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The acceptability of urinary LCR testing for Chlamydia trachomatis among participants in a probability sample survey of sexual attitudes and lifestyles
  1. Kevin A Fenton1,5,
  2. Andrew Copas1,
  3. Kirstin Mitchell3,
  4. Gillian Elam2,
  5. Caroline Carder4,
  6. Geoff Ridgway4,
  7. Kaye Wellings3,
  8. Bob Erens2,
  9. Julia Field2,
  10. Anne M Johnson1
  1. 1Department of Sexually Transmitted Diseases, Royal Free and University College Medical School, London, UK
  2. 2The National Centre for Social Research, London
  3. 3London School of Hygiene and Tropical Medicine, London
  4. 4Department of Microbiology, University College Hospital, London
  5. 5The Public Health Laboratory Service, Communicable Disease Surveillance Centre
  1. Dr Kevin Fenton, Department of Sexually Transmitted Diseases, Royal Free and University College Medical School, Mortimer Market Centre, off Capper Street, London WC1E 6AU, UK kfenton{at}


Objectives: To examine the factors that influence respondents' willingness to participate in urinary testing for Chlamydia trachomatis in a general population feasibility survey of sexual attitudes and lifestyles.

Methods: 199 sexually experienced, 18–44 year old participants, recruited as part of a larger (n=901) methodological study of sexual attitudes and lifestyles, were invited to provide a urine sample for chlamydial infection testing using ligase chain reaction (LCR) techniques. Analysis of the survey data and in-depth qualitative interviews were undertaken to explore the factors that influenced participants' decisions to participate.

Results: 143/199 (72%) participants agreed to provide a urine sample. The likelihood of providing a urine sample was reduced if other individuals were present in the home at the time of interview (OR 0.42, 95% confidence interval 0.20–0.90, p=0.03). Trust and rapport with the interviewer, understanding the aims of the test, sense of obligation, and perceived importance of the test were identified as additional influencing factors in the in-depth interviews.

Conclusions: Survey respondents' uncertainty or embarrassment at participating in urine testing can be overcome if they are well informed, motivated by the potential health gain, and briefed by trained and confident interviewers.

  • screening
  • chlamydia
  • sexually transmitted diseases
  • survey
  • sexual behaviour

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    A table detailing response rates appears on the STI website.