Screening for Chlamydia trachomatis in an anonymous and confidential HIV counseling and testing site: feasibility and prevalence rates.
BACKGROUND
Chlamydia trachomatis is the most common bacterial sexually transmitted disease (STD) in the United States. The development of nucleic acid amplification tests for C trachomatis in urine specimens allows for screening outside traditional clinic settings. Persons visiting an HIV counseling and testing site may be at increased risk for STDs, including C trachomatis.


OBJECTIVE
To measure the acceptance of C trachomatis urine screening and the prevalence of C trachomatis infection among clients at an HIV counseling and testing site.


METHODS
Site HIV counselors offered urine C trachomatis screening to clients, administered a questionnaire, and collected urine samples.


RESULTS
Of 808 counseling and testing site clients approached for C trachomatis screening, 572 (71%) accepted. The most common reasons for declining screening were absence of symptoms (33%) and recent STD testing (32%). Men were more likely to accept urine screening than women (risk ratio, 1.31; 95% CI, 1.06-1.62), as were clients who practiced oral sex, had a history of STD, or who had never been screened for STD. Of 560 urine specimens processed, only 8 (1.43%; 95% CI, 0.66-2.91%) were infected with C trachomatis.


CONCLUSIONS
Sites offering HIV testing and counseling are a feasible alternative to clinical settings for C trachomatis screening. Prevalence may be too low for screening to be cost effective unless higher-risk subpopulations can be identified.
Hamel
M J
MJ
Denver Public Health and the Department of Medicine, University of Colorado Health Sciences Center, USA.
Judson
F N
FN
Rietmeijer
C A
CA
D000293:Adolescent; D000328:Adult; D000368:Aged; D000554:Ambulatory Care Facilities; D002690:Chlamydia Infections / Q000453:epidemiology* / Q000652:urine*; D003120:Colorado; D003376:Counseling; D005260:Female; D006678:HIV; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D015995:Prevalence; D012737:Sex Factors; D011795:Surveys and Questionnaires