Internet-based self-sampling for Chlamydia trachomatis testing

Söderqvist JGullsby KStark L, et al
Internet-based self-sampling for Chlamydia trachomatis testing: a national evaluation in Sweden

Abstract:

Objective Internet-based testing for Chlamydia trachomatis (CT) with self-sampling at home has gradually been implemented in Sweden since 2006 as a free-of-charge service within the public healthcare system. This study evaluated the national diagnostic outcome of this service.

Methods Requests for data on both self-sampling at home and clinic-based sampling for CT testing were sent to the laboratories in 18 of 21 counties. Four laboratories were also asked to provide data on testing patterns at the individual level for the years 2013–2017.

Results The proportion of self-sampling increased gradually from 2013, comprising 22.0% of all CT tests in Sweden in 2017. In an analysis of 14 counties (representing 83% of the population), self-sampling increased by 115% between 2013 and 2017 for women, compared with 71% for men, while test volumes for clinic-based sampling were fairly constant for both sexes (1.8% increase for women, 15% increase for men). In 2017 self-sampling accounted for 20.3% of all detected CT cases, and the detection rate was higher than, but similar to, clinic-based testing (5.5% vs 5.1%). The proportion of self-sampling men was also higher, but similar (33.7% vs 30.8%). Analysis of individual testing patterns in four counties over 5 years showed a higher proportion of men using self-sampling only (67%, n=10 533) compared with women (40%, n=8885).

Conclusions Self-sampling has increased substantially in recent years, especially among women. This service is at least as beneficial as clinic-based screening for detection of CT, and self-sampling reaches men more than clinic-based testing.

Let’s Celebrate Safer Sex this National Condom Day (SHINE SA Media Release)

SHINE SA, 11 February 2020

Forget Valentine’s Day, there’s a new romantic day occupying February 14: National Condom Day! With only 36% of young South Australians always using a condom during casual sex, it’s no surprise that STI rates are on the rise. Like an elusive Valentine’s partner, many STIs are hidden. Around 70% of people with chlamydia have no symptoms, going unnoticed while being transmitted to others.

So what could be more romantic than preventing the unintended consequences of unprotected sex? Show some romance by taking advantage of how easy it is to get your hands on a condom. Condoms are widely available, don’t require a prescription and can even be found for free at SHINE SA clinics. SHINE SA encourages all young people to take steps to engage in safer sex. This means always having a condom handy, making time for that discussion with your partner/s, ensuring you have informed and enthusiastic consent and getting regular sexual health checks either through a GP or at a SHINE SA clinic.

Natasha Miliotis SHINE SA’s Chief Executive said:

“National Condom Day is a great reminder to take control of our own sexual health. Through the use of condoms and regular testing, STIs are preventable.”

For more information on the sexual health of young people in South Australia see: www.sahmri.org/aboriginal-health-equity-theme/news-270/

Want to learn more about safer sex? To mark National Condom Day SHINE SA have released the Safer Sex – Use a Condom campaign. The campaign highlights the importance of condoms and the concepts of safety, pleasure and respect for a safer sex life. View the campaign here: www.shinesa.org.au/safersex

For further information and media enquiries see media release for contacts:

 

Chlamydia trachomatis and the Risk of Pelvic Inflammatory Disease, Ectopic Pregnancy, and Female Infertility

Clinical Infectious Diseases, ciz429, https://doi.org/10.1093/cid/ciz429
Published: 24 August 2019

Abstract

Background

We evaluated the risk of pelvic inflammatory disease (PID), ectopic pregnancy, and infertility in women with a previous Chlamydia trachomatis (CT) diagnosis compared with women who tested negative for CT and CT untested women, considering both targeted and incidental (ie, prescribed for another indication) use of CT-effective antibiotics.

Methods

This was a retrospective study of women aged 12–25 years at start of follow-up within the Clinical Practice Research Datalink GOLD database linked to index of multiple deprivation quintiles, 2000–2013. CT test status and antibiotic use were determined in a time-dependent manner. Risk of PID, ectopic pregnancy, or female infertility were evaluated using of Cox proportional hazard models.

Results

We studied 857 324 women, contributing 6 457 060 person-years. Compared with women who tested CT-negative, women who tested CT-positive had an increased risk of PID (adjusted hazard ratio [aHR], 2.36; 95% confidence interval [CI], 2.01–2.79), ectopic pregnancy (aHR, 1.87; 95% CI, 1.38–2.54), and infertility (aHR, 1.85; 95% CI, 1.27–2.68). The PID risk was higher for women with 2 or more positive CT tests than those with 1 positive test. PID risk increased with the number of previous antibiotic prescriptions, regardless of CT test status.

Conclusions

We showed an association between CT-positive tests and 3 adverse reproductive health outcomes. Moreover, this risk increased with repeat CT infections. CT-effective antibiotic use showed no decreased risks of subsequent PID regardless of CT history. Our results confirm the reproductive health burden of CT, which requires adequate public health interventions.

STI/BBV testing tool for asymptomatic people

NSW STI Programs Unit, ASHM & Qld. Govt.,  2019

This resource has charts and information about how routine STI/BBV testing can be offered, who to, and how to follow up.

Developed by NSW STI Programs Unit, NSW Australia, and reproduced with permission by the Sunshine Coast Hospital and Health Service, ASHM and Communicable Diseases Branch.

 

 

STIs among transgender men and women attending Australian sexual health clinics

Med J Aust. 2019 Aug 29. doi: 10.5694/mja2.50322. [Epub ahead of print]

Abstract

Objectives

To estimate rates of HIV infection, chlamydia, gonorrhoea, and infectious syphilis in transgender men and women in Australia; to compare these rates with those for cisgender people.

Design

Cross‐sectional, comparative analysis of de‐identified health data.

Setting, participants

We analysed data for 1260 transgender people (404 men, 492 women, 364 unrecorded gender), 78 108 cisgender gay and bisexual men, and 309 740 cisgender heterosexual people who attended 46 sexual health clinics across Australia during 2010–2017.

Main outcome measures

First‐visit test positivity for sexually transmitted infections (STIs), stratified by patient group and year; demographic and behavioural factors associated with having STIs.

Results

14 of 233 transgender men (6.0%) and 34 of 326 transgender women (10%) tested during first clinic visits were chlamydia‐positive; nine transgender men (4%) and 28 transgender women (8.6%) were gonorrhoea‐positive. One of 210 tested transgender men (0.5%) and ten of 324 tested transgender women (3.1%) were diagnosed with infectious syphilis; 14 transgender men (3.5%) and 28 transgender women (5.7%) were HIV‐positive at their first visit. The only significant change in prevalence of an STI among transgender patients during the study period was the increased rate of gonorrhoea among transgender women (from 3.1% to 9.8%). Compared with cisgender gay and bisexual men, transgender men were less likely (adjusted odds ratio [aOR], 0.46; 95% CI, 0.29–0.71; P = 0.001) and transgender women as likely (aOR, 0.98; 95% CI, 0.73–1.32; P = 0.92) to be diagnosed with a bacterial STI; compared with heterosexual patients, transgender men were as likely (aOR, 0.72; 95% CI, 0.46–1.13; P = 0.16) and transgender women more likely (aOR, 1.56; 95% CI, 1.16–2.10; P = 0.003) to receive a first‐visit bacterial STI diagnosis.

Conclusions

The epidemiology of STIs in transgender people attending Australian sexual health clinics differs from that of cisgender patients. Gender details must be captured by health data systems to facilitate appropriate delivery of sexual health care.

New report: Surveillance of STIs and Blood-Borne Viruses in South Australia, 2018

Communicable Disease Control Branch, SA Health, July 2019

In 2018, there were 8,556 new notifications of STI and BBV in South Australia. This represents a 3% increase in the number of new notifications compared to notifications received in 2017.

In 2018, there were 6,256 notifications of Chlamydia trachomatis (chlamydia) making this the most commonly notified STI in South Australia. The demographics of people diagnosed with chlamydia have remained relatively stable over the past five
years.

There were no notifications of donovanosis in 2018.

There were 1,288 notifications of gonorrhoea in 2018. The notification rate of gonorrhoea increased from 45 per 100,000 population in 2014 to 74 per 100,000 population in 2017 and 2018. The rate in the Aboriginal population was 813 per 100,000 population in 2018 compared to 55 per 100,000 population in the non-Indigenous population.

There were 203 notifications of infectious syphilis in 2018, the highest number of annual notifications in the past 10 years. The notification rate of infectious syphilis in 2018 was 11.7 per 100,000 population, more than double the rate in 2016 of 5.2 per 100,000 population. In 2018, 88% of notifications were in males, the majority being among men who have sex with men (MSM) (75%). Infectious syphilis remains high in the Aboriginal population. There were no notifications of congenital syphilis in 2018.

There were 39 new diagnoses of human immunodeficiency virus (HIV) infection in 2018. Thirty-two of the 39 notifications were in males (82%). In 2018, 63% of male cases reported male-to-male sex. Six females acquired their infection overseas and one in South Australia.

There were four notifications of newly acquired hepatitis B infection in 2018, below the five year average (2013-2017) of eight cases per year. There were no notifications in the Aboriginal population. There were 254 notifications of unspecified hepatitis B infection reported in 2018, a decrease compared to the five year average (2013-2017) of 325 cases per year. The notification rate has declined in the Aboriginal population over the past five years.

There were 41 notifications of newly acquired hepatitis C in 2018. Sixty-one per cent of cases were males, and 66% were aged 30 years and over. The notification rate of unspecified hepatitis C infection was 22.2 per 100,000 population in 2018, with a
total of 385 notifications in 2018 compared to 465 in 2017.

There were five new diagnoses of hepatitis D infection in 2018, below the five year average (2013-2017) of 9.8 cases per year.