title: A prospective study of the psychosocial impact of a positive Chlamydia trachomatis laboratory test.
abstract: BACKGROUND
  Few data exist on potential harms of chlamydia screening. We assessed the psychosocial impact of receiving a positive Chlamydia trachomatis test result.
  
  
  METHODS
  We prospectively studied women ≥16 years of age undergoing chlamydia testing in 2 Midwestern family planning clinics. We surveyed women at baseline and about 1 month after receiving test results, using 9 validated psychosocial scales/subscales and chlamydia-specific questions. Changes in scale scores were calculated for each woman. Mean percent changes in scores for chlamydia-positive and -negative women were compared using a t test.
  
  
  RESULTS
  We enrolled 1807 women (response rate, 84%). Of the 1688 women with test results, 149 (8.8%) tested positive. At follow-up, chlamydia-positive women (n = 71) had a 75% increase in anxiety about sexual aspects of their life on the Multidimensional Sexual Self-Concept Questionnaire (P < 0.001), significantly greater than the 26% increase among 280 randomly selected chlamydia-negative women (P = 0.02). There were no differences for the other 8 scales/subscales, including general measures of anxiety, depression, and self-esteem. Chlamydia-positive women were more likely than chlamydia-negative women to be "concerned about chlamydia" (80% vs. 40%, P < 0.001) and to report breaking up with a main partner (33% vs. 11%, P < 0.001) at follow-up. Women testing positive reported a range of chlamydia-specific concerns.
  
  
  CONCLUSIONS
  Chlamydia-positive women had significant increases in anxiety about sex and concern about chlamydia, but did not have marked changes in more general measures of psychosocial well-being about 1 month after diagnosis. Chlamydia diagnoses were associated with some disruption of relationships with main partners. Chlamydia-specific concerns may guide counseling messages to minimize psychosocial impact.
authors: Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
authors: Sami L
authors: SL
authors: Gottlieb
authors: Bradley P
authors: BP
authors: Stoner
authors: Akbar A
authors: AA
authors: Zaidi
authors: Christina
authors: C
authors: Buckel
authors: Molly
authors: M
authors: Tran
authors: Jami S
authors: JS
authors: Leichliter
authors: Stuart M
authors: SM
authors: Berman
authors: Lauri E
authors: LE
authors: Markowitz
mesh_terms: D000293:Adolescent; D000328:Adult; D000554:Ambulatory Care Facilities; D001007:Anxiety; D002690:Chlamydia Infections / Q000175:diagnosis* / Q000523:psychology*; D002692:Chlamydia trachomatis; D005193:Family Planning Services; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000523:psychology; D008923:Missouri; D011446:Prospective Studies; D011584:Psychology; D012649:Self Concept; D012725:Sexual Behavior; D012747:Sexual Partners; D011795:Surveys and Questionnaires; D055815:Young Adult