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Chlamydia testing and notification in Australia: more money, more tests
  1. Kathleen Margaret McNamee (kmcnamee{at}fpv.org.au)
  1. Family Planning Victoria, Australia
    1. Christopher K Fairley (cfairley{at}unimelb.edu.au)
    1. University of Melbourne, Australia
      1. Jane S Hocking (jhocking{at}unimelb.edu.au)
      1. University of Melbourne, Australia

        Abstract

        Background: To examine the associations between chlamydia testing and notification and age, sex, socio-economic status and access to services for area of residence for the Australian State of Victoria in 2004.

        Methods:Data on 71295 tests and 7006 notifications for chlamydia were obtained from government sources by age, gender and area of residence. Each of 78 areas of residence was assigned to a population weighted quartile of socio-economic advantage and was scored for access to services. Generalised linear modelling was used to analyse relationships between the variables.

        Results: The odds of being tested for and notified with chlamydia increased by 27% (OR 1.27, 95% CI: 1.26-1.27) and 10% (OR 1.10, 95% CI: 1.08-1.13) respectively and the odds of a test being positive decreased by 13% (OR 0.87, CI: 0.85-0.89) for each quartile increase in socio-economic advantage, when adjusted for access to services. This increased to 37% (OR 1.39, 95% CI: 1.36-1.39) and 25% (OR 1.25, 95% CI: 1.20-1.29) respectively when only those aged 25 years and above were considered. The highest proportion of any subgroup population tested was 7.8% in females aged 20 to 24 years living in the most advantaged quartile. A considerable number of men and women aged over 25 years in advantaged areas receive more testing than men and women aged 20 to 24 years in disadvantaged areas.

        Conclusion: Access to chlamydia testing is inequitable and favouring more advantaged areas despite individuals from these areas being less likely to test positive. Testing in the age groups at most risk, females aged between 20 to 24 years, was low even in those living in the most advantaged quartile. If Australia is to implement a chlamydia screening program through primary care, education should emphasise the appropriate age group to screen.

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