Knowledge of Chlamydia trachomatis infection in genitourinary medicine clinic attenders

Knowledge of sexually transmitted infections and sources of information amongst men

The objective of this study was to investigate menís awareness of sexually transmitted infections (STIs) and sexual health services, together with the best ways of providing information about them.

Information was collated via a self-administered questionnaire, which was answered by 429 men, giving a response rate of 31%.

Men aged 16+ living in two primary care trusts (PCTs) in the north-west of England were accessed through a range of different sources, including social, educational, health, work and religious facilities.

Despite the high rates of STIs in the north-west, approximately one in five men had not heard of herpes, syphilis or chlamydia. One in ten had not heard of gonorrhoea. The majority of men were unaware that many STIs could be asymptomatic. Only 13% knew where their local genitourinary medicine (GUM) clinic was. The main deterrents to accessing the clinic were embarrassment and not knowing where it was.

Menís knowledge of STIs is limited, particularly in relation to the symptoms. The best way of providing information, according to the respondents, was through their general practitioner (GP). However, in practice this might be difficult, as men are reluctant users of GP services in general. Knowledge of the whereabouts of the local GUM clinics is also limited. Although most men thought that they would visit their GP if they thought they might have an STI, this may result from them not knowing the alternatives, rather than having a real choice. More information, targeted wisely, is thus necessary in order to educate men about STIs and service provision.

Knowledge of Chlamydia trachomatis among men and women approached to participate in community-based screening, Scotland, UK

Background

Poor awareness and knowledge of Chlamydia trachomatis could be a barrier to uptake of screening. This study aimed to determine the level of awareness and knowledge of chlamydia among young people who were being approached in a variety of community settings and offered opportunistic screening.

Methods

Men and women aged 16-24 years were approached in education, health and fitness, and workplace settings and invited to complete a self-administered questionnaire then provide a urine sample for chlamydia testing. Follow-up semi-structured interviews with 24 respondents were carried out after test results were received.

Results

363 questionnaires were completed (43.5% from men). Whilst awareness of chlamydia was high, knowledge decreased as questions became increasingly focussed so that around half of respondents were unaware of the asymptomatic nature of chlamydia infections. Men's knowledge of symptoms was consistently lower than women's, with most men failing to identify unusual discharge as a symptom in men (men 58.3%, female 45.8%, p = 0.019); fewer men knew unusual discharge was a symptom among women (men 65.3% female 21.4%, p < 0.001). The asymptomatic nature of the infection resonated with respondents and was the commonest piece of information they picked up from their participation in the study.

Conclusions

Despite scientific gains in understanding chlamydia infection, public understanding remains limited. Greater efforts are required to translate scientific evidence to the public. An improvement in knowledge may maximise gains from interventions to improve detection.

University undergraduates' knowledge of chlamydia screening services and chlamydia infection following the introduction of a National Chlamydia Screening Programme

OBJECTIVES

To determine knowledge of sexually transmitted chlamydia infection among university undergraduates following the introduction of a National Chlamydia Screening Programme (NCSP).

METHODS

Anonymous self-administered questionnaire on chlamydia knowledge and sexual behaviour provided to a convenience sample of 400 university undergraduates.

RESULTS

There were 259 responses (65%) and 17% of respondents were aware of the NCSP. Female students had significantly higher mean knowledge scores than males (p < 0.001), were more likely to be aware of the NCSP (Odds Ratio [OR] 2.70, 95% Confidence Interval [CI] 1.11-7.49) and to have ever attended chlamydia screening (OR 2.98, 95% CI 1.33-6.66). Overall, higher mean knowledge scores did not translate into reduced risk taking sexual behaviour, and female respondents were significantly more likely to attend for a 'general check-up' if they 'had sex without a condom with a person of unknown sexual history' (p = 0.043). Popular sources of chlamydia-related information were friends and the media. The internet was not a major source of information.

CONCLUSIONS

Awareness regarding the NCSP, chlamydia infection and screening is limited and perception of personal risk poor. New evidence-based strategies are required to address knowledge gaps and risk-taking behaviour among university students.

Should asymptomatic men be included in chlamydia screening programs? Cost-effectiveness of chlamydia screening among male and female entrants to a national job training program

OBJECTIVE

To compare the cost-effectiveness of various chlamydia screening strategies within a population of male and female youth entering a national job training program.

STUDY DESIGN

Cost-effectiveness analysis of various chlamydia screening strategies among a cohort of 4000 female and male New England job training students. Strategies for women include (a) no screening, (b) universal endocervical DNA probe screening, (c) universal urine based NAAT screening, and (d) universal endocervical NAAT screening. Strategies for men include (a) no screening, (b) selective urine NAAT screening of leukocyte esterase (LE)-positive urines, and (c) universal urine-based NAAT screening.

RESULTS

Universal endocervical NAAT screening of women and universal urine NAAT screening of men were the most effective and cost-effective strategies individually and in combination. Endocervical NAAT screening of women prevented 23 more cases of PID and saved $27,000 more than endocervical DNA probe screening. Likewise, universal urine NAAT screening of men prevented 21 more cases of PID in their female partners and saved $16,000 more than selective urine NAAT screening of LE positive men.

CONCLUSIONS

Use of a sensitive NAAT to screen both men and women for chlamydia upon entry to a National Job Training Program is cost-effective, cost-saving, and provides a public health opportunity to substantially reduce chlamydia infections among youth at risk for sexually transmitted diseases.

Specific STI knowledge may be acquired too late

Adolescent females in this study knew more about their previously diagnosed sexually transmitted infections (STIs) than about other STIs, including ones that they had unknowingly contracted. They appeared to learn about STIs primarily after diagnosis, too late for effective prevention, early detection, or prompt treatment of their disease.

Sex in Australia: knowledge about sexually transmissible infections and blood-borne viruses in a representative sample of adults

OBJECTIVE

To describe knowledge related to sexually transmitted infection (STI) and blood-borne virus (BBV) infection in a representative sample of Australian adults.

METHODS

Computer-assisted telephone interviews were completed by a representative sample of 10,173 men and 9,134 women aged 16-59 years from all States and Territories. The overall response rate was 73.1% (69.4% among men and 77.6% among women). Respondents were read a series of statements about STIs and BBVs and asked to say if they believed they were true or false. Predictors of knowledge were examined.

RESULTS

Respondents were more likely to answer correctly questions about hepatitis C than questions about herpes, gonorrhoea, genital warts and chlamydia. Women had better knowledge than men. Other predictors of better knowledge included speaking English at home, homosexual or bisexual identity, higher educational levels, higher income, higher occupational level and a previous STI diagnosis.

CONCLUSION

Knowledge of transmission routes and health consequences of the most common STIs was poor. Although knowledge is only one prerequisite for effective disease prevention, the findings suggest that improving public knowledge of STIs is an urgent task in reducing the morbidity associated with these common infections.

IMPLICATIONS

Education campaigns to increase knowledge of the transmission and health consequences of STIs are urgently required if the substantial morbidity associated with these common infections is to be reduced.

Qualitative analysis of psychosocial impact of diagnosis of Chlamydia trachomatis: implications for screening

OBJECTIVES

To investigate the psychosocial impact for women of a diagnosis of Chlamydia trachomatis and discuss the implications for the proposed UK chlamydia screening programme.

DESIGN

Qualitative study with semistructured interviews. Interview transcripts analysed to identify recurrent themes.

PARTICIPANTS

Seventeen women with a current or recent diagnosis of chlamydia.

SETTING

A family planning clinic and a genitourinary medicine clinic in Glasgow.

RESULTS

Three themes were identified: perceptions of stigma associated with sexually transmitted infection, uncertainty about reproductive health after diagnosis, and anxieties regarding partner's reaction to diagnosis. Most women had not previously perceived sexually transmitted infections as personally relevant; this was a function of stereotypical beliefs about who was "at risk" of sexually transmitted infection. These beliefs were pervasive and negatively affected reactions to diagnosis and produced anxiety about disclosure of the condition to others (particularly sexual partners) and future reproductive morbidity. This anxiety, given the uncertain natural history of chlamydia, may prove difficult to dispel.

CONCLUSIONS

There are three primary areas of concern for women after a diagnosis of chlamydia which need to be examined in the proposed screening programme. Information provided should normalise and destigmatise chlamydial infection and positively promote genitourinary medicine services. Support services should be available because notification of partner can cause anxiety. Uncertainty about future reproductive morbidity may be inevitable; staff providing screening will require guidance in providing advice under such conditions.

Knowledge of genital Chlamydia trachomatis infection in family planning clinic attenders

The purpose of this study was to determine the level of awareness of genital Chlamydia infection and level of knowledge related to this infection in family planning (FP) clinic attenders. Clients attending FP clinics during a 3 month study period were invited to complete an anonymous self-administered questionnaire. Five hundred and sixteen questionnaires from female attenders were analysed. Results showed that 54% of respondents had heard of Chlamydia. Subjective knowledge assessment for Chlamydia was low compared to that for other infections. Mean knowledge scores relating to genital chlamydial infection were low. There was no significant age-related trend in knowledge scores. The implications of these findings are discussed in relation to increased Chlamydia screening activity in FP clinics.

Sexually transmitted infections in teenagers

Prevention of sexually transmitted infection in teenagers is a high priority. The introduction of non-invasive methods for diagnostic testing of Chlamydia trachomatis and Neisseria gonorrhoeae has enabled screening for these sexually transmitted micro-organisms in a range of community-based settings among populations at high risk, such as teenagers, who do not readily access existing sexual health services.