@article {Clifton276, author = {Soazig Clifton and Catherine H Mercer and Sarah C Woodhall and Pam Sonnenberg and Nigel Field and Le Lu and Anne M Johnson and Jackie A Cassell}, title = {Patterns of chlamydia testing in different settings and implications for wider STI diagnosis and care: a probability sample survey of the British population}, volume = {93}, number = {4}, pages = {276--283}, year = {2017}, doi = {10.1136/sextrans-2016-052719}, publisher = {The Medical Society for the Study of Venereal Disease}, abstract = {Background Following widespread rollout of chlamydia testing to non-specialist and community settings in the UK, many individuals receive a chlamydia test without being offered comprehensive STI and HIV testing. We assess sexual behaviour among testers in different settings with a view to understanding their need for other STI diagnostic services.Methods A probability sample survey of the British population undertaken 2010{\textendash}2012 (the third National Survey of Sexual Attitudes and Lifestyles). We analysed weighted data on chlamydia testing (past year), including location of most recent test, and diagnoses (past 5 years) from individuals aged 16{\textendash}44 years reporting at least one sexual partner in the past year (4992 women, 3406 men).Results Of the 26.8\% (95\% CI 25.4\% to 28.2\%) of women and 16.7\% (15.5\% to 18.1\%) of men reporting a chlamydia test in the past year, 28.4\% of women and 41.2\% of men had tested in genitourinary medicine (GUM), 41.1\% and 20.7\% of women and men respectively tested in general practice (GP) and the remainder tested in other non-GUM settings. Women tested outside GUM were more likely to be older, in a relationship and to live in rural areas. Individuals tested outside GUM reported fewer risk behaviours; nevertheless, 11.0\% (8.6\% to 14.1\%) of women and 6.8\% (3.9\% to 11.6\%) of men tested in GP and 13.2\% (10.2\% to 16.8\%) and 9.6\% (6.5\% to 13.8\%) of women and men tested in other non-GUM settings reported {\textquoteleft}unsafe sex{\textquoteright}, defined as two or more partners and no condom use with any partner in the past year. Individuals treated for chlamydia outside GUM in the past 5 years were less likely to report an HIV test in that time frame (women: 54.5\% (42.7\% to 65.7\%) vs 74.1\% (65.9\% to 80.9\%) in GUM; men: 23.9\% (12.7\% to 40.5\%) vs 65.8\% (56.2\% to 74.3\%)).Conclusions Most chlamydia testing occurred in non-GUM settings, among populations reporting fewer risk behaviours. However, there is a need to provide pathways to comprehensive STI care to the sizeable minority at higher risk.}, issn = {1368-4973}, URL = {https://sti.bmj.com/content/93/4/276}, eprint = {https://sti.bmj.com/content/93/4/276.full.pdf}, journal = {Sexually Transmitted Infections} }