Home screening for chlamydial genital infection: is it acceptable to young men and women?

Judith Stephenson¹, Caroline Carder², Andrew Copas¹, Angela Robinson³, Geoffrey Ridgway² and Andrew Haines⁴

¹ Department of Sexually Transmitted Diseases, Royal Free and University College Medical School, Mortimer Market Centre, off Capper Street, London WC1
² Department of Microbiology, University College Hospital, London WC1
³ Camden and Islington Community Health Service NHS Trust, Mortimer Market Centre, off Capper Street, London WC1
⁴ Department of Primary Care and Population Sciences, Royal Free and University College Medical School, Royal Free Campus, Rowland Hill Street, London NW3

Correspondence to:
Dr Judith Stephenson

Objectives: To determine the acceptability, to young men and women, of home screening for chlamydial infection.

Methods: We wrote to a random sample of 208 women aged 18–25 years and 225 men aged 18–35 years from three general practices, inviting them to undergo home screening for chlamydial infection. They were asked to return, by normal post, a urine specimen (for men and half of the women) or a vulval swab (other half of the women) for ligase chain reaction (LCR) testing for chlamydial infection. They were also asked to return a short questionnaire about risk status and the acceptability of this approach.

Results: The participation rate among the available sample was 39% for women and 46% for men (p=0.3). However, among women, the rate was slightly higher (p=0.05) for urine samples (47%) than for vulval swabs (32%). Six per cent of women and 9% of men declined to take part, while 42% of women and 33% of men failed to respond. Two men objected to receiving the package at home. We received few other comments, positive and negative in about equal measure.

Conclusion: Home screening for chlamydial infection is a potentially efficient method of reaching young people who may have little contact with health services. Men were at least as likely as women to respond to this screening approach. Home screening might form a useful component of a future chlamydial screening programme in the United Kingdom.

Key Words: chlamydial infection; screening; non-invasive sampling

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