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BMC Public Health
Published in: BMC Public Health 1/2010

Open Access 01-12-2010 | Research article

Home-based chlamydia testing of young people attending a music festival - who will pee and post?

Authors: Rachel Sacks-Davis, Judy Gold, Campbell K Aitken, Margaret E Hellard

Published in: BMC Public Health | Issue 1/2010

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Abstract

Background

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.

Methods

We 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.

Results

Nine 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.

Conclusions

A 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.
Appendix
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Literature
1.
2.
National Centre in HIV Epidemiology and Clinical Research: HIV/AIDS, viral hepatitis and sexually transmissible infections in Australia annual surveillance report 2008. 2008, Sydney: National Centre in HIV Epidemiology and Clinical Research The University of New South Wales
3.
Peipert J: Genital Chlamydial infections. N Engl J Med. 2003, 349: 2424-2430. 10.1056/NEJMcp030542.CrossRefPubMed
4.
Smith A, Agius P, Mitchell A, Barrett C, Pitts M: Secondary Students and Sexual Health 2008. Monograph series No 70. 2009, Melbourne: Australian Research Centre in Sex Health & Society La Trobe University
5.
Kong F, Guy R, Bergeri I, Boyle D, Hocking J, Merritt T, Britt H, Lau P, Pirotta M, Heal C, et al: Chlamydia testing rates in general practices across Australia: the Australian Collaboration for Chlamydia Enhanced Sentinel Surveillance (ACCESS). Australasian Sexual Health Conference. Brisbane. 2009
6.
Regan DG, Wilson DP, Hocking JS: Coverage Is the Key for Effective Screening of Chlamydia trachomatis in Australia. J Infect Dis. 2008, 198: 349-358. 10.1086/589883.CrossRefPubMed
7.
Pavlin NL, Gunn JM, Parker R, Fairley CK, Hocking J: Implementing chlamydia screening: what do women think? A systematic review of the literature. BMC Public Health. 2006, 6: 221-10.1186/1471-2458-6-221.CrossRefPubMedPubMedCentral
8.
Buhrer-Skinner M, Muller R, Bialasiewicz S, Sloots TP, Debattista J, Gordon R, Buettner PG: The check is in the mail: piloting a novel approach to Chlamydia trachomatis testing using self-collected, mailed specimen. Sex Health. 2009, 6: 163-169. 10.1071/SH08076.CrossRefPubMed
9.
Ford CA, Viadro CI, Miller WC: Testing for chlamydial and gonorrheal infections outside of clinic settings: a summary of the literature. Sex Transm Dis. 2004, 31: 38-51. 10.1097/01.OLQ.0000105117.77684.B9.CrossRefPubMed
10.
Marrazzo JM, Scholes D: Acceptability of urine-based screening for Chlamydia trachomatis in asymptomatic young men: a systematic review. Sex Transm Dis. 2008, 35: S28-33. 10.1097/OLQ.0b013e31816938ca.CrossRefPubMed
11.
Jones HE, Altini L, de Kock A, Young T, van de Wijgert JHHM: Home-based versus clinic-based self-sampling and testing for sexually transmitted infections in Gugulethu, South Africa randomised controlled trial. Sex Transm Infect. 2007, 83: 552-557. 10.1136/sti.2007.027060.CrossRefPubMedPubMedCentral
12.
Lippman SA, Jones HE, Luppi CG, Pinho AA, Veras MAMS, van de Wijgert JHHM: Home-based self-sampling and self-testing for sexually transmitted infections: acceptable and feasible alternatives to provider-based screening in low-income women in Sao Paulo, Brazil. Sex Transm Dis. 2007, 34: 421-428.PubMed
13.
van Bergen JEAM, Postma MJ, Peerbooms PGH, Spangenberg AC, Tjen-A-Tak J, Bindels PJE: Effectiveness and cost-effectiveness of a pharmacy-based screening programme for Chlamydia trachomatis in a high-risk health centre population in Amsterdam using mailed home-collected urine samples. Int J STD AIDS. 2004, 15: 797-802. 10.1258/0956462042563765.CrossRefPubMed
14.
Gaydos CA, Barnes M, Aumakhan B, Quinn N, Agreda P, Whittle P, Hogan T: Males will submit self-obtained penile swabs for the detection of Chlamydia Trachomatis when recruited via the internet: acceptability and accuracy. J Adolesc Health. 2009, 44: S9-10.1016/j.jadohealth.2008.10.028.CrossRef
15.
Gaydos CA, Dwyer K, Barnes M, Rizzo-Price PA, Wood BJ, Flemming T, Hogan MT: Internet-based screening for Chlamydia trachomatis to reach non-clinic populations with mailed self-administered vaginal swabs.[erratum appears in Sex Transm Dis. 2007 Aug;34(8):625]. Sex Transm Dis. 2006, 33: 451-457. 10.1097/01.olq.0000200497.14326.fb.CrossRefPubMed
16.
Gaydos CA, Rizzo-Price PA, Barnes M, Dwyer K, Wood BJ, Hogan MT: The use of focus groups to design an internet-based program for chlamydia screening with self-administered vaginal swabs: what women want. Sex Health. 2006, 3: 209-215. 10.1071/SH05059.CrossRefPubMed
17.
Tebb KP, Paukku MH, Pai-Dhungat MR, Gyamfi A-A, Shafer M-AB: Home STI testing: the adolescent female's opinion. J Adolesc Health. 2004, 35: 462-467.PubMed
18.
Domeika M, Oscarsson L, Hallén A, Hjelm E, Sylvan S: Mailed urine samples are not an effective screening approach for Chlamydia trachomatis case finding among young men. J Eur Acad Dermatol Venereol. 2007, 21: 789-794. 10.1111/j.1468-3083.2006.02088.x.CrossRefPubMed
19.
van Bergen J, Gotz HM, Richardus JH, Hoebe CJPA, Broer J, Coenen AJT, for the PCTsg: Prevalence of urogenital Chlamydia trachomatis increases significantly with level of urbanisation and suggests targeted screening approaches: results from the first national population based study in the Netherlands. Sex Transm Infect. 2005, 81: 17-23. 10.1136/sti.2004.010173.CrossRefPubMedPubMedCentral
20.
Low N, McCarthy A, Macleod J, Salisbury C, Campbell R, Roberts TE, Horner P, Skidmore S, Sterne JAC, Sanford E, et al: Epidemiological, social diagnostic and economic evaluation of population screening for genital chlamydial infection. Health Technol Assess. 2007, 11: iii-iv. ix-xii, 1-165CrossRefPubMed
21.
Bloomfield PJ, Kent C, Campbell D, Hanbrook L, Klausner JD: Community-based chlamydia and gonorrhea screening through the United States mail, San Francisco. Sex Transm Dis. 2002, 29: 294-297. 10.1097/00007435-200205000-00008.CrossRefPubMed
22.
Brabin L, Thomas G, Hopkins M, O'Brien K, Roberts S: Delivery of chlamydia screening to young women requesting emergency hormonal contraception at pharmacies in Manchester, UK: a prospective study. BMC Womens Health. 2009, 26: 7-10.1186/1472-6874-9-7.CrossRef
23.
Andersen B, Ostergaard L, Moller J, Olesen F: Effectiveness of a mass media campaign to recruit young adults for testing of Chlamydia trachomatis among participants in a probability sample survey of sexual attitudes and lifestyles. Sex Transm Infect. 2001, 77: 416-418. 10.1136/sti.77.6.416.CrossRefPubMedPubMedCentral
24.
Lim M, Hellard M: Surveillance of STI risk behaviour among young people attending a music festival in Australia, 2005-08. Aust N Z J Public Health. 2009, 33 (5): 482-484. 10.1111/j.1753-6405.2009.00434.x.CrossRefPubMed
25.
Lim MSC, Hellard ME, Hocking JS, Aitken CK: A cross-sectional survey of young people attending a music festival: associations between drug use and musical preference. Drug Alcohol Rev. 2008, 27: 439-441. 10.1080/09595230802089719.CrossRefPubMed
26.
National Pathology Accreditation Advisory Council: Requirements for the packaging and transport of pathology specimens and associated materials: third edition. 2007, Canberra: Commonwealth of Australia
27.
Costa A-M, Fairley CK, Garland SM, Tabrizi SN: Evaluation of self-collected urine dip swab method for detection of Chlamydia trachomatis. Sex Health. 2009, 6: 213-216.CrossRefPubMed
28.
Knox JMF, Tabrizi SNP, Miller PMF, Petoumenos KBMA, Law MMAMP, Chen SM, Garland SMMMFFF: Evaluation of Self-Collected Samples in Contrast to Practitioner-Collected Samples for Detection of Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis by Polymerase Chain Reaction Among Women Living in Remote Areas. Sex Transm Dis. 2002, 29: 647-654. 10.1097/00007435-200211000-00006.CrossRefPubMed
29.
Gordon A, Maisto S, McNeil M, Kraemer K, Conigliaro R, Kelley M: Three questions can detect hazardous drinkers. J Fam Pract. 2001, 50: 313-320.PubMed
30.
Australian Institute of Health and Welfare: Rural, regional and remote health: a guide to remoteness classifications. Rural health. 2004, Canberra: Australian Government Australian Institute of Health and Welfare
31.
Australian Bureau of Statistics: Australian Standard Geographical Classification (ASGC) Remoteness Areas (cat. no. 1216.0). 2006
32.
Currie M, Schmidt M, Davis B, Baynes A, O'Keefe E, Bavinton T, McNiven M, Martin S, Bowden F: 'Show me the money': financial incentives increase chlamydia screening rates among tertiary students: a pilot study. Sexual Health. 2010, 7: 60-65. 10.1071/SH08091.CrossRefPubMed
33.
Kong FY, Hocking JS, Link CK, Chen MY, Hellard ME: Sex and sport: chlamydia screening in rural sporting clubs. BMC Infect Dis. 2009, 9: 73-10.1186/1471-2334-9-73.CrossRefPubMedPubMedCentral
34.
Blake DR, Lemay CA, Indurkhya A: Correlates of Readiness to Receive Chlamydia Screening Among 2 Populations of Youths. Arch Pediatr Adolesc Med. 2007, 161: 1088-1094. 10.1001/archpedi.161.11.1088.CrossRefPubMed
35.
Leenaars PEM, Rombouts R, Kok G: Seeking medical care for a Sexually Transmitted Disease: Determinants of delay-behavior. Psychology & Health. 1993, 8: 17-32. 10.1080/08870449308403164.CrossRef
36.
Kahn JA, Goodman E, Huang B, Slap GB, Emans SJ: Predictors of papanicolaou smear return in a hospital-based adolescent and young adult clinic. Obstet Gynecol. 2003, 101: 490-499. 10.1016/S0029-7844(02)02592-9.PubMed
37.
Egger G, Spark R, Donovan R: Health Promotion Strategies and Methods. 2005, North Ryde: McGraw Hill
38.
Rosenthal D, Hall C, Moore S: AIDS, adolescents and sexual risk-taking: a test of the health belief model. Australian Psychologist. 1992, 27: 166-171. 10.1080/00050069208257605.CrossRef
39.
Banikarim C, Chacko MR, Wiemann CM, Smith PB: Gonorrhea and Chlamydia Screening Among Young Women: Stage of Change DecisionalBalanceand Self-efficacy. J Adolesc Health. 2003, 32: 288-295. 10.1016/S1054-139X(02)00706-1.CrossRefPubMed
40.
Ford C, English A, Sigman G: Confidential health care for adolescents: position paper for the Society for Adolescent Medicine. J Adolesc Health. 2004, 35: 160-167.CrossRefPubMed
41.
Navarro C, Jolly A, Nair R, Chen Y: Risk factors for genital chlamydia infection. Journal of Sexual and Reproductive Medicine. 2003, 3: 23-34.
42.
Hoover K, Tao G: Missed opportunities for chlamydia screening of young women in the United States. Obstet Gynecol. 2008, 111: 1097-1102.CrossRefPubMed
43.
Ray MN, Wall T, Casebeer L, Weissman N, Spettell C, Abdolrasulnia M, Mian MAH, Collins B, Kiefe CI, Allison JJ: Chlamydia screening of at-risk young women in managed health care: characteristics of top-performing primary care offices. Sex Transm Dis. 2005, 32: 382-386. 10.1097/01.olq.0000162367.39209.01.CrossRefPubMed
44.
Ward B, Rodger AJ, Jackson TJ: Modelling the impact of opportunistic screening on the sequelae and public healthcare costs of infection with Chlamydia trachomatis in Australian women. Public Health. 2006, 120: 42-49. 10.1016/j.puhe.2005.03.002.CrossRefPubMed
45.
Hocking J, Lim M, Vidanapathirana J, Read T, Hellard M: Chlamydia testing in general practice - a survey of Victorian general practitioners. Sex Health. 2006, 3: 241-244. 10.1071/SH06042.CrossRefPubMed
46.
Joffe A, Radius S, Gall M: Health Counseling for Adolescents: What They Want, What They Get, and Who Gives It. Pediatrics. 1988, 82: 481-485.PubMed
47.
Cooper M: Alcohol use and risky seual behavior among college students and youth: evaluating the evidence. J Stud Alcohol. 2002, 101-117. Suppl
48.
Weinhardt LS, Carey MP: Does alcohol lead to sexual risk behavior? Findings from event-level research. Annu Rev Sex Res. 2000, 11: 124-157.
49.
Lim M, Hocking J, Aitken C, Hellard M: Discrepancies between young people's self-reported sexual experience and their perceptions of 'normality'. Sex Health. 2009, 6: 171-172. 10.1071/SH09001.CrossRefPubMed
50.
Lim MSC, Hellard ME, Hocking JS, Aitken CK: A cross-sectional survey of young people attending a music festival: associations between drug use and musical preference. Drug Alcohol Rev. 2008, 27: 439-441. 10.1080/09595230802089719.CrossRefPubMed
51.
Catania J, Gibson D, Chitwood D, Coates T: Methodological problems in AIDS behavioral research: influences on measurement error and participation bias in studies of sexual behavior. Psychol Bull. 1990, 108: 339-362. 10.1037/0033-2909.108.3.339.CrossRefPubMed
Metadata
Title
Home-based chlamydia testing of young people attending a music festival - who will pee and post?
Authors
Rachel Sacks-Davis
Judy Gold
Campbell K Aitken
Margaret E Hellard
Publication date
01-12-2010
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2010
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-10-376

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