Coverage and uptake of systematic postal screening for genital Chlamydia trachomatis and prevalence of infection in the United Kingdom general population: cross sectional study.
OBJECTIVE
To measure the coverage and uptake of systematic postal screening for genital Chlamydia trachomatis and the prevalence of infection in the general population in the United Kingdom. To investigate factors associated with these measures.


METHODS
Cross sectional survey of people randomly selected from general practice registers. Invitation to provide a specimen collected at home.


METHODS
England.


METHODS
19,773 men and women aged 16-39 years invited to participate in screening.


METHODS
Coverage and uptake of screening; prevalence of chlamydia.


RESULTS
Coverage of chlamydia screening was 73% and was lower in areas with a higher proportion of non-white residents. Uptake in 16-24 year olds was 31.5% and was lower in men, younger adults, and practices in disadvantaged areas. Overall prevalence of chlamydia was 2.8% (95%confidence interval 2.2% to 3.4%) in men and 3.6% (3.1% to 4.9%) in women, but it was higher in people younger than 25 years (men 5.1%; 4.0% to 6.3%; women 6.2%; 5.2% to 7.8%). Prevalence was higher in the subgroup of younger women who were harder to engage in screening. The strongest determinant of chlamydial infection was having one or more new sexual partners in the past year.


CONCLUSIONS
Postal chlamydia screening was feasible, but coverage was incomplete and uptake was modest. Lower coverage of postal screening in areas with more non-white residents along with poorer uptake in more deprived areas and among women at higher risk of infection could mean that screening leads to wider inequalities in sexual health.
Macleod
John
J
Department of Primary Care and General Practice, University of Birmingham, Birmingham B15 2TT. j.a.macleod@bham.ac.uk
Salisbury
Chris
C
Low
Nicola
N
McCarthy
Anne
A
Sterne
Jonathan A C
JA
Holloway
Aisha
A
Patel
Rita
R
Sanford
Emma
E
Morcom
Andrea
A
Horner
Paddy
P
Davey Smith
George
G
Skidmore
Susan
S
Herring
Alan
A
Caul
Owen
O
Hobbs
F D Richard
FD
Egger
Matthias
M
D000293:Adolescent; D000328:Adult; D002690:Chlamydia Infections / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control; D002692:Chlamydia trachomatis; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods / Q000706:statistics & numerical data*; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D015995:Prevalence; D013689:Telephone / Q000706:statistics & numerical data; D006113:United Kingdom / Q000453:epidemiology