Reducing barriers to testing for Chlamydia trachomatis by mailed self-collected samples
Monika Buhrer-Skinner A B E , Reinhold Muller A C , Petra G. Buettner A C , Rose Gordon B and Joseph Debattista D
+ Author Affiliations
- Author Affiliations
A Anton Breinl Centre for Public Health and Tropical Medicine, James Cook University, Townsville, QLD 4811, Australia.
B Townsville Sexual Health Service, Townsville Hospital and Health Service, North Ward Health Campus, PO Box 5224, Townsville, QLD 4810, Australia.
C Tropical Health Solutions Pty Ltd, Townsville, QLD 4810, Australia.
D Sexual Health & HIV Service, Metro North Hospital and Health Service, Brisbane, QLD 4000, Australia.
E Corresponding author. Email: monika.buhrerskinner@jcu.edu.au
Sexual Health 10(1) 32-38 https://doi.org/10.1071/SH11065
Submitted: 20 April 2011 Accepted: 22 June 2012 Published: 19 November 2012
Abstract
Background: Chlamydia trachomatis (chlamydia) is the most commonly notified sexually transmissible bacterial infection in Australia, where distance to health services can be a barrier. This study investigated the acceptability of a self-collection kit for chlamydia testing (sent by mail) and assessed the risk profiles of participants with respect to locality. Methods: In total, 2587 self-collection kits were distributed opportunistically or sent directly to participants upon request, as was a self-administered questionnaire. Results: The return rate was 13.2% (n = 341) for samples and questionnaires. The return rate did not differ with location (P = 0.522) but with mode of distribution (opportunistic: 9.7%; by request: 27.4%; P < 0.001). Although 37% of participants had previously been tested for chlamydia, 77.5% said that they would not have sought testing otherwise. The median age of participants was 22.6 years, 33.8% were male and 9.1% were of Aboriginal descent. Overall, 9.0% (95% confidence interval (CI) = 6.1–12.5) of participants were chlamydia-positive. Prevalence of chlamydia and Aboriginal participation increased with remoteness (P < 0.001), and self-reported condom use was significantly reduced for remote and very remote locations (P = 0.008). Within remote and very remote locations, 30.8% (95% CI = 9.1–61.4) of Aboriginal participants and 38.9% of nonIndigenous participants were chlamydia-positive (P = 0.718; 95% CI = 17.3–64.3). Discussion: Testing for chlamydia using a mailed self-collection kit opened access to a predominantly test-naïve population. The proposed model was able to reach remote populations. Actively requested kits were more likely to be returned.
Additional keywords: Aboriginal and Torres Strait Islander, Australia, geographic location, Queensland, remote, sexually transmissible infection.
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