RT Journal Article SR Electronic T1 It matters what you measure: a systematic literature review examining whether young people in poorer socioeconomic circumstances are more at risk of chlamydia JF Sexually Transmitted Infections JO Sex Transm Infect FD BMJ Publishing Group Ltd SP 175 OP 180 DO 10.1136/sextrans-2011-050223 VO 89 IS 2 A1 Sheringham, Jessica A1 Mann, Sue A1 Simms, Ian A1 Stafford, Mai A1 Hart, Graham J A1 Raine, Rosalind YR 2013 UL http://sti.bmj.com/content/89/2/175.abstract AB Background England has invested in chlamydia screening interventions for young people. It is not known whether young people in poorer socioeconomic circumstances (SEC) are at greater risk of chlamydia and therefore in greater need of screening. Objective To conduct a systematic review examining socioeconomic variations in chlamydia prevalence or positivity in young people. Data sources Eight bibliographic databases using terms related to chlamydia and SEC, supplemented by website and reference searches. Eligibility Studies published 1999–2011 in North America, Western Europe, Australia or New Zealand, including populations aged 15–24 years, with chlamydia prevalence or positivity diagnosed by nucleic acid amplification testing. Appraisal and synthesis Two reviewers independently screened references, extracted data, appraised studies meeting inclusion criteria and rated studies as high, medium or low according to their quality and relevance. Socioeconomic variations in chlamydia were synthesised for medium/high-rated studies only. Results No high-rated studies were identified. Eight medium-rated studies reported variations in chlamydia prevalence by SEC. In 6/8 studies, prevalence was higher in people of poorer SEC. Associations were more often significant when measured by education than when using other indicators. All studies measuring positivity were rated low. Across all studies, methodological limitations in SEC measurement were identified. Conclusions The current literature is limited in its capacity to describe associations between SEC and chlamydia risk. The choice of SEC measure may explain why some studies find higher chlamydia prevalence in young people in disadvantaged circumstances while others do not. Studies using appropriate SEC indicators (eg, education) are needed to inform decisions about targeting chlamydia screening.