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RESEARCH ARTICLE

The C-project: use of self-collection kits to screen for Chlamydia trachomatis in young people in a community-based health promotion project

Lynne Martin A E , Eleanor Freedman A , Leanne Burton A , Scott Rutter A , Vickie Knight A , Alfa D’Amato B , Carolyn Murray B , Jackie Drysdale B , Sophie Harvey C and Anna McNulty A D
+ Author Affiliations
- Author Affiliations

A Sydney Sexual Health Centre, Nightingale Building, Sydney & Sydney Eye Hospitals, Macquarie Street, Sydney, NSW 2000, Australia.

B SESIAHS HIV/AIDS & Related Programs Unit, Level 2 McNevin Dickson Building, Prince of Wales Hospital, Randwick, NSW 2031, Australia.

C Waverley Action for Youth Services, 63a Wairoa Avenue, Bondi, NSW 2026, Australia.

D School of Public Health and Community Medicine, University of NSW, Kensington, NSW 2052, Australia.

E Corresponding author. Email: lynne.martin@sesiahs.health.nsw.gov.au

Sexual Health 6(2) 157-162 https://doi.org/10.1071/SH08039
Submitted: 2 June 2008  Accepted: 26 March 2009   Published: 18 May 2009

Abstract

Background: The present study aimed to ascertain the acceptability to at-risk young people of self-collected urine samples as a means of testing for Chlamydia trachomatis (chlamydia); to determine the effectiveness of drop-off and outreach collection methods as a means of detecting and treating chlamydia; and to determine the rate of positive chlamydia tests in a sample of the target group. Methods: Participants requested postal testing kits from the project website, the NSW Sexual Health Infoline or at an outreach event and either returned urine samples at selected drop-off locations or directly to the researchers during active outreach events. Results: A total of 413 kits were requested – 196 (47.5%) via email, 204 (49.4%) during outreach events and nine (2.2%) via the NSW Sexual Health Infoline. A total of 195 samples (47.2% of ordered kits) were returned. Participants were less likely to return samples if they had been requested by email (odds ratio = 9.6; 95% confidence interval: 6.0–15.0) or via telephone (odds ratio = 22.0; 95% confidence interval: 2.7–181.0) compared with directly obtaining a kit at an outreach event. The number of specimens positive for chlamydia in the targeted age range was 4, giving a 3.1% positive rate (95% confidence interval: 1.0–8.0). Conclusions: This study identified that free testing kits and online communication worked well as a means of engaging young people and raising awareness of sexual health. However, the requirement to drop-off urine samples at selected locations was not well accepted.

Additional keywords: outreach, sexually transmissible infections, STI testing, youth.


Acknowledgements

We acknowledge the assistance of Damian Castles Feeney, HARP Unit Southern Network SESIAHS, Jennifer Farinella, Healthy Cities Illawarra; and Cheryl Maylin, Port Kembla Sexual Health Centre for their assistance with the C-project in Wollongong. We also wish to thank the drop-off sites – the pharmacies, youth services and GPs – for their support and commitment; Isobel Harcourt, Heng Lu and Dr Nathan Ryder at SSHC; and a special thanks to all participants. This study was funded by a Faculty Research Grant from the School of Public Health and Community Medicine, UNSW.


References


[1] National Centre in HIV Epidemiology and Clinical Research. HIV/AIDS, hepatitis C and sexually transmissible infections Australia Annual Surveillance Report 2007. Sydney: The University of New South Wales, Sydney, NSW; Australian Institute of Health and Welfare, Canberra, ACT, 2007. Available online at: www.med.unsw.edu.au/nchecr [accessed 6 February 2008].

[2] Chen M,  Donovan B. Genital Chlamydia trachomatis infection in Australia: epidemiology and clinical implications. Sex Health 2004; 1 189–96.
Crossref | GoogleScholarGoogle Scholar | PubMed | [accessed 7 October 2005].

[6] Skinner SR,  Hickey M. Current priorities for adolescent sexual and reproductive health in Australia. Med J Aust 2003; 179 158–61.
PubMed |

[7] Bernard D,  Quine S,  Kang M,  Alperstein G,  Usherwood T,  Bennett D, et al. Access to primary health care for Australian adolescents: how congruent are the perspectives of health service providers and young people, and does it matter? Aust N Z J Public Health 2004; 28 487–92.
PubMed |

[8] Booth M , Bernard D , Quine S , Kang M , Usherwood T , Alperstein G et al. Access to health care among NSW adolescents. Report by NSW Centre for the Advancement of Adolescent Health 2002. Sydney: NSW Centre for the Advancement of Adolescent Health; 2002.

[9] Tribe Research Ltd. Safe Summer Survival Survey Report. Sydney: Tribe Research Ltd; 2008.

[10] Australian Government Department of Health and Ageing. Australasian Contact Tracing Manual Edition 3. Canberra: Commonwealth of Australia; 2006.

[11] Andersen B,  Østergaard L,  Møller JK,  Olesen F. Effectiveness of a mass media campaign to recruit young adults for testing of Chlamydia trachomatis by use of home obtained and mailed samples. Sex Transm Infect 2001; 77 416–8.
Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |

[12] Gotz HM,  Hoebe C,  Van Bergen J,  Veldhuijzen IK,  Broer J,  De Groot F, et al. Management of chlamydia cases and their partners: Results from a home-based screening program organized by municipal public health services with referral to regular health care. Sex Transm Dis 2005; 32 625–9.
Crossref | GoogleScholarGoogle Scholar | PubMed |

[13] Hocking JS,  Willis J,  Tabrizi S,  Fairly CK,  Garland SM,  Hellard M. A chlamydia prevalence survey of young women living in Melbourne, Victoria. Sex Health 2006; 3 235–40.
Crossref | GoogleScholarGoogle Scholar | PubMed |

[14] Honey E,  Augood C,  Templeton A,  Russell I,  Paavonen J,  Mardh P-A, et al. Cost effectiveness of screening for Chlamydia trachomatis: a review of published studies. Sex Transm Infect 2002; 78 406–12.
Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |

[15] Low N,  McCarthy A,  Macleod J,  Salisbury C,  Horner PJ,  Roberts TE, et al. The chlamydia screening studies: rationale and design. Sex Transm Infect 2004; 80 342–8.
Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |

[16] Bloomfield PJ,  Steiner KC,  Kent CK,  Klausner JD. Repeat chlamydia screening by mail, San Francisco. Sex Transm Infect 2003; 79 28–30.
Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |

[17] Morré SA,  van Valkengoed IG,  de Jong A,  Boeke AJ,  van Eijk JT,  Meijer CJ, et al. Mailed, home-obtained urine specimens: a reliable screening approach for the detection of asymptomatic Chlamydia trachomatis infections. J Clin Microbiol 1999; 37 976–80.
PubMed |

[18] Smith JA,  Braunack-Mayer A,  Wittert G. What do we know about men’s help-seeking and health service use? Med J Aust 2006; 184 81–3.
PubMed |

[19] Australia Post. Post Guide: Dangerous and Prohibited Goods and Packaging. Melbourne: Australia Post; 2005.

[20] Bialasiewicz S,  Whiley DM,  Buhrer-Skinner M,  Bautista C,  Barker K,  Aitken S, et al. A novel gel based method for self collection and ambient temperature postal transport of urine for PCR detection of Chlamydia trachomatis. Sex Transm Inf 2009; 85 102–105.
Crossref | GoogleScholarGoogle Scholar | CAS |