Abstract
BackgroundSexually active young people attending London further education (FE) colleges have high rates of chlamydia, but screening rates are low. We will conduct a cluster randomised feasibility trial of frequent, rapid, on-site chlamydia testing and same-day treatment (Test and Treat (TnT)) in six FE colleges (with parallel qualitative and economic assessments) to assess the feasibility of conducting a future trial to investigate if TnT reduces chlamydia rates.MethodsWe will recruit 80 sexually active students aged 16–24 years from public areas at each of six colleges. All participants (total n = 480) will be asked to provide samples (urine for males, self-taken vaginal swabs for females) and complete questionnaires on sexual lifestyle and healthcare use at baseline and after 7 months. Participants will be informed that baseline samples will not be tested for 7 months and be advised to get screened separately. Colleges will be randomly allocated to the intervention (TnT) or the control group (no TnT).One and 4 months after recruitment, participants at each intervention college (n = 3) will be texted and invited for on-site chlamydia tests using the 90-min Cepheid GeneXpert system. Students with positive results will be asked to see a visiting nurse health adviser for same-day treatment and partner notification, (backed by genitourinary medicine follow-up). Participants in control colleges (n = 3) will receive ‘thank you’ texts 1 and 4 months after recruitment.Seven months after recruitment, participants from both groups will be invited to complete questionnaires and provide samples for TnT. All samples will be tested, and same-day treatment offered to students with positive results.Acceptability of TnT will be assessed by qualitative interviews of purposively sampled students (n = 30) and college staff (n = 12). We will collect data on costs of TnT and usual healthcare.DiscussionFindings will provide key values to inform feasibility, sample size and timescales of a future definitive trial of TnT in FE colleges, including:Recruitment ratesTnT uptake ratesFollow-up ratesPrevalence of chlamydia in participants at baseline and 7 monthsAcceptability of TnT to students and college staffEstimate of the cost per person screened/treated in TnT versus usual careTrial registrationInternational Standard Randomised Controlled Trials Registry, ID: ISRCTN58038795, Registered on 31 August 2016.
Highlights
Active young people attending London further education (FE) colleges have high rates of chlamydia, but screening rates are low
It is estimated that 10–16% of women with untreated chlamydia will develop clinical pelvic inflammatory disease of whom 8% will have an ectopic pregnancy and 11% will suffer from tubal-factor infertility [6]
Introducing rapid, on-the-spot chlamydia tests and treatment into the community could make it easier for young people to get tested and treated faster, and before they can pass on their infection
Summary
We will recruit 80 sexually active students aged 16–24 years from public areas at each of six colleges. All participants (total n = 480) will be asked to provide samples (urine for males, self-taken vaginal swabs for females) and complete questionnaires on sexual lifestyle and healthcare use at baseline and after 7 months. One and 4 months after recruitment, participants at each intervention college (n = 3) will be texted and invited for on-site chlamydia tests using the 90-min Cepheid GeneXpert system. Students with positive results will be asked to see a visiting nurse health adviser for same-day treatment and partner notification, (backed by genitourinary medicine follow-up). Participants in control colleges (n = 3) will receive ‘thank you’ texts 1 and 4 months after recruitment. Participants from both groups will be invited to complete questionnaires and provide samples for TnT. All samples will be tested, and same-day treatment offered to students with positive results. We will collect data on costs of TnT and usual healthcare
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