Introduction of chlamydia screening to a busy, inner city contraception and reproductive health clinic

Introduction of chlamydia screening to a busy, inner city contraception

and reproductive health clinic

K. Jones (1), C. Hazledine (2)

Royal Liverpool and Broadgreen Hospitals, Liverpool, UK (1)l Abacus

Clinics, Liverpool, UK (2)

Introduction: Our city is recognised as a clubbing capital attracting

many young visitors nationally and internationally. It also has three

universities and a number of colleges of higher education, attracting many young

people. Between 1996 and 2002 the overall rates of uncomplicated chlamydia

diagnoses among 16 to 19 year olds more than doubled, from 7,324 cases to


Objectives: To evaluate whether it was possible to reproduce results

of a successful chlamydia screening service from a previous small study. To

evaluate how quickly and easily the staff assimilated the screening process. To

confirm acceptability of urine testing and community based management. To

improve the sexual health of the local young population.

Design & methods: From May 02 to March 03, testing was offered in

the large city centre sexual health clinic. All staff received written and oral

training, reiterated on various occasions, enabling them to offer enough

information to make an informed choice. All clients under the age of 25, who

were asymptomatic, were offered urinary screening for chlamydia during their

contraceptive and reproductive health discussion. All urine samples, which

tested positive for chlamydia, were also tested for gonorrhoea. Clients with a

negative result were contacted via a letter. Those clients who tested positive

were contacted by telephone, with postal contact as back up. They were seen by

appointment for discussion, treatment and partner notification. Regular audit of

case notes was performed to determine whether staff offered the test


Results: 80% of eligible clients had documented evidence that the test

had been discussed. Most clients offered testing accepted screening at the

initial contact. Of 2337 clients tested, 304 were positive. 4 also had

gonorrhoea. All clients with a positive result were contacted and all but 4

definitely received treatment. 94% chose to receive treatment at the testing

site, others chose to attend local GUM services. 69% of named contacts were seen

and treated.

Conclusions: It is possible to introduce acceptable chlamydia

screening service into a large, busy city centre clinic. There is a high

incidence of asymptomatic chlamydia infection in the population targeted for

screening. The management of uncomplicated genital chlamydia infection in this

setting was acceptable to both clients and staff. Follow up of positive clients

by a designated team with links into genitourinary medicine clinic worked well.

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