The results of an 18-month prospective study of 1,971 women in England have prompted calls for annual chlamydia screening for all women aged 16 to 24, with earlier tests for those with a new sexual partner.
Women testing positive for chlamydia should be retested at six-month intervals, or sooner, if they have a new or untreated partner, researchers suggested.
The participants were aged between 16 and 24 years and were recruited from GP practices, GUM or family planning clinics. The women completed behavioural questionnaires and underwent chlamydia testing at six-month intervals.
Analysis showed that infection rates were up to six times higher in women previously infected with chlamydia than those whose initial result was negative.
Among women recruited from GP practices, chlamydia incidence was 4.9 per 100 person-years and the reinfection rate was 29.9 per 100 person-years. New sexual partner transition and young age were also associated with high incidence of infection. Failure to treat sexual partners was a major cause of reinfection.
The current National Chlamydia Screening Programme, which should be rolled out nationally by April 2007, recommends women aged 16 to 24 are tested but does not run to a schedule.
North London GP Dr Richard Ma, a member of the National Chlamydia Screening steering group, said the evidence will ‘definitely inform’ any guidelines developed on retesting patients and is likely to be discussed at their next meeting in December.
‘It would mean more work for GPs because screening once is not good enough, so the implication is more screening,’ he said.
Dr Chris Ford, a GP in Brent and member of the RCGP sex, drugs and HIV working party, backed the research and said annual chlamydia screens for women aged 16 to 24 were already under way in her PCT.
‘It should be done in general practice as smears are done now,’ she said, adding that this will only take place nationally if chlamydia screening is incentivised in the quality framework.
