ObjectivesTo develop and measure the effectiveness and acceptability of a pharmacy-based chlamydia screening intervention called Emergency Contraception Mediated Pharmacy Access to Chlamydia Testing (ECOMPACT).DesignSelective, opportunistic and cross-sectional study targeting asymptomatic women requesting emergency contraception (EC).Setting20 community pharmacies in the Perth metropolitan region, Australia.MethodsECOMAPCT was developed through literature review and stakeholder consensus. Pharmacists were trained to offer ECOMPACT after the EC consultation. Women with signs and symptoms of sexually transmitted infections (STI) were referred to a physician for a full sexual health check. Asymptomatic women were offered a free ECOMPACT testing kit. The women self-collected a low-vaginal swab and returned their pathological specimen to designated drop-off sites. A pathology service analysed the specimens and sent the results to a sexual health physician. The effectiveness of ECOMPACT was determined by the uptake of the intervention and how well the target population was reached. An effective screening rate was calculated. Qualitative analysis was undertaken to understand acceptability issues from the perspective of the consumer and the pharmacists.ResultsOf the 769 EC consultations in a 6-month period, 569 (78%) women were given information on chlamydia screening. All 247 (41%) agreed to participate. 81 (33%) of these women were ineligible. They were either symptomatic (n=33; 41%), or were under 18 years of age (n=48; 59%). Pharmacists successfully requested 166 (67%) pathology tests, of which 46 (28%) were returned to a pathology drop-off site. All tested negative for Chlamydia trachomatis. The effective screening rate was 6%. Consumers and pharmacists considered ECOMPACT to be highly convenient and the time taken to offer a chlamydia test along with an EC consultation as highly appropriate.ConclusionsECOMPACT was found to be simple, effective and acceptable. Given the opportunity, adequate training and support, community pharmacists in Australia were capable of requesting direct-to-consumer chlamydia tests.

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Results Violencephysical assault, sexual assault, drink-driving crashes, and suicidecomprised 84% of the burden in Alexandra, 74% in Zacatecas, 65% in Leuven, and 56%-59% elsewhere. Physical and sexual assault alone comprised 32%-72%. Drink-driving comprised 10%-21%. Conclusions Achieving this SDG goal will require creating effective violence prevention programs. Our physical assault estimates greatly exceed GBD's estimates. GBD's assault incidence sets a high severity threshold for qualifying cases. Its alcohol-attributable fractions for physical assault average one third of the estimates in widely respected multinational studies. GBD 2017 also attributed no sexual violence to harmful alcohol use.

Background: Intimate partner violence (IPV) and reproductive coercion (RC) can result in serious psychological, social and physical harm. Screening patients for IPV/RC has the potential to identify and assist patients who may not otherwise discuss this with a health practitioner. Targeted screening for those with a range of specific presentations including many sexual and reproductive health issues has been recommended, but universal screening has not. Methods:The implementation and evaluation of a screening program for IPV and RC in an urban sexual and reproductive health clinic is described. Results:The program enabled patients who had been exposed to IPV and/or RC to receive assistance and support. Screening was highly acceptable to patients, and the reception and clinical staff became both highly supportive of screening and increasingly confident to assist patients who were exposed to IPV and/or RC. Conclusion and implications for public health:This program could be adapted for use in a number of healthcare settings and lead to positive health outcomes.