title: Asking about condom use: a key to individualized care when screening for chlamydia.
abstract: Chlamydia trachomatis (CT) infection has been a target for both selective and national screening programmes, and Sweden has an opportunistic approach. A national plan of action states that risk groups should be identified and offered risk reduction counselling. Patients attending a drop-in sexually transmitted infection (STI) clinic reception at the University Hospital, Umeå, Sweden, were invited to complete a questionnaire regarding sociodemographic characteristics, symptoms and sexual risk behaviour; all had a CT test taken. A total of 1305 patients were included, 58% men, mean age 27.8 years. CT prevalence was 11%; 51% of those with CT were ≥ 25 years old. Only 5% used a condom during the entire sexual intercourse with their last new/temporary partner. Sexually active inconsistent condom users comprised 62% of the study population and contributed to 81% of the chlamydia infections. Asking whether a condom was used could quickly triage patients into groups with a 'higher risk' (none or inconsistent use of condoms and at least one new/temporary partners), and 'lower risk' (with more consistent condom use, although not always accurate) allowing for individualized care and counselling when screening for chlamydia. Evaluating whether a condom was used throughout the sexual intercourse did not add any useful information.
authors.affiliation: Department of Public Health and Clinical Medicine/Dermatology and Venereology, Umeå University, Umeå, Sweden. helena.carre@dermven.umu.se
authors.forename: H
authors.initials: H
authors.lastname: Carré
authors.forename: R
authors.initials: R
authors.lastname: Lindström
authors.forename: J
authors.initials: J
authors.lastname: Boman
authors.forename: U
authors.initials: U
authors.lastname: Janlert
authors.forename: L
authors.initials: L
authors.lastname: Lundqvist
authors.forename: E
authors.initials: E
authors.lastname: Nylander
mesh_terms: D000293:Adolescent; D000328:Adult; D002690:Chlamydia Infections / Q000175:diagnosis* / Q000453:epidemiology; D017280:Condoms / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D012309:Risk-Taking; D012725:Sexual Behavior / Q000706:statistics & numerical data*; D013548:Sweden / Q000453:epidemiology