Chlamydia screening in Ireland: A pilot study of opportunistic screening for genital chlamydia trachomatic infection in Ireland ( 2007 - 2009): pre-screening report: study background, acceptability and feasability of screening

摘要

1udSummaryududA series of background studies in 18 to 29 year olds were conductedudin a rangeudof primary care settings in Dublin and Galway, 2007ud-ud09, to assess theudacceptability and feasibility of opportunistic screening for chlamydia:udoudsemiud-udstructured interviews witudh 35 women who had never been testedudfor a sexually transmitted infection (STI)udoudsimilar interviews with 30 men and women who had had a STI testudouda questionnaire survey of 5685 students and 400 primary care patientsudoudfour focus group discussions with universiudty studentsudoudsemiud-udstructured interviews with eight doctors and 10 practice nurses.ududThe most important barrierudto seeking or taking a STI testudwas the stigmaudyoung Irish men and womenudassociated with chlamydia and other STIsud, andudthe fear of being seen doingudthis. This fear was greater among young women.ududYoung people, especially women, were aware that chlamydia infection wasudoften asymptomatic and were conscious of the danger of complications such asudinfertility and the consequences of transmitting chlamydiuda to other women.ududFactors that would encourage acceptance of a chlamydia screening test, whichudwere common to women and men, were:udoudnormalisudingudSTI testing, by portraying it as a responsible practice thatudadults should engage inudoudnot being asked questions budy staff about their sexual historyudoudbudeing offered screening by younger nonud-udjudgmental female healthcareudprofessionalsudoudbeing offeredudscreening in privateudor general health care settings, whereudothers would not be aware that they were getting an STI testududTherude was a high level of acceptance of chlamydia screening among youngudpeople: 95% said it would be acceptable to be offered a test, and 90% of healthudfacility attendees and 75% of students said they would accept a test if offered.ududThe most acceptable settinudg for chlamydia screening was a General Practiceudwhere respondents were most comfortable with being offered screening by auddoctor or nurse. Other primary care settings were also acceptable, whereasudpharmacies were not because they were seen as public settudings.udud80% said they would inform their current partner if they tested positive forudchlamydia, though this fell to 55ud-ud60% in the case of previous partners.ududHealth care providers (doctors and nurses) viewed chlamydia screening as audpriority, because young peudople are sexually active and are at high risk becauseudof alcohol. Providers anticipated high chlamydia test offers and uptake rates.ududProviders viewed chlamydia testing as a core activity to undertake in primaryudcare, but they would need support for partneudr notification and easy access toudlaboratory tests, especially urineud-udbased ones.udConclusion:udMost 18ud-ud29 year old men and women would respond positively if offered a test forudchlamydia, when attending a health care facility for other reasons. They recognisude theudrisks and the importance of their sexual contacts being tested, if they themselves testudpositive for chlamydia. However, sexual health services in Ireland need to minimiseudstigma and ensure the confidentiality and acceptability of STI testing of youudng people.