August 11, 2005
According to the current study, noninvasive molecular tests for bacterial STIs provide new opportunities for testing in nonclinical settings. The authors' objective was to "examine patient treatment preferences and partner notification outcomes among Chlamydia trachomatis-positive cases identified in the 2000 national survey of sexual attitudes and lifestyles (Natsal 2000), and factors associated with providing a urine sample."
Using computer-assisted self-interviews, the authors conducted a stratified probability survey of 11,161 British men and women ages 16-44. A random half of the sexually active respondents ages 18-44 were offered urine testing for chlamydia using ligase chain reaction. Positive respondents were notified, treated and followed up.
Of the 5,105 participants who were invited to provide a urine sample, 3,628 (71 percent) agreed, and 3,608 samples were successfully tested. Those reporting previous homosexual experience, heterosexual anal sex, and STI diagnosis were significantly more willing to provide a urine sample. Seventy-three respondents (42 women and 31 men) were diagnosed with genital chlamydial infection, of whom 65 (89 percent) responded to their infection notification and were recommended for treatment and partner notification. Fifty patients (77 percent) preferred to see their general practitioner, and 15 (23 percent) preferred their local genitourinary medicine clinic. Though the authors obtained physician feedback on treatment and partner notification outcomes for just half of respondents (n=34), follow-up interviews with respondents confirmed that 49 (75 percent) actually underwent this process.
"In this community-based survey, the rate of provision of urine samples was high, and those who provided samples were found to be at somewhat greater risk of infection on average. This was accounted for in estimating population chlamydia prevalence," reported the authors, who found that treatment and partner notification of newly diagnosed infections can be successfully achieved in STI prevalence studies.