Chlamydia trachomatis testing among 13-25-year-olds in non-genitourinary medicine settings

In this paper we examine Chlamydia trachomatis testing in settings other than genitourinary medicine (GUM) clinics, focusing on the factors associated with chlamydial infection and with postal testing.

Analysis of tests collected from young people aged 13-25 years (n = 4475) between May 2001 and June 2004 via postal testing kits, at a local sexual health clinic, and at further education colleges in Lothian, Scotland.

84.8% of the testers were female and 15.2% were male. 84 men (12.3%, 95% CI 10.1-15.0) and 403 women (10.6%, 95% CI 9.7-11.6) tested positive. The odds of a positive result was nearly doubled for postal and clinic testers, relative to college testers; and increased by 70% for 16-19-year-olds, compared with 13-15-year-olds. Postal testing was the main source for men (80.2%) while 46.1% of women used postal and 48.1% used clinic testing. Postal testing was significantly associated with age, sex and National Health Service (NHS) board area, with odds increasing with age, and lower odds among females than males, and among Lothian residents than those outwith this NHS board area.

Substantial chlamydial infection was apparent among the young people in this study and positivity rates were highest among postal and clinic testers and those in the 16-19-year age group. While postal kits were the main source for men, and should be used to target them, the combination of this approach with continuing screening programmes in clinic settings would be most effective at targeting those most at risk.