Do the characteristics of sexual health centre clients predict chlamydia infection sufficiently strongly to allow selective screening?
OBJECTIVE
This study aimed to estimate chlamydia prevalence and risk factors for infection and to assess the performance of chlamydia-selective screening criteria among clients attending a large sexually transmitted infection (STI) clinic.


METHODS
Computerised records for all attendances between 1 July 2002 and 30 June 2003 were analysed. Chlamydia prevalence and risk factors for infection were determined for all new clients. The sensitivity and specificity of risk factors for chlamydia were assessed.


RESULTS
2642 male and 2084 female new clients were tested for chlamydia with a prevalence of 7.3% (95% CI: 6.3%, 8.4%) among men and 3.9% (95% CI: 3.1%, 4.9%) among women. Screening heterosexual men based on a positive contact or symptoms of non-specific urethritis or any two of age <25 years, 4+ partners last 12 months, inconsistent condom use or not presenting for an asymptomatic screen detected 88% of infections by screening 62%. Screening women based on a positive contact or injecting drug use or any two of age <25 years, 2+ partners last 12 months or inconsistent condom use would detect 86% of infections by screening 57%.


CONCLUSIONS
Selective screening could be used to more efficiently identify heterosexual men and women at risk of chlamydia.
Hocking
Jane
J
Macfarlane Burnet Institute for Medical Research and Public Health, Melbourne, Australia. hocking@burnet.edu.au
Fairley
Christopher K
CK
D000328:Adult; D017677:Age Distribution; D000368:Aged; D001315:Australia / Q000453:epidemiology; D002690:Chlamydia Infections / Q000175:diagnosis* / Q000453:epidemiology*; D002692:Chlamydia trachomatis / Q000302:isolation & purification*; D017280:Condoms / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data*; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D012680:Sensitivity and Specificity; D017678:Sex Distribution; D012736:Sex Education / Q000592:standards