Chlamydia tests need to be 'destigmatised'

Quizzing women about their sexual history discourages attendance for chlamydia screening.

GPs should offer chlamydia screening to patients based on age rather than sexual history to help boost screening uptake, according to Australian research.

The proportion of chlamydia screens performed in GP practices in England has fallen from 63 per cent in 2003, when the National Chlamydia Screening Programme (NCSP) was first introduced, to just 15 per cent in 2006/7.

However, the research found that young women were found to be more likely to agree to be screened for the infection if their GP did not discuss sexual history with them.

For the study, face-to-face interviews were conducted with 24 young, sexually active women, aged 16 to 24, to determine their attitudes towards chlamydia screening in general practice.

All of the women felt that chlamydia screening should be offered to all young women, aged 16-24, rather than targeted at high-risk women based on sexual history.

The women also reported that they did not want to be asked to provide a sexual history as part of being asked to have a chlamydia test. Many said that they would lie if asked about the number of people with whom they had had sexual contact.

The researchers acknowledged the importance of young women understanding that chlamydia was an STI and that sexual partners should be notified of positive tests, but added that chlamydia testing nevertheless needed to be destigmatised.

Lead researcher Dr Natasha Pavlin, from the department of general practice at the Univer-sity of Melbourne, said: 'The importance of normalising the offer of chlamydia testing, so that individual women do not feel singled out, cannot be overemphasised.'

But north London GP Dr Richard Ma, a member of the NCSP committee, warned that a screening strategy based solely on age could lead to patients with chlamydia being left untreated.

'Some patients may come forward and be screened just once between the ages of 16-24,' he said. 'They are not likely to be screened every year so it is important to take a sexual history to identify those most at-risk.'

BMC Infectious Diseases 2008; 1471: 2,334-62

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