Chlamydia trachomatis is the most commonly diagnosed sexually transmitted infection (STI) in Australia, with annual notifications having quadrupled in the last decade from 20 275 cases in 2001 to 80 724 cases in 2011.[1, 2] Although the number of cases of chlamydia diagnosed has increased in most age groups and in both males and
females, the greatest increase (almost 80%) has been in the 15–29 year age group.[1, 2] The concern with chlamydia infections is that it is most often asymptomatic in women. Left untreated, persistent infection can have significant clinical consequences such as pelvic inflammatory disease, ectopic pregnancy and tubal infertility in women and epididymitis and epididymo-orchitis in men.[3-5]
For these reasons, regular testing of those that are thought to be most at risk of chlamydia is considered a key public health control strategy.[3, 6, 7] In its first IWR-1 price selleck chemical National Sexually Transmissible Infections Strategy (NSTIS) in 2005, the Australian federal government stated that chlamydia screening programmes should be designed to specifically identify and test male and female sub-populations on the basis of risk factors. This should include targeting all sexually active young people aged 15–29 years, those who have experienced inconsistent barrier contraception, those with multiple sexual partners and those with a prior diagnosed history of STIs. Consequently the Australian federal government committed to improving chlamydia screening from general practice on the basis that nearly 90% of women and 70% of men aged between 15 and 29 years see their general practitioner (GP) at least once a year. Although national guidelines for GPs recommend testing all sexually active people aged 15–25 years for chlamydia annually, an evaluation of Medicare data for the period of October 2007 to September 2008 indicated that only 8.9% (95% confidence interval, 8.88–8.94%) of young people between the ages of 15–29 years had been tested. An Australian mathematical
modelling study predicts that this percentage would have to increase to 30% among the 15–29 year age group to halve the prevalence of chlamydia in Australia Acyl CoA dehydrogenase within 4 years. Australia is a long way from achieving this target and while current health services such as general practice, family planning and sexual health clinics are well equipped to treat diagnosed cases of chlamydia, there is evidently an unmet need for testing those at risk and venues other than general practice may have to be considered. The second NSTIS, released in 2009, recommended a re-orientation of health services so that young people have easy access to confidential, youth-friendly chlamydia screening sites that have late evening and weekend opening hours.