A pilot project for chlamydia screening in adolescent females using self-testing: characteristics of participants and...

A self-test screening program for genital C. trachomatis infection in female students attending high school in rural Nova Scotia was introduced. The objectives of this pilot study were to determine the extent of uptake, reasons for being/not being screened, and whether students at risk would be more likely to be screened.

The screening program was carried out between September 2005 and May 2006. Test kits were accessed through the school's health centre without first seeing the school nurse for counselling. Tests were processed non-nominally at the laboratory. A cross-sectional survey was offered to all students in the school to assess factors related to participation or non-participation. Univariate analysis was carried out for young women's sexual activity and risk taking, reasons for being participants or non-participants, risk behaviours, and knowledge about chlamydia.

One hundred and sixty-three women (58%) had had vaginal intercourse at least once. Twenty-four of these used the self-test kit. Though 83% of those not using the self-test knew that females with chlamydia are very often asymptomatic, 54% indicated lack of symptoms as a reason for not doing so. Many (49%) gave low probability of infection as a reason for not using the kit, but high-risk sexual activity was frequent in these young

Uptake of self-testing for C. trachomatis was lower than anticipated. This may be due to lack of counselling meant to encourage testing to overcome a dissonance of knowledge and behaviour. Self-testing should be further explored to better understand its potential to increase chlamydia screening among Canadian adolescents.