There is limited research in Australia focusing on C. trachomatis infection at a population level utilising systematic non-random recruitment methodologies. In addition, little is known in the Australian Defence Force (ADF) about the prevalence of C. trachomatis and of risk behaviours that may impact on sexual health. This study utilised an existing process in the ADF, the Annual Health Assessment, to source new information about C. trachomatis infection and about sexual risk and behaviour. The outcomes of this research may assist the ADF to maintain the health of personnel and consequently a high degree of operational preparedness, and may contribute to the understanding of C. trachomatis prevalence in Australia and across the world.The aims of this study were to determine the prevalence of C. trachomatis infection and to identify potential high risk populations in the ADF with a view to discussing secondary prevention interventions for the control of C. trachomatis infection within the ADF.Seven hundred and thirty-three ADF personnel were recruited into the study over a 24 month period. Participants were asked to complete an 8 page comprehensive survey about sexual behaviour and to provide a urine sample to be tested for C. trachomatis.
Ethics approval was received from both the Australian Defence Human Research EthicsCommittee and the University of Queensland Medical Research Ethics Committee.The study examined ADF personnel on deployment and on base in order to provide a comparison of populations across varying work environments. Similarly, this study examined ADF personnel who had recently taken a course of doxycycline for malaria prophylaxis as part of deployment and those who had not in order to assess whether the prophylactic use of antibiotics for other purposes may have had an effect on the acquisition of C. trachomatis. This study enrolled participants from the three services in the ADF, the army, navy and air force, across 10 sites in Australia and four deployments to obtain a wide cross section of the ADF population. The findings from this study provide a profile of ADF sexual health and sexual behaviour that is comparable to the Australian population and identifies, in some instances, greater levels of safe practice and lower levels of risk behaviour. Additionally, the ADF has a lower prevalence of C. trachomatis This study examined rates of attendance at health services for sexual health concerns.18.12% (age and gender adjusted) of participants indicated they attended a health service for a sexual health concern in the previous 12 months. Females were significantly more likely to attend a health service than males (26.45% vs 16.52%; p=0.005; OR 1.81 95% CI 1.19-2.76) for a sexual health matter. Participants were three times more likely to attend an ADF health service for testing and treatment of an STI than to attend a civilian health service (16.4% vs 5.61% p<0.0001). Those who engaged in some unsafe sex were significantly more likely to attend a health service for a sexual health matter ...