Register      Login
Sexual Health Sexual Health Society
Publishing on sexual health from the widest perspective
RESEARCH ARTICLE

Future chlamydia screening preferences of men attending a sexually transmissible infection clinic

Alexis Roth A C , Barbara Van Der Pol A B C D , Brian Dodge C , J. Dennis Fortenberry A C and Gregory Zimet A
+ Author Affiliations
- Author Affiliations

A Departments of Pediatrics and Medicine, Indiana University School of Medicine, 410 W. 10th Street, Indianapolis, IN 46202, USA.

B Indiana University School of Health, Physical Education, and Recreation, Department of Kinesiology, 1025 E. 7th Street, HPER 115, Bloomington, IN 47405-7109, USA.

C Center for Sexual Health Promotion, 1025 E. 7th Street, HPER 116, Bloomington, IN 47405, USA.

D Corresponding author. Email: bvanderp@iupui.edu

Sexual Health 8(3) 419-426 https://doi.org/10.1071/SH10017
Submitted: 15 February 2010  Accepted: 21 October 2010   Published: 23 May 2011

Abstract

Background: Despite years of public health efforts, Chlamydia trachomatis remains a highly prevalent disease suggesting that current control strategies are not sufficient. Asymptomatic men with chlamydial infections are under-identified and probably play an important role in sustaining the epidemic. Novel methods of actively screening asymptomatic men are needed to reduce the prevalence of chlamydia. This formative study explored the features of a sexually transmissible infection (STI) control program that would encourage annual testing among men. Methods: Using semi-structured interviews and focus group discussions, we explored issues related to health seeking behaviours and preferences for STI screening among men recruited from a public health STI clinic. Results: All 29 participants acknowledged the expertise of clinic staff and most men preferred speaking with a provider over using electronic informational resources. The clinic was the preferred venue for future screening, followed by self-collected home sampling with clinic drop-off. Men expressed a preference for receiving results via the telephone rather than electronic options, and preferred personalised reminders for future STI screening. Conclusions: In this sample, there was high interest in utilising the expertise of STI clinic personnel and less in non-clinical options. While this may be due to recruiting from an STI clinic, the data serves as a reminder that service provision must be responsive to the needs of potential users. Our findings suggest that future non-clinic based screening strategies may require an initial educational component to address concerns about confidentiality and sample quality in order to be acceptable.

Additional keywords: clinics, males, qualitative methods, testing.


References

[1]  Centers for Disease Control and Prevention. 2006 disease profile. Atlanta: Centers for Disease Control and Prevention; 2008 . Available online at: http://www.cdc.gov/hiv/topics/surveillance/resources/slides/incidence/slides/HIV-Incidence.pdf [verified July 2010].

[2]  Schillinger JA, Dunne EF, Chapin JB, Ellen JM, Gaydos CA, Willard NJ, et al Prevalence of Chlamydia trachomatis infection among men screened in 4 U.S. cities. Sex Transm Dis 2005; 32 74–7.
Prevalence of Chlamydia trachomatis infection among men screened in 4 U.S. cities.Crossref | GoogleScholarGoogle Scholar |

[3]  Celum CL, Bolan G, Krone M, Code K, Leone P, Spaulding C, et al Patients attending STD clinics in an evolving health care environment: demographics, insurance coverage, preferences for STD services, and STD morbidity. Sex Transm Dis 1997; 24 599–605.
Patients attending STD clinics in an evolving health care environment: demographics, insurance coverage, preferences for STD services, and STD morbidity.Crossref | GoogleScholarGoogle Scholar |

[4]  Andersen B, Olesen F, Møller J, Østergaard L. Population-based strategies for outreach screening of urogenital Chlamydia trachomatis infections: a randomized controlled trial. J Infect Dis 2002; 185 252–8.
Population-based strategies for outreach screening of urogenital Chlamydia trachomatis infections: a randomized controlled trial.Crossref | GoogleScholarGoogle Scholar |

[5]  Kahn R, Moseley K, Thilges J, Johnson G, Farley T. Community-based screening and treatment for STDs: results from a mobile clinic initiative. Sex Transm Dis 2003; 30 654–8.
Community-based screening and treatment for STDs: results from a mobile clinic initiative.Crossref | GoogleScholarGoogle Scholar |

[6]  Marcell A, Halpern-Felsher B. Adolescents’ beliefs about preferred resources for help vary depending on the health issue. J Adolesc Health 2007; 41 61–8.
Adolescents’ beliefs about preferred resources for help vary depending on the health issue.Crossref | GoogleScholarGoogle Scholar |

[7]  Marcell A, Raine T, Eyre S. Where does reproductive health fit into the lives of adolescent males? Perspect Sex Reprod Health 2003; 35 180–6.
Where does reproductive health fit into the lives of adolescent males?Crossref | GoogleScholarGoogle Scholar |

[8]  Raine T, Marcell A, Rocca CH, Harper CC. The other half of the equation: serving young men in a young women’s reproductive health clinic. Perspect Sex Reprod Health 2003; 35 208–14.
The other half of the equation: serving young men in a young women’s reproductive health clinic.Crossref | GoogleScholarGoogle Scholar |

[9]  Centers for Disease Control and Prevention. 2008 STD surveillance report. Atlanta: Centers for Disease Control and Prevention; 2009. Available online at: http://www.cdc.gov/std/stats08/toc.htm [verified July 2010].

[10]  Low N, Egger M. What should we do about screening for genital chlamydia? Int J Epidemiol 2002; 31 891–3.
What should we do about screening for genital chlamydia?Crossref | GoogleScholarGoogle Scholar |

[11]  Ross M, Berman S, Aral S, Courtney PE, Dennison JM, Klovdahl AS, et al Process, efficacy and sample demographics of three approaches to behavioural surveillance for gonorrhoea: case interviews, place surveys and network studies. Int J STD AIDS 2007; 18 846–50.
Process, efficacy and sample demographics of three approaches to behavioural surveillance for gonorrhoea: case interviews, place surveys and network studies.Crossref | GoogleScholarGoogle Scholar |

[12]  Tilson E, Sanchez V, Ford C, Smurzynski M, Leone P, Fox K, et al Barriers to asymptomatic screening and other STD services for adolescents and young adults: focus group discussions. BMC Public Health 2004; 4 21
Barriers to asymptomatic screening and other STD services for adolescents and young adults: focus group discussions.Crossref | GoogleScholarGoogle Scholar |

[13]  Gaydos CA, Dwyer K, Barnes M, Rizzo-Price PA, Wood BJ, Flemming T, et al Internet-based screening for Chlamydia trachomatis to reach nonclinic populations with mailed self-administered vaginal swabs. Sex Transm Dis 2006; 33 451–7.
Internet-based screening for Chlamydia trachomatis to reach nonclinic populations with mailed self-administered vaginal swabs.Crossref | GoogleScholarGoogle Scholar |

[14]  Martin L, Freedman E, Burton L, Rutter S, Knight V, D’Amato A, et al The C-project: use of self-collection kits to screen for Chlamydia trachomatis in young people in a community-based health promotion project. Sex Health 2009; 6 157–62.
The C-project: use of self-collection kits to screen for Chlamydia trachomatis in young people in a community-based health promotion project.Crossref | GoogleScholarGoogle Scholar |

[15]  Chai SJ, Aumakhan B, Barnes M, Jett-Goheen M, Quinn N, Agreda P, et al Internet-based screening for sexually transmitted infections to reach nonclinic populations in the community: risk factors for infection in men. Sex Transm Dis 2010; in press.
Internet-based screening for sexually transmitted infections to reach nonclinic populations in the community: risk factors for infection in men.Crossref | GoogleScholarGoogle Scholar |

[16]  Fenton K. Screening men for Chlamydia trachomatis infection: have we fully explored the possibilities. Commun Dis Public Health 2000; 3 86–9.

[17]  Auerswald C, Greene K, Minnis A, Doherty I, Ellen J, Padian N. Qualitative assessment of venues for purposive sampling of hard-to-reach youth: an illustration in a Latino community. Sex Transm Dis 2004; 31 133–8.
Qualitative assessment of venues for purposive sampling of hard-to-reach youth: an illustration in a Latino community.Crossref | GoogleScholarGoogle Scholar |

[18]  Auerswald C, Sugano E, Ellen J, Klausner J. Street-based STD testing and treatment of homeless youth are feasible, acceptable and effective. J Adolesc Health 2006; 38 208–12.
Street-based STD testing and treatment of homeless youth are feasible, acceptable and effective.Crossref | GoogleScholarGoogle Scholar |

[19]  Rietmeijer C, Hopkins E, Geisler W, Orr D, Kent C. Chlamydia trachomatis positivity rates among men in selected venues in the United States: a review of the recent literature. Sex Transm Dis 2008; 35 S8–18.
Chlamydia trachomatis positivity rates among men in selected venues in the United States: a review of the recent literature.Crossref | GoogleScholarGoogle Scholar |

[20]  Scholes D, Heidrich F, Yarbro P, Lindenbaum J, Marrazzo J. Population-based outreach for chlamydia screening in men: results from a randomized trial. Sex Transm Dis 2007; 34 837–9.
Population-based outreach for chlamydia screening in men: results from a randomized trial.Crossref | GoogleScholarGoogle Scholar |

[21]  Centers for Disease Control and Prevention. 2008 county reports syphilis outbreak. Atlanta: Centers for Disease Control and Prevention; 2008. Available online at: http://www.cdcnpin.org/scripts/display/NewsDisplay.asp?NewsNbr=50635 [verified April 2010].

[22]  Rietmeijer CA, Bull SS, Ortiz CG, Leroux T, Douglas JMJ. Patterns of general health care and STD services use among high-risk youth in Denver participating in community-based urine chlamydia screening. Sex Transm Dis 1998; 25 457–63.
Patterns of general health care and STD services use among high-risk youth in Denver participating in community-based urine chlamydia screening.Crossref | GoogleScholarGoogle Scholar |

[23]  Parrish DD, Kent CK. Access to care issues for African American communities: implications for STD disparities. Sex Transm Dis 2008; 35 S19–22.
Access to care issues for African American communities: implications for STD disparities.Crossref | GoogleScholarGoogle Scholar |

[24]  Rosenstock IM. The Health Belief Model and preventive health behavior. Health Educ Monogr 1974; 2 354–86.

[25]  Rosenberger J, Dodge B, Van Der Pol B, Reece M, Herbenick D, Fortenberry JD. Reactions to self-sampling for ano-rectal sexually transmitted infections among men who have sex with men: a qualitative study. Arch Sex Behav in press;
Reactions to self-sampling for ano-rectal sexually transmitted infections among men who have sex with men: a qualitative study.Crossref | GoogleScholarGoogle Scholar |

[26]  Dodge B, Van Der Pol B, Rosenberger JG, Reece M, Roth AM, Herbenick D, et al Field collection of rectal samples for sexually transmitted infection diagnostics among men who have sex with men. Int J STD AIDS 2010; 21 260–4.
Field collection of rectal samples for sexually transmitted infection diagnostics among men who have sex with men.Crossref | GoogleScholarGoogle Scholar |

[27]  Gift TL, Blake DR, Gaydos CA, Marrazzo JM. The cost-effectiveness of screening men for Chlamydia trachomatis: a review of the literature. Sex Transm Dis 2008; 35 S51–60.
The cost-effectiveness of screening men for Chlamydia trachomatis: a review of the literature.Crossref | GoogleScholarGoogle Scholar |

[28]  Hobbs MM, van der Pol B, Totten P, Gaydos CA, Wald A, Warren T, et al From the NIH: proceedings of a workshop on the importance of self-obtained vaginal specimens for detection of sexually transmitted infections. Sex Transm Dis 2008; 35 8–13.
From the NIH: proceedings of a workshop on the importance of self-obtained vaginal specimens for detection of sexually transmitted infections.Crossref | GoogleScholarGoogle Scholar |