The legal context appeared to affect the conduct of health promotion programs targeting the sex industry. Brothel licensing and police-controlled illegal brothels can result in the unlicensed sector being isolated from peer-education and support.

Pooled specimen CT and NG testing by the GeneXpert was accurate when compared with single specimen testing and has potential for screening MSM for CT and NG. The role of pooled specimen testing with the GeneXpert as a point-of-care nucleic acid test in MSM requires further investigation.

Internet-based screening for chlamydia is an effective means of increasing access to testing for young people at risk of sexually transmitted infections and is a valuable addition to opportunistic, clinic-based strategies.

ObjectivesTo develop and measure the effectiveness and acceptability of a pharmacy-based chlamydia screening intervention called Emergency Contraception Mediated Pharmacy Access to Chlamydia Testing (ECOMPACT).DesignSelective, opportunistic and cross-sectional study targeting asymptomatic women requesting emergency contraception (EC).Setting20 community pharmacies in the Perth metropolitan region, Australia.MethodsECOMAPCT was developed through literature review and stakeholder consensus. Pharmacists were trained to offer ECOMPACT after the EC consultation. Women with signs and symptoms of sexually transmitted infections (STI) were referred to a physician for a full sexual health check. Asymptomatic women were offered a free ECOMPACT testing kit. The women self-collected a low-vaginal swab and returned their pathological specimen to designated drop-off sites. A pathology service analysed the specimens and sent the results to a sexual health physician. The effectiveness of ECOMPACT was determined by the uptake of the intervention and how well the target population was reached. An effective screening rate was calculated. Qualitative analysis was undertaken to understand acceptability issues from the perspective of the consumer and the pharmacists.ResultsOf the 769 EC consultations in a 6-month period, 569 (78%) women were given information on chlamydia screening. All 247 (41%) agreed to participate. 81 (33%) of these women were ineligible. They were either symptomatic (n=33; 41%), or were under 18 years of age (n=48; 59%). Pharmacists successfully requested 166 (67%) pathology tests, of which 46 (28%) were returned to a pathology drop-off site. All tested negative for Chlamydia trachomatis. The effective screening rate was 6%. Consumers and pharmacists considered ECOMPACT to be highly convenient and the time taken to offer a chlamydia test along with an EC consultation as highly appropriate.ConclusionsECOMPACT was found to be simple, effective and acceptable. Given the opportunity, adequate training and support, community pharmacists in Australia were capable of requesting direct-to-consumer chlamydia tests.

The sexual health service network suggests a moderate increase in chlamydia prevalence in young heterosexuals tested at sexual health services, in contrast to the steep increase shown by notifications. This highlights the caution needed in interpreting chlamydia trends without a corresponding testing denominator.