Background/introduction Young men aged 20 to 24 years who are screened through the National Chlamydia Screening Programme have a high rate of infection. The majority of them choose to self-request screening via anonymous postal testing as opposed to seeking alternative health service provision.

Aim(s)/objectives To explore the complex factors involved in men’s sexual health decision making following a request for an internet test for chlamydia.

Methods Ten young men who had requested a test for chlamydia via the internet were recruited through the North of Tyne Chlamydia Screening Programme. Data were collected through in-depth interviews, follow-up interviews at 12 months and patients’ NHS health records.

Results Decisions about sexual partners and sexual practice were based on men’s perceptions and belief about women, categorising them as ‘risky’ with a sexually transmitted infection or ‘clean’ with no infection. Factors influencing decisions to seek testing were triggered by unprotected sex with casual partners, strengthened by catalytic influences including media campaigns. The findings suggest a negative chlamydia test result gave respondents a clean bill of health allowing them to engage in further unprotected sex. A positive diagnosis resulted in short-term behaviour change and modified sexual practice. After follow up interviews, behaviour change was not maintained and many became re-infected within 6 months.

Discussion/conclusion This has implications for the transmission of chlamydia infection in terms of infection spreading, re-infection of partners and complications to their own health. Further work is required around interventions for chlamydia screening which focus on behaviour change as opposed to screening volume.