ,Cultural Competency ,education.field_of_study ,Chlamydia ,lcsh:Public aspects of medicine ,16. Peace & justice ,3. Good health ,Treatment Outcome ,Psychotherapy, Group ,Female ,0305 other medical science ,Adult ,medicine.medical_specialty ,Adolescent ,Sexual Behavior ,Population ,HIV prevention ,Intervention ,Transgender Persons ,03 medical and health sciences ,Young Adult ,Humans ,Transgender women ,education ,Chicago ,030505 public health ,business.industry ,Public health ,Public Health, Environmental and Occupational Health ,lcsh:RA1-1270 ,medicine.disease ,Family medicine ,Physical therapy ,Feasibility Studies ,Biostatistics ,Power, Psychological ,business ,Boston ,Follow-Up Studies - Abstract
Background Transgender women in the U.S. have an alarmingly high incidence rate of HIV infection; condomless anal and vaginal sex is the primary risk behavior driving transmission. Young transgender women are the subpopulation at the highest risk for HIV. Despite this, there are no published randomized controlled efficacy trials testing interventions to reduce sexual risk for HIV among this group. This paper describes the design of a group-based intervention trial to reduce sexual risk for HIV acquisition and transmission in young transgender women. Methods This study, funded by the National Institutes of Health, is a randomized controlled trial of a culturally-specific, empowerment-based, and group-delivered six-session HIV prevention intervention, Project LifeSkills, among sexually active young transgender women, ages 16-29 years in Boston and Chicago. Participants are randomized (2:2:1) to either the LifeSkills intervention, standard of care only, or a diet and nutrition time- and attention-matched control. At enrollment, all participants receive standardized HIV pre- and post-test counseling and screening for HIV and urogenital gonorrhea and chlamydia infections. The primary outcome is difference in the rate of change in the number of self-reported condomless anal or vaginal sex acts during the prior 4-months, assessed at baseline, 4-, 8-, and 12-month follow-up visits. Discussion Behavioral interventions to reduce sexual risk for HIV acquisition and transmission are sorely needed for young transgender women. This study will provide evidence to determine feasibility and efficacy in one of the first rigorously designed trials for this population. Trial registration ClinicalTrials.gov number, NCT01575938 , registered March 29, 2012.
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- 2017
21. Repeat infection with Chlamydia trachomatis: a prospective cohort study from an STI-clinic in Stockholm
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Maria Rotzén-Östlund, Jennie Everljung, Sharon Kühlmann-Berenzon, Maria Grünewald, Ivar Qvarnström, and Karin Edgardh
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Adult ,Male ,medicine.medical_specialty ,Sexual Behavior ,Chlamydia trachomatis ,urologic and male genital diseases ,medicine.disease_cause ,Cohort Studies ,Study Protocol ,Young Adult ,Sex Factors ,Recurrence ,Risk Factors ,Internal medicine ,Surveys and Questionnaires ,Epidemiology ,Pelvic inflammatory disease ,medicine ,Humans ,Sex organ ,Prospective cohort study ,Contraception Behavior ,Gynecology ,Sweden ,Chlamydia ,Ectopic pregnancy ,business.industry ,lcsh:Public aspects of medicine ,Public Health, Environmental and Occupational Health ,lcsh:RA1-1270 ,Chlamydia Infections ,medicine.disease ,female genital diseases and pregnancy complications ,Reproductive Medicine ,Female ,business ,Attitude to Health ,Cohort study - Abstract
Background Infection with genital Chlamydia trachomatis (Ct) is the most common notifiable sexually transmitted infection (STI) in Sweden. A mutated Chlamydia, nvCT, has contributed to the increase. The occurrence of repeat infections is not investigated in Sweden. The current paper presents the study protocol for the first Swedish clinical investigation of repeat Chlamydial infection. The concern of the study is whether a Chlamydia infection at inclusion indicates an increased risk for Chlamydia at follow-up after 6–8 months, gender-specific risk factors for and clinical presentation of repeat infections. Methods and design Sesam City is a drop-in clinic in the city centre of Stockholm. Patients 20 years and older are admitted. During 2007, the clinic had 15 000 visits, 60% made by men. In December 2007, a cohort study began, and data collection was finished in April 2009. A total of 2813 study participants aged 20–39 years were recruited. Data collection included an anonymous self-administered paper-and-pen questionnaire on sexual behaviour, reproductive health and history of Chlamydia, and condom use. Chlamydia tests were performed by self-sampled specimens, analyzed by the ProbeTec (Becton Dickinson) method, Ct-positive specimens also analyzed with a nvCT-specific method. Data from medical records were summarized in clinical report forms. Patients positive for Chlamydia were retested 4 weeks after treatment. Contact tracing covered sexual contacts during the last 12 months. At follow-up 6–8 months after inclusion, Chlamydia tests were performed, and a new questionnaire and CRF completed. Discussion A STI-clinic-based prospective cohort study allowed us to survey 2813 adult patients. The collected data will provide gender-specific information on the occurrence of and risk for repeat Chlamydia infection, the occurrence of nvCT, and clinical data and information on sexual behaviour and reproductive health, risk-taking and condom use.
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22. Sexual behaviour, sexually transmitted infections and attitudes to chlamydia testing among a unique national sample of young Australians: baseline data from a randomised controlled trial
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S. Rachel Skinner, Adrian Mindel, Marianne Webb, Arlie Rochford, Melissa Kang, Jenny Peat, and Tim Usherwood
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Questionnaires ,Adult ,Male ,Health Knowledge, Attitudes, Practice ,Pediatrics ,medicine.medical_specialty ,Adolescent ,Substance-Related Disorders ,Health risk behaviour ,Sexual Behavior ,Sexually Transmitted Diseases ,Psychological intervention ,Adolescents ,urologic and male genital diseases ,law.invention ,Young Adult ,Risk-Taking ,Condom ,Randomized controlled trial ,law ,Surveys and Questionnaires ,Epidemiology ,Sexually transmitted infections ,medicine ,Humans ,Chlamydia ,Young adult ,Randomized Controlled Trials as Topic ,business.industry ,Public health ,Australia ,Public Health, Environmental and Occupational Health ,Chlamydia Infections ,medicine.disease ,female genital diseases and pregnancy complications ,Family medicine ,Young people ,Female ,Public Health ,Biostatistics ,business ,Research Article - Abstract
Background Chlamydia infection is the most common notifiable sexually transmitted infection (STI) in Australia and mostly affects young people (15 – 25 years). This paper presents baseline data from a randomised controlled trial that aimed to increase chlamydia testing among sexually active young people. The objectives were to identify associations between sexual behaviour, substance use and STI history and explore attitudes to chlamydia testing. Methods This study was conducted in cyberspace. Study recruitment, allocation, delivery of interventions and baseline and follow up data collection all took place online. Participants were 16 – 25 years old and resided in Australia. Substance use correlates of sexual activity; predictors of history of STIs; barriers to and facilitators of chlamydia testing were analysed. Results Of 856 participants (79.1% female), 704 had experienced penetrative intercourse. Sexually active participants were more likely to smoke regularly or daily, to drink alcohol, or to have binge drunk or used marijuana or other illicit substances recently. Risk factors for having a history of any STI were 3 or more sexual partners ever, 6 or more partners in the past 12 months, condom non-use and being 20 years or older. Almost all sexually active participants said that they would have a chlamydia test if their doctor recommended it. Conclusions Sexually active young people are at risk of STIs and may engage in substance use risk behaviours. Where one health risk behaviour is identified, it is important to seek information about others. Chlamydia testing can be facilitated by doctors and nurses recommending it. Primary care providers have a useful role in chlamydia control. Trial Registration Australian and New Zealand Trials Registry ACTRN12607000582459
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- 2014
23. Home-based chlamydia and gonorrhoea screening: a systematic review of strategies and outcomes
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Muhammad S Jamil, Heidi M. Bauer, Rebecca Guy, Hammad Ali, Handan Wand, John M. Kaldor, Jane S Hocking, Jennifer Walker, Basil Donovan, and Kirsty S Smith
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medicine.medical_specialty ,Gonorrhea ,Population ,Chlamydia trachomatis ,Context (language use) ,medicine.disease_cause ,Outcome Assessment, Health Care ,Epidemiology ,Sexually transmitted infections ,Humans ,Mass Screening ,Medicine ,education ,Mass screening ,Gynecology ,education.field_of_study ,Chlamydia ,business.industry ,Public Health, Environmental and Occupational Health ,Chlamydia Infections ,medicine.disease ,Home Care Services ,Family medicine ,Screening ,Biostatistics ,Home ,business ,Research Article - Abstract
Background In many countries, low Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) screening rates among young people in primary-care have encouraged screening programs outside of clinics. Nucleic acid amplification tests (NAATs) make it possible to screen people in homes with self-collected specimens. We systematically reviewed the strategies and outcomes of home-based CT/NG screening programs. Methods Electronic databases were searched for home-based CT and/or NG screening studies published since January 2005. Screening information (e.g. target group, recruitment and specimen-collection method) and quantitative outcomes (e.g. number of participants, tests and positivity) were extracted. The screening programs were classified into seven groups on the basis of strategies used. Results We found 29 eligible papers describing 32 home-based screening programs. In seven outreach programs, people were approached in their homes: a median of 97% participants provided specimens and 76% were tested overall (13717 tests). In seven programs, people were invited to receive postal test-kits (PTKs) at their homes: a median of 37% accepted PTKs, 79% returned specimens and 19% were tested (46225 tests). PTKs were sent along with invitation letters in five programs: a median of 33% returned specimens and 29% of those invited were tested (15126 tests). PTKs were requested through the internet or phone without invitations in four programs and a median of 32% returned specimens (2666 tests). Four programs involved study personnel directly inviting people to receive PTKs: a median of 46% accepted PTKs, 21% returned specimens and 9.1% were tested (341 tests). PTKs were picked-up from designated locations in three programs: a total of 6765 kits were picked-up and 1167 (17%) specimens were returned for screening. Two programs used a combination of above strategies (2395 tests) but the outcomes were not reported separately. The overall median CT positivity was 3.6% (inter-quartile range: 1.7-7.3%). Conclusions A variety of strategies have been used in home-based CT/NG screening programs. The screening strategies and their feasibility in the local context need to be carefully considered to maximize the effectiveness of home-based screening programs.
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- 2013
24. Maximising retention in a longitudinal study of genital Chlamydia trachomatis among young women in Australia
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Christopher K Fairley, Marcus Y Chen, Jane Gunn, Sandra Walker, Francis J. Bowden, Suzanne M. Garland, Veerakathy Harindra, Marie Pirotta, Kathleen McNamee, Hudson Birden, Catriona S. Bradshaw, Jane S Hocking, Eve Urban, Jennifer Walker, Sepehr N. Tabrizi, John M. Kaldor, Marian J. Currie, Basil Donovan, and Lyle C. Gurrin
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Adult ,Longitudinal study ,medicine.medical_specialty ,Patient Dropouts ,Adolescent ,Chlamydia trachomatis ,medicine.disease_cause ,Cohort Studies ,Young Adult ,Recurrence ,medicine ,Humans ,Longitudinal Studies ,Prospective Studies ,Young adult ,Prospective cohort study ,Reproductive health ,Gynecology ,Chlamydia ,business.industry ,Incidence ,Patient Selection ,lcsh:Public aspects of medicine ,Hazard ratio ,Australia ,Public Health, Environmental and Occupational Health ,lcsh:RA1-1270 ,Chlamydia Infections ,medicine.disease ,Family medicine ,Female ,business ,Genital Diseases, Female ,Research Article ,Cohort study - Abstract
Background Cohort studies are an important study design however they are difficult to implement, often suffer from poor retention, low participation and bias. The aims of this paper are to describe the methods used to recruit and retain young women in a longitudinal study and to explore factors associated with loss to follow up. Methods The Chlamydia Incidence and Re-infection Rates Study (CIRIS) was a longitudinal study of Australian women aged 16 to 25 years recruited from primary health care clinics. They were followed up via the post at three-monthly intervals and required to return questionnaires and self collected vaginal swabs for chlamydia testing. The protocol was designed to maximise retention in the study and included using recruiting staff independent of the clinic staff, recruiting in private, regular communication with study staff, making the follow up as straightforward as possible and providing incentives and small gifts to engender good will. Results The study recruited 66% of eligible women. Despite the nature of the study (sexual health) and the mobility of the women (35% moved address at least once), 79% of the women completed the final stage of the study after 12 months. Loss to follow up bias was associated with lower education level [adjusted hazard ratio (AHR): 0.7 (95% Confidence Interval (CI): 0.5, 1.0)], recruitment from a sexual health centre as opposed to a general practice clinic [AHR: 1.6 (95% CI: 1.0, 2.7)] and previously testing positive for chlamydia [AHR: 0.8 (95% CI: 0.5, 1.0)]. No other factors such as age, numbers of sexual partners were associated with loss to follow up. Conclusions The methods used were considered effective for recruiting and retaining women in the study. Further research is needed to improve participation from less well-educated women.
- Published
- 2011
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