Access to chlamydia testing in remote and rural Scotland

Area of Science:

• Public Health
• Epidemiology
• Sexual Health

Background:

• Assessing sexual health care access in remote and rural areas is crucial.
• Chlamydia testing serves as a key indicator for sexual health service accessibility.

Purpose of the Study:

• To evaluate Chlamydia testing access and positivity in the Scottish Highlands.
• To analyze testing patterns in relation to the Scottish Index of Multiple Deprivation (SIMD) and Urban Rural 8-fold index (UR8).

Main Methods:

• Analysis of 9644 Chlamydia test results processed through Raigmore Hospital.
• Assessment of testing locations relative to patient residence (UR8) and deprivation (SIMD).
• Comparison of positivity rates between genders and settings (urban vs. rural).

Main Results:

• Overall Chlamydia positivity was 8.1%, with higher rates from sexual health sources compared to general practice.
• Men showed a higher positivity rate (12.7%) than women (6.6%), despite fewer tests.
• No significant difference in positivity was found based on UR8 or SIMD, though rural residents tested in urban settings showed a tendency for higher positivity.

Conclusions:

• Chlamydia positivity rates are comparable between rural and urban settings.
• A significant proportion of rural residents utilize urban testing facilities, potentially bypassing local services.
• Men are more likely to test in genitourinary settings and have higher positive results, supporting the need for tailored rural sexual health services, particularly for men.