Acceptability and consequences of screening for chlamydia trachomatis by home-based urine testing

Area of Science:

• Public Health
• Sexual Health
• Infectious Disease Screening

Background:

• Chlamydia trachomatis (CT) is a common sexually transmitted infection, particularly among young adults.
• Home-based screening offers a convenient approach to increase testing accessibility.
• Understanding participant acceptability and the psychological impact of CT screening is crucial for program effectiveness.

Purpose of the Study:

• To evaluate the acceptability and consequences of home-based chlamydia screening.
• To assess the impact of Municipal Health Services (MHS) organized screening on individuals aged 15-29.
• To identify factors influencing participation and willingness for future chlamydia testing.

Main Methods:

• Cross-sectional study involving 156 CT-positive and 600 randomly sampled CT-negative individuals.
• Participants received results from their chlamydia test.
• Data collected on response rates, acceptance of screening, psychological impact, and motivations for participation.

Main Results:

• Response rates were 38% for men and 59% for women; the screening method was well-accepted.
• 70% of CT-positives were surprised by their result; infected women reported more anxiety and feelings of being 'dirty'.
• Curiosity drove participation (68%), while perceived personal risk was low; willingness for regular testing linked to infection status, age, partner history, and prior testing.

Conclusions:

• Municipal Health Services (MHS)-organized chlamydia screening is acceptable for future implementation.
• High-risk individuals are keen on screening if test kits are readily available.
• Targeted counseling on CT effects, particularly for women, is essential; alternative strategies are needed for men and non-Dutch high-risk groups.