Simplifying chlamydia testing: an innovative Chlamydia trachomatis testing approach using the internet and a home sampling strategy: population based study

Abstract

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...

Poor uptake of self‐sample collection kits for Chlamydia testing outside primary care

“…22,23 These opportunities for self-testing rely on people identifying themselves as candidates for Chlamydia testing, as well as knowing where to seek kits for testing. Past studies offering test-kits via the internet have had low rates of kit-use even when individuals themselves request the test.…”

Prevalence of cases of Mycoplasma hominis, Mycoplasma genitalium, Ureaplasma urealyticum and Chlamydia trachomatis in women with no gynecologic complaints

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