"Pee-in-a-Pot": acceptability and uptake of on-site chlamydia screening in a student population in the Republic of Ireland

Abstract

BackgroundThe aim of the study was to explore the acceptability and uptake of on-campus screening using a youth friendly approach in two Third Level higher education institutions (HEIs). This study is part of wider research exploring the optimal setting for chlamydia screening in Ireland.MethodsMale and female students were given the opportunity to take a free anonymous test for chlamydia during a one week programme of "pee-in-a-pot" days at two HEI campuses in the West of Ireland. The study was set up after extensive consultation with the two HEIs and advertised on the two campuses using a variety of media in the two weeks preceding the screening days. Screening involved the provision and distribution of testing packs at communal areas and in toilet facilities. In Ireland, chlamydia notifications are highest amongst 20-29 year olds and hence the screening criterion was aimed at 18-29 year olds. Urine samples were tested using a nucleic acid amplification test (NAAT). Following the screening days, qualitative in-depth interviews were conducted with participants about their experiences of the event.ResultsOut of 1,249 test kits distributed in two HEIs, 592 specimens were collected giving a return rate of 47.5%. Tests excluded (54) were due to labelling errors or ineligibility of participants' age. Two thirds of those tested were females and the mean age was 21 years. Overall,3.9% (21/538) of participants tested positive, 5% (17/336) among females and 2% (4/191) among males. Participant interviews identified factors which enhanced student participation such as anonymity, convenience, accessibility of testing, and the informal and non-medical approach to testing.ConclusionsScreening for chlamydia using on-campus "pee-in-a-pot" days is an acceptable strategy in this population. This model can detect and treat asymptomatic cases of chlamydia and avoid many of the barriers associated with testing for sexually transmitted infections (STIs) in clinical settings.

Factors associated with Chlamydia trachomatis testing in a high school based screening and previously in clinical practice: a cross-sectional study in Norway

“…Male participants frequently commented on the simplicity of urinating in a cup and the convenience of a class-wise approach with everyone getting tested. Adolescent males are more likely to accept STI testing if the testing procedures are convenient [17,21,22] and if they feel that confidentiality is maintained [23]. Individual provider characteristics may also impact on their decision [24,25].…”

Chlamydia trachomatis screening in young women

“…Sexual health promotion advice can be provided on websites or through telephone counselling. Young people value the anonymity, convenience and accessibility of testing without the need for a consultation and the informal and nonmedical approach [51,52]. Emerging evidence suggesting that testing via the Internet is increasing and may appeal to young people at high risk of infection; a US study reported higher positivity from Internet screens than tests taken from contraceptive services [53].…”

Chlamydia Screening Strategies and Outcomes in Educational Settings

“…In a program that conducted screening in 2 consecutive school years, 53% of participants in the first year were retested in the next year, and the repeat CT positivity was 21.1%. These 4 programs used various student events for screening such as orientation week 29 ; sexual health awareness and guidance week 48 ; school health fair 46 ; orientation week; market stalls; band and bar nights; sporting events; scavenger hunts; and Halls of Residence. 36 Event-Based Screening.…”

“…36 Event-Based Screening. 48 In one program, test packs were available in bathrooms as well as distributed by volunteers with specimen collection boxes placed inside toilet areas. 31 Screening was promoted through advertisements including posters 29 ; posters, student media, SMS, Web sites, and education sessions 31 ; and posters, leaflets, media, radio, e-mail, and newspapers.…”

“…These 4 programs used various student events for screening such as orientation week 29 ; sexual health awareness and guidance week 48 ; school health fair 46 ; orientation week; market stalls; band and bar nights; sporting events; scavenger hunts; and Halls of Residence. 48 Across these programs, 1861 tests were conducted (median, 564). 48 In one program, test packs were available in bathrooms as well as distributed by volunteers with specimen collection boxes placed inside toilet areas.…”