Centralised contact tracing, exploring the sexual history for at least 12 months back in time, shows good results. Combined with screening of certain risk groups it is probably one effective way of preventing C trachomatis infections. Preventing C trachomatis by primary prevention such as information and counselling is, however, still of great importance.

Chlamydia trachomatis (CT) infection has been a target for both selective and national screening programmes, and Sweden has an opportunistic approach. A national plan of action states that risk groups should be identified and offered risk reduction counselling. Patients attending a drop-in sexually transmitted infection (STI) clinic reception at the University Hospital, Umeå, Sweden, were invited to complete a questionnaire regarding sociodemographic characteristics, symptoms and sexual risk behaviour; all had a CT test taken. A total of 1305 patients were included, 58% men, mean age 27.8 years. CT prevalence was 11%; 51% of those with CT were ≥ 25 years old. Only 5% used a condom during the entire sexual intercourse with their last new/temporary partner. Sexually active inconsistent condom users comprised 62% of the study population and contributed to 81% of the chlamydia infections. Asking whether a condom was used could quickly triage patients into groups with a 'higher risk' (none or inconsistent use of condoms and at least one new/temporary partners), and 'lower risk' (with more consistent condom use, although not always accurate) allowing for individualized care and counselling when screening for chlamydia. Evaluating whether a condom was used throughout the sexual intercourse did not add any useful information.

Women and men reacted differently when diagnosed with CT. Women worried more about complications and more often blamed themselves for being infected. Being aware of these gender differences may be important when planning preventive measures and during counselling of CT-infected patients. Persons working with patients with CT must also be aware of the high frequency of harmful alcohol consumption among their patients.

No abstract

Sexual habits have changed over the last few years, including an increase in the practise of oral sex. As a result, the frequency of genital herpes simplex virus type I infections has increased (I). Because of these changing habits, this study aimed to investigate whether patients attending our venereological clinic are also infected by Chlamydia trachomatis in the throat. Knowledge about extra-genital C. irachortiatis infection in the throat is not extensive, and the prevalence of C. trachomatis in patients complaining of sore throat is unknown. MATERIALS AND METHODSA total of 172 patients (92 men. 80 women) attending the Venereological Clinic, Department of Dermatology and Venereology, University Hospitai, Umea, during 2002 to 2006, for C. fríichoniíitis tests and confirming practising oral sex within the last 6 months were included in the study. Ail patients reported heterosexual contacts only.Tests were taken both as pharyngcal swabs and by letting the patient gargie 10 ml of water for about 30 s and then spit it into a test tube. Both tests were taken from the same patient and the swab was placed in the tube with the water that had been gargled. Ali patients were also tested for cervical or urethral C. trachotvatt.s in urine samples and a swab taken from the cervix and transported to the laboratory in the urine sampie. Patients with symptoms in the eyes were also tested with a swab roiled on the inside ofthe conjunctiva.Swab and gargle tests, urine/cervix or urine samples and eye samples were analysed by nucleic acid amplification test (NAAT). Detection for C. trachomatis was made by Becton & Dickinson ProbeTec ET an strand displacement amplification (SDA) test (2). RESULTSFour out of 172 (2.3%) patients, 3 women and I man, tested positive for C. trachomatis in the throat. They all also tested positive in the urine and 3 of thetn, 2 women and 1 man, in the eye as well.This means that 2.3% ofthe patients were positive regarding C. trachomatis in the throat, ln the genital/ urethral C. trachomatis sample 12.9% were positive, and 1.8% were positive regarding C. trachotnatis in the eye. Some patients complained of sore throat, most of them due to a cold, and 3 out of4 ofthe patients with C. trachomatis in the throat were found to be completely free of throat symptoms. DISCUSSIONIn our opinion it is impossible to identify patients infected with C trachomatis in the throat by clinical symptoms and signs alone.Our findings ofa frequency of C. trachomatis in the throat of 2.3% is in accordance with that of Kent et al.(3). who found a prevalence of pharyngeal C. trachotnatis among men having sex with men (MSM) of 1.4%; and Winter et al. (4) who had a prevalence of 1.5% in a study of 264 patients, sexual preference unknown. Coughlan & Young (5) found no pharyngeal C. trachomatis in 297 patients, 18 women and 279 men. mostly MSM. Regarding our C. trachotnatis positive patients, 4out of 22 patients, 18%, 3/15 women and 1/7 men were positive in the throat as well as in the cervix/urethra. The remaining 144 patients were ...