Correlates of sexually transmissible infection testing among a sample of at-risk young Australians
Caitlin H. Douglass A B D , Alyce M. Vella A , Margaret E. Hellard A B and Megan S. C. Lim A B C
+ Author Affiliations
- Author Affiliations
A Centre for Population Health, Burnet Institute, 85 Commercial Road, Melbourne, Vic. 3004, Australia.
B School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, Commercial Road, Melbourne, Vic. 3004, Australia.
C Melbourne School of Population and Global Health, University of Melbourne, Carlton, Vic. 3053, Australia.
D Corresponding author. Email: caitlin.douglass@burnet.edu.au
Australian Journal of Primary Health 23(3) 272-277 https://doi.org/10.1071/PY16115
Submitted: 19 September 2016 Accepted: 3 February 2017 Published: 20 April 2017
Abstract
Annual chlamydia testing is recommended for all sexually active Australians aged 15–29 years; however, the testing rate is below recommended levels. Three surveys at a Melbourne music festival were conducted over 2012–14 to identify correlates of sexually transmissible infection (STI) testing among young people at risk of STIs. In total, 3588 participants were recruited; 72% reported having sex in the past year. Based on sexual behaviours, 38% of sexually active participants were classified as at risk of contracting STIs. In the past year, at-risk participants had significantly higher odds of reporting a STI test (37%) than participants classified as not at risk (24%) (OR = 1.9; CI = 1.6–2.3). Among at-risk participants, correlates of STI testing in the past year included being aged 20–24 years, visiting a GP, higher knowledge levels, earlier sexual debut and reporting more than five lifetime partners. Testing rates in our sample did not meet levels required to reduce chlamydia prevalence. However, the testing rate was higher in at-risk participants than participants who were not at risk. Future programs aiming to increase chlamydia testing should improve knowledge and promote the importance of testing after risk exposure, particularly among 16- to 19-year-olds.
Additional keywords: chlamydia, secondary prevention.
References
Australian Bureau of Statistics (2012) Australian social trends, Jun 2012. Sexually transmissible infections. Catalogue number 4102.0. ABS, Canberra. Available at http://www.abs.gov.au/AUSSTATS/abs@.nsf/Lookup/4102.0Main+Features10Jun+2012 [Verified 2 September 2016]Australian Sexual Health Alliance (2016) Australian STI management guidelines for use in primary care. (ASHA: Sydney, NSW) Available at http://www.sti.guidelines.org.au/sexually-transmissible-infections/chlamydia#clinical-presentation [Verified 2 September 2016]
Dimech W, Lim M, Van Gemert C, Guy R, Boyle D, Donovan B, Hellard M (2014) Analysis of laboratory testing results collected in an enhanced chlamydia surveillance system in Australia, 2008–2010. BMC Infectious Diseases 14, 325
| Analysis of laboratory testing results collected in an enhanced chlamydia surveillance system in Australia, 2008–2010.Crossref | GoogleScholarGoogle Scholar |
Fenton KA, Johnson AM, McManus S, Erens B (2001) Measuring sexual behaviour: methodological challenges in survey research. Sexually Transmitted Infections 77, 84–92.
| Measuring sexual behaviour: methodological challenges in survey research.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3M3gtVyhsA%3D%3D&md5=6758a9108b51e01eae7f0c03ab354910CAS |
Hocking JS, Willis J, Tabrizi S, Fairley CK, Garland SM, Hellard M (2006) A chlamydia prevalence survey of young women living in Melbourne, Victoria. Sexual Health 3, 235–240.
| A chlamydia prevalence survey of young women living in Melbourne, Victoria.Crossref | GoogleScholarGoogle Scholar |
Jones T, Mitchell A (2014) Young people and HIV prevention in Australian schools. AIDS Education and Prevention 26, 224–233.
| Young people and HIV prevention in Australian schools.Crossref | GoogleScholarGoogle Scholar |
Kang M, Rochford A, Skinner S, Mindel A, Webb M, Peat J, Usherwood T (2014) Sexual behaviour, sexually transmitted infections and attitudes to chlamydia testing among a unique national sample of young Australians: baseline data from a randomised controlled trial. BMC Public Health 14, 12
| Sexual behaviour, sexually transmitted infections and attitudes to chlamydia testing among a unique national sample of young Australians: baseline data from a randomised controlled trial.Crossref | GoogleScholarGoogle Scholar |
Khosropour CM, Broad JM, Scholes D, Saint-Johnson J, Manhart L, Golden MR (2014) Estimating chlamydia screening coverage: a comparison of self-report and health care effectiveness data and information set measures. Sexually Transmitted Diseases 41, 665–670.
| Estimating chlamydia screening coverage: a comparison of self-report and health care effectiveness data and information set measures.Crossref | GoogleScholarGoogle Scholar |
Kong FYS, Hocking JS, Link CK, Chen MY, Hellard ME (2009) Sex and sport: chlamydia screening in rural sporting clubs. BMC Infectious Diseases 9, 73
| Sex and sport: chlamydia screening in rural sporting clubs.Crossref | GoogleScholarGoogle Scholar |
Kong FYS, Guy RJ, Hocking JS, Merritt T, Pirotta M, Heal C, Bergeri I, Donovan B, Hellard ME (2011) Australian general practitioner chlamydia testing rates among young people. The Medical Journal of Australia 194, 249–252.
Lau A, Spark S, Tomnay J, Temple-Smith M, Fairley CK, Guy R, Donovan B, Hocking JS (2016) Socio- demographic and structural barriers to being tested for chlamydia in general practice. The Medical Journal of Australia 204, 112
| Socio- demographic and structural barriers to being tested for chlamydia in general practice.Crossref | GoogleScholarGoogle Scholar |
Lim MS, Bowring AL, Gold J, Aitken C, Hellard ME (2012) Trends in sexual behavior, testing, and knowledge in young people; 2006–2011. Sexually Transmitted Diseases 39, 831–834.
| Trends in sexual behavior, testing, and knowledge in young people; 2006–2011.Crossref | GoogleScholarGoogle Scholar |
Lim MSC, El-Hayek C, Goller JL, Fairley CK, Nguyen PLT, Hamilton RA, Henning DJ, McNamee KM, Hellard ME, Stoove MA (2014) Trends in chlamydia positivity among heterosexual patients from the Victorian Primary Care Network for Sentinel Surveillance, 2007–2011. The Medical Journal of Australia 200, 166–169.
| Trends in chlamydia positivity among heterosexual patients from the Victorian Primary Care Network for Sentinel Surveillance, 2007–2011.Crossref | GoogleScholarGoogle Scholar |
Lorch R, Hocking JS, Temple-Smith M, Law M, Yeung A, Wood A, Vaisey A, Donovan B, Fairley C, Kaldor J, Guy R (2013) The chlamydia knowledge, awareness and testing practices of Australian general practitioners and practice nurses: survey findings from the Australian Chlamydia Control Effectiveness Pilot (ACCEPt). BMC Family Practice 14, 169
| The chlamydia knowledge, awareness and testing practices of Australian general practitioners and practice nurses: survey findings from the Australian Chlamydia Control Effectiveness Pilot (ACCEPt).Crossref | GoogleScholarGoogle Scholar |
Low N, Bender N, Nartey L, Shang A, Stephenson J (2009) Effectiveness of chlamydia screening: systematic review. International Journal of Epidemiology 38, 435–448.
| Effectiveness of chlamydia screening: systematic review.Crossref | GoogleScholarGoogle Scholar |
Mann T (2014) Big Day Out attendance plummets in 2014. (Faster Louder: Melbourne) Available at http://fasterlouder.junkee.com/big-day-out-attendance-plummets-in-2014/835725 [Verified 5 December 2016]
O’Rourke KM, Fairley CK, Samaranayake A, Collignon P, Hocking JS (2009) Trends in chlamydia positivity over time among women in Melbourne Australia, 2003 to 2007. Sexually Transmitted Diseases 36, 763–767.
| Trends in chlamydia positivity over time among women in Melbourne Australia, 2003 to 2007.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD1MjotVegtw%3D%3D&md5=da8946e6d677e356484861af3759a030CAS |
Pavlin NL, Parker R, Fairley CK, Gunn JM, Hocking J (2008) Take the sex out of STI screening! Views of young women on implementing chlamydia screening in General Practice. BMC Infectious Diseases 8, 62
| Take the sex out of STI screening! Views of young women on implementing chlamydia screening in General Practice.Crossref | GoogleScholarGoogle Scholar |
Regan DG, Wilson DP, Hocking JS (2008) Coverage is the key for effective screening of Chlamydia trachomatis in Australia. The Journal of Infectious Diseases 198, 349–358.
| Coverage is the key for effective screening of Chlamydia trachomatis in Australia.Crossref | GoogleScholarGoogle Scholar |
Rekart ML, Gilbert M, Meza R, Kim PH, Chang M, Money DM, Brunham RC (2013) Chlamydia public health programs and the epidemiology of pelvic inflammatory disease and ectopic pregnancy. The Journal of Infectious Diseases 207, 30–38.
| Chlamydia public health programs and the epidemiology of pelvic inflammatory disease and ectopic pregnancy.Crossref | GoogleScholarGoogle Scholar |
Rissel C, Heywood W, de Visser R, Simpson J, Grulich A, Badcock P, Smith A, Richters J (2014) First vaginal intercourse and oral sex among a representative sample of Australian adults: the Second Australian Study of Health and Relationships. Sexual Health 11, 406–415.
| First vaginal intercourse and oral sex among a representative sample of Australian adults: the Second Australian Study of Health and Relationships.Crossref | GoogleScholarGoogle Scholar |
Royal Australian College of General Practitioners (2012) Guidelines for preventive activities in general practice. (RACGP: Melbourne, Vic., Australia) Available at http://www.racgp.org.au/download/Documents/Guidelines/Redbook8/redbook8.pdf [Verified 2 September 2016]
Temple-Smith M, Guy R, Gunn J, Low N, Donovan B, Kaldor J, Law M, Fairley C, Braat S, Wood A, Hocking J (2016) Screening for chlamydia in Australian general practice – what works? In ‘45th annual scientific meeting of the Society for Academic Primary Care’, 6th–8th July 2016, Dublin, Ireland. (SAPC Society for Academic Primary Care) Abstract available at https://sapc.ac.uk/conference/2016/abstract/screening-chlamydia-australian-general-practice-what-works_1b-5 [Verified 6 April 2017]
van den Broek IVF, van Bergen JEAM, Brouwers EEHG, Fennema JSA, Götz HM, Hoebe CJPA, Koekenbier RH, Kretzschmar M, Over EAB, Schmid BV, Pars LL, van Ravesteijn SM, van der Sande MAB, de Wit GA, Low N, Op de Coul ELM (2012a) Effectiveness of yearly, register based screening for chlamydia in the Netherlands; controlled trial with randomised stepped wedged implementation. British Medical Journal 345, e4316
| Effectiveness of yearly, register based screening for chlamydia in the Netherlands; controlled trial with randomised stepped wedged implementation.Crossref | GoogleScholarGoogle Scholar |
van den Broek IVF, Brouwers EEHG, Götz HM, van Bergen JEAM, Op de Coul ELM, Fennema JSA, Koekenbier RH, Pars LL, van Ravesteijn SM, Hoebe CJPA (2012b) Systematic selection of screening participants by risk score in a chlamydia screening programme is feasible and effective. Sexually Transmitted Infections 88, 205–211.
| Systematic selection of screening participants by risk score in a chlamydia screening programme is feasible and effective.Crossref | GoogleScholarGoogle Scholar |
Yeung A, Temple-Smith M, Fairley C, Hocking J (2015) Narrative review of the barriers and facilitators to chlamydia testing in general practice. Australian Journal of Primary Health 21, 139–147.
| Narrative review of the barriers and facilitators to chlamydia testing in general practice.Crossref | GoogleScholarGoogle Scholar |
