Chlamydia testing and notification in Australia: more money, more tests.
BACKGROUND
To examine the associations between chlamydia testing and notification and age, sex, socioeconomic status and access to services for area of residence for the Australian state of Victoria in 2004.


METHODS
Data on 71 295 tests and 7006 notifications for chlamydia were obtained by age, gender and area of residence. Each area of residence was assigned to a population-weighted quartile of socioeconomic advantage and was scored for access to services. Generalised linear modelling was used to analyse relationships between the variables.


RESULTS
The odds of being tested for and notified with chlamydia increased by 27% (odds ratio (OR) 1.27, 95% CI 1.26 to 1.27) and 10% (OR 1.10, 95% CI 1.08 to 1.13), respectively, and the odds of a test being positive decreased by 13% (OR 0.87, CI 0.85 to 0.89) for each quartile increase in socioeconomic advantage, when adjusted for access to services. The highest proportion of any subgroup population tested was 7.8% in women aged 20-24 years living in the most advantaged quartile. Men and women over 25 years in advantaged areas receive more testing than men and women aged 20-24 years in disadvantaged areas.


CONCLUSIONS
Access to chlamydia testing is inequitable and favours more advantaged areas. Testing in the age groups at most risk, women aged between 20 and 24 years, was low even in those living in the most advantaged quartile. If Australia is to implement a chlamydia screening programme, education should emphasise the appropriate age group to screen.
McNamee
K M
KM
Family Planning Victoria, 901 Whitehorse Road, Box Hill, Victoria 3128, Australia. kmcnamee@fpv.org.au
Fairley
C K
CK
Hocking
J S
JS
D000293:Adolescent; D000328:Adult; D000368:Aged; D002690:Chlamydia Infections / Q000175:diagnosis* / Q000191:economics; D018563:Disease Notification; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D012959:Socioeconomic Factors; D014739:Victoria; D055815:Young Adult