Motivation for VCT uptake was driven by knowledge and education rather than sexual risk. Increased sexual risk following receipt of a negative result may be a serious unintended consequence of VCT. It should be minimized with appropriate pre- and post-test counselling.

ANC estimates understate female HIV prevalence in this low fertility population but, here, the primary cause is not selection of pregnant women. ANC estimate adjustment procedures that control for contraceptive use and age at first sex are needed.

IntroductionThe objectives of this study were to compare the rates of sexually transmitted infections (STIs) and the uptake of chlamydia test in a Level 3 sexual health clinic during pre and post National chlamydia screening programme (NCSP) periods. The programme has also included children aged <16 years if they are found to be Fraser competent.MethodsThe study period1stSeptember 2002 – 31stAugust 2016. Data were collected retrospectively from the Lilie Sexual Health Management System.ResultsTotal of 894 (N=894) children were studied; of whom 80% were girls. Age range was 13-15 years. Demographic details were similar in pre and post- NSCP periods.Abstract P223 Table 1STI and testing ratesOverall STI rateChlamydia rateTest UptakePre-NSCP2003&2004 (n=160)19%6%46%Introduction of NSCP locally in 2004Post- NSCP2005&2006 (n=155)23%13%59%2007&2008 (n=156)21%15%60%Level 2 young people sexual health service was introduced in 20082009&2010 (n=140), 5 years later14%7%64%2011&2012 (n=107)8%4%66%2013&2014(n=94)12%8%66%2015&2016 (n=82), 10 years later9%3%67%DiscussionThe rate of genital chlamydia infections had peaked during the immediate post- NSCP period. This is probably related to increased uptake of chlamydia test using the less invasive method. However, the overall trend has shown some reduction in both chlamydia and other STI rates in children aged 13-15 years attending our clinic for the past eight years. The reduction might have been contributed by NSCP in addition to changes in the sexual health services locally.