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Chlamydia trachomatis testing in the second British National
Survey of sexual attitudes and lifestyles: Respondent uptake and treatment
outcomes.
Sexually Transmitted Diseases 2005;32(6):387-394.
McCadden A, Fenton KA, McManus S, Mercer CH, Erens B, Carder C, Ridgway
G, Macdowall W, Nanchahal K, Byron CL,
Copas A, Wellings K, Johnson AM.
Abstract
BACKGROUND: Noninvasive molecular tests for bacterial sexually transmitted
infections (STIs) provide new opportunities for testing in nonclinical settings.
Little information is available on the outcomes when applied to asymptomatic
sex survey participants. OBJECTIVE: The objective of this study was to examine
patient treatment preferences and partner notification outcomes among Chlamydia
trachomatis-positive cases identified in the 2000 national survey of sexual
attitudes and lifestyles (Natsal 2000), and factors associated with providing
a urine sample. METHODS: The authors conducted a stratified probability sample
survey of 11,161 men and women aged 16 to 44 years residing in Britain using
computer-assisted self-interviews. Urine testing was performed for C. trachomatis
offered to a random half of sexually active respondents aged 18 to 44 using
ligase chain reaction. Notification, treatment, and follow up of ligase chain
reaction-positive respondents were undertaken. RESULTS: A total of 5105 respondents
were invited to provide a urine sample. A total of 3628 (71%) agreed and
3608 samples were successfully tested. Willingness to provide a urine sample
was significantly higher among those reporting previous homosexual experience,
heterosexual anal sex, and STI diagnosis. Seventy-three respondents (31 men
and 42 women) were diagnosed with genital chlamydial infection. Sixty-five
(89%) responded to notification of their infection and were recommended for
treatment and partner notification. Fifty (77%) respondents preferred to
be seen by their general practitioner and 15 (23%) by their local genitourinary
medicine clinic. Although physician feedback on treatment and partner notification
outcomes was obtained for only half (n = 34) of respondents, follow-up respondent
interviews confirmed that a total of 49 (75%) respondents underwent this
process. INTERPRETATION: In this community-based survey, the rate of provision
of urine samples was high, and those who provided samples were found to be
at somewhat greater risk of infection on average. This was accounted for
in estimating population chlamydia prevalence. The authors found that treatment
and partner notification of newly diagnosed infections can be successfully
achieved in STI prevalence studies.