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Patterns of chlamydia testing in different settings and implications for wider STI diagnosis and care: a probability sample survey of the British population

Clifton, S; Mercer, CH; Woodhall, SC; Sonnenberg, P; Field, N; Lu, L; Johnson, AM; (2017) Patterns of chlamydia testing in different settings and implications for wider STI diagnosis and care: a probability sample survey of the British population. SEXUALLY TRANSMITTED INFECTIONS , 93 (4) pp. 276-283. 10.1136/sextrans-2016-052719. Green open access

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Abstract

Background: Following widespread rollout of chlamydia testing to non-specialist and community settings in the UK, many individuals receive a chlamydia test without being offered comprehensive STI and HIV testing. We assess sexual behaviour among testers in different settings with a view to understanding their need for other STI diagnostic services. Methods: A probability sample survey of the British population undertaken 2010–2012 (the third National Survey of Sexual Attitudes and Lifestyles). We analysed weighted data on chlamydia testing (past year), including location of most recent test, and diagnoses (past 5 years) from individuals aged 16–44 years reporting at least one sexual partner in the past year (4992 women, 3406 men). Results: Of the 26.8% (95% CI 25.4% to 28.2%) of women and 16.7% (15.5% to 18.1%) of men reporting a chlamydia test in the past year, 28.4% of women and 41.2% of men had tested in genitourinary medicine (GUM), 41.1% and 20.7% of women and men respectively tested in general practice (GP) and the remainder tested in other non-GUM settings. Women tested outside GUM were more likely to be older, in a relationship and to live in rural areas. Individuals tested outside GUM reported fewer risk behaviours; nevertheless, 11.0% (8.6% to 14.1%) of women and 6.8% (3.9% to 11.6%) of men tested in GP and 13.2% (10.2% to 16.8%) and 9.6% (6.5% to 13.8%) of women and men tested in other non-GUM settings reported ‘unsafe sex’, defined as two or more partners and no condom use with any partner in the past year. Individuals treated for chlamydia outside GUM in the past 5 years were less likely to report an HIV test in that time frame (women: 54.5% (42.7% to 65.7%) vs 74.1% (65.9% to 80.9%) in GUM; men: 23.9% (12.7% to 40.5%) vs 65.8% (56.2% to 74.3%)). Conclusions: Most chlamydia testing occurred in non-GUM settings, among populations reporting fewer risk behaviours. However, there is a need to provide pathways to comprehensive STI care to the sizeable minority at higher risk.

Type: Article
Title: Patterns of chlamydia testing in different settings and implications for wider STI diagnosis and care: a probability sample survey of the British population
Open access status: An open access version is available from UCL Discovery
DOI: 10.1136/sextrans-2016-052719
Publisher version: http://dx.doi.org/10.1136/sextrans-2016-052719
Additional information: This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/
Keywords: Science & Technology, Life Sciences & Biomedicine, Infectious Diseases, SEXUALLY-TRANSMITTED INFECTIONS, LIFE-STYLES NATSAL-3, UK GENERAL-PRACTICE, GENITAL CHLAMYDIA, NATIONAL-SURVEY, YOUNG-ADULTS, HEALTH, TRACHOMATIS, ATTITUDES, INTERNET
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health > Infection and Population Health
URI: https://discovery.ucl.ac.uk/id/eprint/1534430
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