P1-S6.16 Australian chlamydia control effectiveness pilot: preliminary results from a trial of chlamydia testing in general practice

Abstract

Predictors of repeat users were measured in a matched case-control study by conditional logistic regression analysis. A case (N¼304) was defined as reporting having ever used IWTK before. A control was a user who reported never using the program earlier. Two controls (N¼608) were systematically sampled for each case by matching date of use of IWTK of the case within 3 months. Results From 2007 to 2010, 17% of 1747 women who used IWTK for STI testing indicated they had used IWTK previously. Of these, 45% used it >2 times. Mean age was 24.765.7 yr; most were African American (69%); single (87%); 57% had 2e4 sexual partners previous yr; 44% had new partners in last 3 months; 32% were currently having sex >1 person; 16% practiced anal sex in the last 3 months; 13% never used condoms; 77% had been treated for an STI; (5 HIV+). In multivariate analysis, repeat IWTK users were more likely to be $20 yr. (OR¼2.10, 95% CI 1.30 to 3.38) and reside in Maryland (OR¼2.03, 95% CI 1.31 to 3.13). They were more likely to have had a pelvic exam in past yr (OR¼2.03, 95% CI 1.36 to 3.05); be treated for an STI (OR¼2.32, 95% CI 1.57 to 3.44); to perceive internet screening as confidential (OR¼1.98, 95% CI 1.32 to 2.97); report results from self-administrated swabs as accurate (OR¼2.49, 95% CI 1.61 to 3.87); be less likely to drink alcohol before sex (OR¼0.63, 95% CI 0.44 to 0.91); and to never use condoms with vaginal sex (OR¼0.43, 95% CI 0.27 to 0.69). Of repeat users, 84.2% reported having a negative prior test and 48/304 (15.8%) reported last test positive; 27 had CT; 24 had TV; 3 had GC; 6 were mixed infections. At present test, 40 (13.2%) were positive: 14 had CT, 2 had GC, 28 had TV; 4 were mixed infections. Previous TV was associated with current TV positivity (p<0.05). Conclusions IWTK attracted many previous participants who practiced high-risk sexual behaviours to use IWTK for repeat STI testing. IWTK may offer an alternate approach for rescreening previously infected women.

Effectiveness of yearly, register based screening for chlamydia in the Netherlands: controlled trial with randomised stepped wedge implementation

“…11 The results of the Australian Chlamydia Control and Effectiveness Pilot trial of multiple rounds of opportunistic chlamydia screening in general practice could fill this evidence gap by 2014. 51 There might be other settings where systematic screening would work, for example in countries with higher prevalence or lower levels of opportunistic testing. Evaluation of interventions in cluster randomised trials with biological end points would be valuable.…”

Systematic selection of screening participants by risk score in a chlamydia screening programme is feasible and effective

“…The criteria used for selection were quite similar, including age, ethnicity, sexual behaviour and symptoms, but the application of a specific score per risk category and a cut-off total score as we used adds to the usefulness of the selection tool in a relatively low-risk population. Within opportunistic screening programmes where recruitment is either via the internet,20 the general practitioner21 or a wider range of healthcare venues,22 a risk score selection will be of great value to standardise the focus on higher risk groups, get more insight in who is applying for a test and make people aware of their own risk level.…”