Feasibility and acceptability in health centers of screening for chlamydia in deprived population

Abstract

Abstract Issue The French Health Insurance (FHI) is in charge of the governance of 100 Health Examination Centers (HEC). HEC provide evidence-based interventions in prevention, focused on deprived population. In France, Chlamydia trachomatis (Ct) infection is the most sexually transmitted infection, especially among young women. Description of the problem To assess the feasibility of systematic screening Ct infection, in HEC, among 18-25 years women and 18-30 years men, with a focus on self-sampling. Pragmatics questions were: how the youth accept the screening of Ct infection (especially the self-taken vaginal swabs)? Was the feasibility and Ct positivity similar between deprived and non-deprived population (according to the EPICES score)? A cross-sectional multicenter survey was performed in 13 HEC in January 2018. Results Screening was proposed to 1702 eligible young people (sexually active and no recent Ct treatment). 90.3% [88.8-91.6] accepted and participated: 44% women, 54% deprived people. Among women, 76.8% [73.4-79.9] used self-taken vaginal swabs, others urinary tests. Rates did not differ according to deprivation (p = 0.96). Screening was performed in 1487 people (96.7% for deprived vs 97.7% for non-deprived population, p = 0.258). Ct detection rate was 4.7% [3.7%-5.9%], significantly higher for deprived population (6.5% vs 2.5%, p < 0.001). Lessons The results demonstrated the feasibility of Ct screening in HEC with a good acceptance among youth even among young deprived. The performance rate of the test was similar according to deprivation. However, deprivation was associated with having a positive Ct result. This feasibility led to the implementation of Ct screening in all HEC. Key messages Chlamydia trachomatis screening can be easily implemented even in deprived populations that accept and perform it as well as non-deprived populations. Promoting access to Chlamydia trachomatis screening to deprived populations might contribute to reduce social inequalities in health.