Socioeconomic, behavioural and health factors associated with chlamydia testing in sexually active young women: an Australian observational cohort study
Louise Forsyth Wilson
A * , Annette Jane Dobson A , Jenny Doust A and Gita Devi Mishra A
+ Author Affiliations
- Author Affiliations
A The University of Queensland, NHMRC Centre for Research Excellence on Women and Non-communicable Diseases (CREWaND), School of Public Health, Herston Road, Herston, Qld, Australia.
Sexual Health 19(2) 112-121 https://doi.org/10.1071/SH21230
Submitted: 18 November 2021 Accepted: 10 March 2022 Published: 28 April 2022
© 2022 The Author(s) (or their employer(s)). Published by CSIRO Publishing. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)
Abstract
Background: Chlamydia trachomatis is the most frequently notified sexually transmitted infection in Australia. Untreated infections in women can cause health problems. Professional guidelines encourage opportunistic testing of young people. To increase understanding of who is being tested, we investigated factors associated with testing in a population of young women.
Methods: In total, 14 002 sexually active women, aged 18–23 years at baseline (2013), from the Australian Longitudinal Study on Women’s Health, were included. We used random intercepts, mixed-effects binary logistic regression with robust standard errors to assess associations between socioeconomic, health and behavioural factors and chlamydia testing.
Results: Associations between chlamydia testing and partner status varied by a woman’s body mass index (BMI). Compared to women with a stable partner/BMI <25 kg/m2, women with a stable partner/BMI ≥25 kg/m2 were less likely to be tested (adjusted odds ratios [AOR] = 0.79, 95% CI: 0.71–0.88). In contrast, although women without a partner were more likely to be tested irrespective of BMI, the odds were higher for those with a BMI <25 kg/m2 (AOR = 2.68, 95% CI: 2.44–2.94) than a BMI ≥25 kg/m2 (AOR = 1.65, 95% CI: 1.48–1.84). Women who reported a prior chlamydia infection were also more likely to be tested (AOR = 2.01, 95% CI: 1.83–2.20), as were women engaging in any combination of cannabis use and/or heavy episodic drinking compared to doing neither of these activities.
Conclusions: Women without a partner, women with a prior chlamydia infection and those engaging in risk-taking behaviours are more likely to have chlamydia testing. Additional research is needed to understand whether there are deficits in testing among overweight/obese women.
Keywords: Australia, binge drinking, cannabis use, Chlamydia trachomatis, cohort study, obesity, testing, women.
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