The prevalence of human papillomavirus (HPV) infection in cervical cell scrapes from a cohort of 276 young women was determined by a general two-step polymerase chain reaction. HPV infection fluctuated among young women during a 2-year interval. The total prevalence of HPV infection decreased from 21% to 8.3%. The most prevalent HPV types at enrollment were HPV-16 (3.3%) and HPV-6 (2.9%). At follow-up, the most common type was HPV-16 (2.9%), while no HPV-6 was detected. In 2 women only, the same HPV type persisted. Regression of HPV infection was found in 80% of the women. A new HPV type-specific infection was detected in 7.2% of the women and was independently associated with a new sex partner or an abnormal smear since enrollment.

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Objectives: To measure the coverage, gender distribution, and participants' prevalence of genital Chlamydia trachomatis infections using a new internet based self selective testing approach by means of home sampling in the general population in Sweden. To investigate factors associated with these measures. Methods: Observational survey of people actively ordering coded testing packages, and checking their test results, from a known website. No personal invitations were sent out. All inhabitants (256 885 men and women) in a Swedish county were eligible to participate. A special interest was taken in coverage, gender distribution, participants' chlamydia prevalence, and determinants for infection. Results: Testing was highest in the age group 20-24 years, where 298/9495 (3.1%) of all women and 171/9574 (1.8%) of all men in the population participated. The overall population participation (all ages) was 906/256 885 (0.4%). 40% (364/906) of the tests were from men and 60% (542/906) from women. The prevalence of Chlamydia trachomatis infection was 6.0% (95% CI: 3.6% to 8.4%) among male participants and 4.6% (95% CI: 2.8% to 6.4%) among female participants. Prevalence increased with decreasing age. Believing to be infected and having symptoms were the strongest determinants of infection. Conclusion: Simplifying and increasing the accessibility of chlamydia testing by means of internet and home sampling proved feasible. Self risk assessment improves the chance of finding people infected by Chlamydia trachomatis, especially among men, if an accessible testing method is offered. This new method can serve as a supplement to regular preventive methods and might encourage young people to be tested. Infections caused by Chlamydia trachomatis, being easily treated but mostly asymptomatic, have long posed a challenge to primary and secondary prevention. Despite current preventive measures chlamydia rates are increasing in Sweden and other European countries.1 With the advent of home sampling new possibilities for active screening have emerged but many posted testing kits are never used.2 All large scale chlamydia screening programmes have up till now consistently showed a lower male than female participation rate.3 4 It has been suggested that long term reduction in the prevalence of chlamydia infections seems improbable with the current screening programmes, unless men are included comprehensively and innovative strategies are developed to encourage young people to be screened.5 6 With an individualised self selective testing approach we wanted to investigate the feasibility of a simpler and more effective chlamydia testing method using home sampling and the internet. A special interest was taken in coverage, gender distribution, participants' C trachomatis prevalence, and factors associated with these measures. METHODS Eligible peopleThe study was conducted from September 2004 to April 2005. All males and females with permanent addresses in the county of Västerbotten were eligible to participate. Västerbotten is a sparsely p...

The prevalence of human papillomavirus (HPV) infection in cervical cell scrapes from young women was determined by polymerase chain reaction (PCR) by using general primer pairs localized within the Li region. With a one-step general PCR, 5.9%Yo (35 of 590) of young women in a population-based study were found to contain HPV DNA. The proportion of HPV-positive women increased with age, from 1.4% (1 of 69) among women aged 19 years to 9.2% (13 of 142) among women aged 25 years. Among the cervical scrapes from women with normal cytology, 5.6% (30 of 539) harbored HPV DNA. A total of 5 of 19 (26.3%) of the women with pathological signs were positive for HPV DNA. By a two-step PCR, using nested general primers, 20.3% (118 of 581) of all women were shown to contain HPV DNA. The proportion of HPV-positive women also increased with age, from 17.4% (12 of 69) among women aged 19 years to 31.9%o (43 of 135) among women aged 25 years, when the two-step PCR was used. Some 19.2% (102 of 530) of cervical scrapes from women with normal cytology contained HPV DNA. Among the women with pathological signs, 16 of 19 (84.2%) were positive for HPV DNA. The HPV DNA-positive specimens were demonstrated to contain HPV type 6, 11, 16, 18, 31, 33, 35, 39, 40, 45, 55, or 56. The most prevalent HPV types were 6 (2.0%o) and 16 (2.7%). More than one type was found in 16 specimens. Sixty HPV-positive samples could not be typed.

The objective of this study was to evaluate a new C. trachomatis screening method based on a home sampling strategy and using the internet as a facility for the participants to obtain their test results. A population based screening study was designed in primary care setting in Umeå, Sweden. It included all males aged 22 years (n=1074), living in Umeå, a city with 100 000 inhabitants. The participation rate was 38.5%. In the study group, 1.1% were infected with C. trachomatis. Participants obtained their results on the internet and three quarters of males infected with C. trachomatis sought medical treatment independently. The number of times the internet was visited exceeded the number of urine samples tested. The internet C. trachomatis screening strategy achieved the highest male participation rate yet published, and also reached young males outside the high risk groups.