title: Outreach for chlamydia and gonorrhoea screening: a systematic review of strategies and outcomes.
abstract: BACKGROUND
  High Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) prevalence have been reported in populations that do not regularly access health centres for sexually transmissible infections (STI) testing. We reviewed current outreach strategies used to increase access to STI testing and their outcomes.
  
  
  METHODS
  We systematically reviewed the literature for English language studies published between 1 January 2005 and 28 January 2011 describing CT and/or NG screening programs in non-clinical outreach settings.
  
  
  RESULTS
  We identified 25 programs, with the majority occurring in either Australia (32%) or the United States (32%). The most common target groups were young people aged 15-29 years (52%), men who have sex with men (24%) and sex workers (8%). The median CT positivity was 7.7% (Inter Quartile Range [IQR]: 3.0%-11.1%, n=19 programs), and median NG positivity was 2.6% (IQR: 0.0%-8.0%, n=10). The median participation rate was 53% (IQR: 23.9%-81.3%), and a median of 79.6% (IQR: 55.1%-89.4%) of participants were tested, with a median of 100 tests conducted per program (IQR: 65-331, range: 11-1808). Across all settings the participation rate was highest among target groups gathering in community service venues (community centres, parenting centres, homeless shelters) (median=81.4%, n=4), and social venues (sporting venues or bars) (80.4%, n=1). Lower participation rates were found in street/public community areas (median=23.9%, n=3) and sex on premises venues (10.4% and 24.3%, n=2).
  
  
  CONCLUSIONS
  The review indicated that although CT and NG outreach programs reached a relatively small number of people the yield of infections is high. Settings which appear to be more effective at encouraging participation appear to be those within an existing venue, rather than in public areas.
authors.affiliation: Apunipima Cape York Health Council, Cairns, Australia. Belinda.hengel@apunipima.org.au.
authors.forename: Belinda
authors.initials: B
authors.lastname: Hengel
authors.forename: Muhammad S
authors.initials: MS
authors.lastname: Jamil
authors.forename: Jacqueline K
authors.initials: JK
authors.lastname: Mein
authors.forename: Lisa
authors.initials: L
authors.lastname: Maher
authors.forename: John M
authors.initials: JM
authors.lastname: Kaldor
authors.forename: Rebecca J
authors.initials: RJ
authors.lastname: Guy
mesh_terms: D000293:Adolescent; D000328:Adult; D002690:Chlamydia Infections / Q000175:diagnosis*; D003159:Community-Institutional Relations; D005260:Female; D006069:Gonorrhea / Q000175:diagnosis*; D006703:Ill-Housed Persons / Q000706:statistics & numerical data; D018451:Homosexuality, Male / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D015397:Program Evaluation; D060386:Sex Workers / Q000706:statistics & numerical data; D055815:Young Adult