Chlamydia trachomatis is a common, often asymptomatic sexually transmitted infection.
The goal was to estimate the prevalence and predictors of C. trachomatis among young women using self-collected vaginal swabs, and the preferences of women and physicians for self-testing.
A total of 514 attendees of university/college health clinics, adolescent birth control clinics, centers providing health services to homeless youth and adults (street health centers), a sexually transmitted diseases clinic, and family practices were tested by ligase chain reaction. Preference for self- versus provider-testing was examined.
Prevalence was 6.0% and was highest (18.2%) in the street health centers. In multivariate analysis, only recent contact with someone with C. trachomatis infection was significantly associated with infection (odds ratio, 7.1; 95% confidence interval, 2.5–20.0). Most women (54.2%; 256 of 472) preferred self-sampling compared with physician sampling (15.9%; 75 of 472). The majority of physicians (75.0%; 9 of 12) reported at the start and end of the study that they would use vaginal swab self-sampling if available.
Prevalence of infection in young women attending homeless youth organizations was high. Self-sampling was acceptable and could facilitate screening in high-risk women who do not regularly access health services.
Prevalence of Chlamydia trachomatis (6.0%) in self-collected vaginal swabs ranged from 2.3% in student health centers to 18.2% in centers servicing homeless young women. Self-sampling was preferred over physician sampling.
*Public Health and Community Services Department, City of Hamilton, the Departments of †Family Medicine, ‡Clinical Epidemiology and Biostatistics, and §Pathology and Molecular Medicine, McMaster University, Hamilton, and ∥Father Sean O'Sullivan Research Center, St. Joseph's Healthcare, Hamilton, Ontario, Canada
This research was supported by grants provided by the Public Health Research, Education & Development Program (PHRED) and Pfizer Canada.
Dr. Sellors is now affiliated with the Program for Appropriate Technology in Health, Seattle, Washington.
Correspondence: Elizabeth Richardson, MD, MHSc, FRCP, City of Hamilton, Public Health & Community Services Department, 1 Hughson St. N., 4th Floor, Hamilton, Ontario, Canada L8R 3L5. E-mail: email@example.com
Received for publication March 4, 2003,
revised July 10, 2003, and accepted July 16, 2003.