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RESEARCH ARTICLE (Open Access)

What do young women living in regional and rural Victoria say about chlamydia testing? A qualitative study

Emma Wagg A D , Jane Hocking B and Jane Tomnay C
+ Author Affiliations
- Author Affiliations

A Women’s Health Goulburn North East (WHGNE), PO Box 853, Wangaratta, Vic. 3676, Australia.

B Melbourne School of Population and Global Health, The University of Melbourne, Level 4, 207 Bouverie Street, Parkville, Vic. 3010, Australia.

C Centre for Excellence in Rural Sexual Health (CERSH), Department of Rural Health, The University of Melbourne, 49 Graham Street, Shepparton, Vic. 3630, Australia.

D Corresponding author. Email: E.Wagg@whealth.com.au

Sexual Health 17(2) 160-166 https://doi.org/10.1071/SH19182
Submitted: 14 October 2019  Accepted: 9 December 2019   Published: 18 March 2020

Journal compilation © CSIRO 2020 Open Access CC BY-NC-ND

Abstract

Background: Chlamydia trachomatis is the most commonly notified sexually transmissible infection in Australia, with almost 100 000 cases diagnosed in 2018. Chlamydia is easy to diagnose and treat, but infections are underdiagnosed. Eighty per cent of chlamydia cases are asymptomatic. Without testing, infections will remain undetected. Several barriers to testing have been identified in previous research, including cost, privacy concerns for young rural people, knowledge gaps, embarrassment and stigma. The aim of this study was to investigate young regional and rural women’s understanding of chlamydia and factors that may prevent or delay testing. Methods: Semistructured interviews were conducted with 11 women aged between 18 and 30 years residing in north-east Victoria, Australia. Interviews were transcribed verbatim and analysed thematically. Results: Themes were grouped under four categories: (1) chlamydia and stigma; (2) the application of stigma to self and others; (3) factors affecting testing; and (4) knowledge. A chlamydia infection was associated with stigma. The young women in this study anticipated self-stigma in relation to a positive diagnosis, but resisted stigmatising others. Increased knowledge about chlamydia prevalence was associated with reduced self-stigma. The most consistent factor affecting testing decisions was personal risk assessment. Knowledge gaps about symptoms, testing and treatment were also identified, with participants not always accessing information from reputable sources. Conclusion: Chlamydia testing was viewed as a positive activity among this cohort. However, there is considerable perceived stigma about being diagnosed with an infection. Interventions that communicate prevalence, reduce stigma and provide factual information about testing and risk are still needed. Clinicians have an opportunity to convey this information at consultation. Health promotion workers should continue to develop and run campaigns at a community level to encourage regular screening.

Additional keywords: Australia, perceptions, sexually transmitted infection, STI.


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