title: Prevalence of Chlamydia trachomatis infections and specimen collection preference among women, using self-collected vaginal swabs in community settings.
abstract: BACKGROUND
  Chlamydia trachomatis is a common, often asymptomatic sexually transmitted infection.
  
  
  OBJECTIVE
  The goal was to estimate the prevalence and predictors of C. trachomatis among young women using self-collected vaginal swabs, and the preferences of women and physicians for self-testing.
  
  
  METHODS
  A total of 514 attendees of university/college health clinics, adolescent birth control clinics, centers providing health services to homeless youth and adults (street health centers), a sexually transmitted diseases clinic, and family practices were tested by ligase chain reaction. Preference for self- versus provider-testing was examined.
  
  
  RESULTS
  Prevalence was 6.0% and was highest (18.2%) in the street health centers. In multivariate analysis, only recent contact with someone with C. trachomatis infection was significantly associated with infection (odds ratio, 7.1; 95% confidence interval, 2.5-20.0). Most women (54.2%; 256 of 472) preferred self-sampling compared with physician sampling (15.9%; 75 of 472). The majority of physicians (75.0%; 9 of 12) reported at the start and end of the study that they would use vaginal swab self-sampling if available.
  
  
  CONCLUSIONS
  Prevalence of infection in young women attending homeless youth organizations was high. Self-sampling was acceptable and could facilitate screening in high-risk women who do not regularly access health services.
authors.affiliation: Public Health and Community Services Department, City of Hamilton, the Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada. erichard@hamilton.ca
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Richardson
authors.forename: John W
authors.initials: JW
authors.lastname: Sellors
authors.forename: Sharon
authors.initials: S
authors.lastname: Mackinnon
authors.forename: Vicki
authors.initials: V
authors.lastname: Woodcox
authors.forename: Michelle
authors.initials: M
authors.lastname: Howard
authors.forename: Dan
authors.initials: D
authors.lastname: Jang
authors.forename: Tina
authors.initials: T
authors.lastname: Karwalajtys
authors.forename: Max A
authors.initials: MA
authors.lastname: Chernesky
mesh_terms: D000293:Adolescent; D000328:Adult; D000554:Ambulatory Care Facilities; D002690:Chlamydia Infections / Q000453:epidemiology* / Q000382:microbiology; D002692:Chlamydia trachomatis / Q000302:isolation & purification*; D005260:Female; D006801:Humans; D009864:Ontario / Q000453:epidemiology; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D015995:Prevalence; D012646:Self Administration; D013048:Specimen Handling; D014621:Vagina / Q000382:microbiology*