title: High rates of chlamydia found among 12- to 16-year-olds attending a rural sexual health clinic: implications for practice.
abstract: Background Chlamydia is the most commonly diagnosed bacterial sexually transmissible infection (STI) and is asymptomatic in ~80% of women. If untreated, potential consequences include pelvic inflammatory disease, ectopic pregnancy and infertility.
  
  
  METHODS
  In 2014, a retrospective audit was undertaken at a rural service to determine what proportion of patients were aged 12-16 years, infected with chlamydia and their reasons for attending the clinic.
  
  
  RESULTS
  There were 111 patients aged 12-16 years attending during 2011-2014; 104 (95%) were female. One hundred and ninety-four chlamydia tests were conducted, with the proportion of patients having at least one test annually being 100% in 2011, 81% in 2012, 72% in 2013 and 78% in 2014. There was no difference in the proportion tested by age during the study (P=0.59). Forty-six tests were positive for chlamydia (23.7%; 95%CI: 17.8%, 30.9%) with proportions decreasing with increasing age from 46.7% (95%CI: 16.4%, 79.5%) in 12- or 13-year-olds to 15.5% (95%CI: 9.4%, 24.2%) in 16-year-olds (P=0.02). The reasons for attending when a chlamydia test was ordered included: (i) fear of pregnancy (18.3%, 34/185); (ii) symptoms (16.7%, 31/185); (iii) STI test/treatment (32.4%, 60/185); and (iv) contraception (32.4%, 60/185). Only 29.7% (33/111) would have been tested if symptoms or requesting a test were impetus.
  
  
  CONCLUSIONS
  Sexually active 12- to 16-year-olds should be tested for chlamydia, and establishing their sexual history is crucial. Amending the current Australian guidelines to annual testing of any sexually active person under the age of 30 years should be considered.
authors.affiliation: Centre for Excellence in Rural Sexual Health, Department of Rural Health, University of Melbourne, 49 Graham Street, Shepparton, Vic. 3630, Australia.
authors.forename: Jane Elizabeth
authors.initials: JE
authors.lastname: Tomnay
authors.affiliation: Gateway Health, 155 High Street, Wodonga, Vic. 3690, Australia.
authors.forename: Lauren
authors.initials: L
authors.lastname: Coelli
authors.affiliation: Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Level 3, 207 Bouverie Street, Carlton South, Vic. 3053, Australia.
authors.forename: Jane Simone
authors.initials: JS
authors.lastname: Hocking
mesh_terms: D000293:Adolescent; D001315:Australia / Q000453:epidemiology; D002648:Child; D002690:Chlamydia Infections / Q000175:diagnosis / Q000453:epidemiology*; D002692:Chlamydia trachomatis; D005260:Female; D006801:Humans; D011247:Pregnancy; D012189:Retrospective Studies; D012725:Sexual Behavior; D000074384:Sexual Health