Abstract
BackgroundChlamydia is most common among young people, but only a small proportion of Australian young people are tested annually. Home-based chlamydia testing has been piloted in several countries to increase testing rates, but uptake has been low. We aimed to identify predictors of uptake of home-based chlamydia testing to inform future testing programs.MethodsWe offered home-based chlamydia testing kits to participants in a sexual behaviour cross-sectional survey conducted at a music festival in Melbourne, Australia. Those who consented received a testing kit and were asked to return their urine or vaginal swab sample via post.ResultsNine hundred and two sexually active music festival attendees aged 16-29 completed the survey; 313 (35%) opted to receive chlamydia testing kits, and 67 of 313 (21%) returned a specimen for testing. One participant was infected with chlamydia (1% prevalence). Independent predictors of consenting to receive a testing kit included older age, knowing that chlamydia can make women infertile, reporting more than three lifetime sexual partners and inconsistent condom use. Independent predictors of returning a sample to the laboratory included knowing that chlamydia can be asymptomatic, not having had an STI test in the past six months and not living with parents.ConclusionsA low proportion of participants returned their chlamydia test, suggesting that this model is not ideal for reaching young people. Home-based chlamydia testing is most attractive to those who report engaging in sexual risk behaviours and are aware of the often asymptomatic nature and potential sequelae of chlamydia infection.
Highlights
Chlamydia is most common among young people, but only a small proportion of Australian young people are tested annually
We offered all participants the opportunity to be posted a home chlamydia testing kit, and 313 (35%; 32% of male and 37% of female participants) consented
Given that young people who engage in sexual risk behaviour are more likely to express interest in home-based chlamydia testing, our study may over-estimate the proportion of young people interested in testing
Summary
Chlamydia is most common among young people, but only a small proportion of Australian young people are tested annually. Home-based chlamydia testing has been piloted in several countries to increase testing rates, but uptake has been low. We aimed to identify predictors of uptake of home-based chlamydia testing to inform future testing programs. Chlamydia (Chlamydia trachomatis) is the most prevalent bacterial sexually transmitted infection (STI) in the western world[1] and the most common notifiable infectious disease in Australia[2]. Rates of chlamydia infection are increasing worldwide, and Australian notification rates quadrupled from 1999 to 2008[2]. Infection is concentrated in youth, with approximately 80% of notifications being among those aged 15 to 29 years[2]. Despite being the population group at highest risk of STIs, young Australians know little about STIs other than Over 80% of infections are asymptomatic,[3] making screening necessary to detect and treat cases.
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