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P019 Implementing home-sampling strategies to engage young heterosexuals in chlamydia trachomatis re-testing and peer-testing
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  1. Nicole Dukers-Muijrers,
  2. Jeanine Leenen,
  3. Christian Hoebe
  1. Public Health Service South Limburg, Maastricht University Medical Center (MUMC), Sexual Health, Infectious Diseases and Environmental Health, Medical Microbiology, Care and Public Health Research Institute (CAPHRI), Heerlen, Netherlands

Abstract

Background Home-sampling is an increasingly used method to promote testing for Chlamydia trachomatis. Here, we implement and evaluate home-sampling for re-testing and peer-testing in young (<25 years) heterosexual men and women.

Methods At our STI clinics (Limburg, Netherlands, 2015–2018), indexes, i.e. young heterosexuals diagnosed with chlamydia, were (a) offered a self-sampling test for a peer, and (b) offered to receive an SMS-reminder after 5 months to order a re-test for themselves and a peer. Test offers were free-of-charge self-sampling tests for chlamydia and gonorrhea (urine sample for men; vaginal and rectal swabs for women). We interviewed care providers on implementation-barriers and facilitators and performed a process evaluation on test-uptake and overall (genital or rectal) STI positivity.

Results Of 1709 indexes (1221 women): (a) 571 (33.4%) were given a test for a peer; 211 (37.0%) peers tested and peer-positivity was 18.5% (17.9% in women-including 3 cases of gonorrhea and 12.8% rectal chlamydia; 19.5% in men). (b) 1048 (61.3%) accepted to receive a re-test reminder; 417 (39.8%) ordered the re-test and 266 (63.8%) re-tested with 13.9% re-test positivity (15.6% in women –including 10.4% rectal chlamydia–, 8.2% in men – including one gonorrhea case). 155/417 (37.2%) also ordered a peer-test; 62 (40%) peers tested but only 6.5% (n=4) were positive. In (a) and (b), nearly half of positive peers never tested before; rectal infections in women were frequently without a genital infection. Interviews with care-providers revealed problems in implementing logistics which could be solved by an easy-to-use online system.

Conclusion A future implementation using an online system needs to improve test-kit returns by including reminders or provisionary payment, and strategies to help indexes find and motivate high risk peers. High STI positivity in peers (many first time testers) from clinic-indexes reveals the need to especially target these peers to tap into a hidden (untested) infected population.

Disclosure No significant relationships.

  • diagnosis
  • youth
  • Netherlands

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