Take-home chlamydia tests tied to more screening

NEW YORK Fri Jul 22, 2011 5:02pm EDT

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NEW YORK (Reuters Health) - Women at risk for chlamydia infections are more likely to get tested if they can do it at home instead of going to a clinic, suggests new research.

The study participants had all previously tested positive for chlamydia and were treated for the sexually-transmitted disease. But guidelines recommend women get tested again, three months after treatment, because it's easy to re-catch the infection from a partner who hasn't been treated.

"Once you've had an infection, that puts you at increased risk for having another infection," said Charlotte Gaydos, who studies STDs and testing at Johns Hopkins University School of Medicine in Baltimore.

But, she told Reuters Health, "It's a very hard thing for clinicians, once they've treated women for an infection, to get them to come back in" for retesting.

About 1 percent of the U.S. population gets chlamydia every year, and it's most common in young people in their teens and 20's.

Chlamydia often doesn't have symptoms, but can lead to reproductive problems down the road in women who don't get adequate treatment.

For the new study, Dr. Fujie Xu of the Centers for Disease Control and Prevention and colleagues wanted to see if they could encourage women to get retested for chlamydia after a first round of treatment by letting them do that testing at home.

At family planning and STD clinics in New Orleans, St. Louis, and Jackson, Mississippi, they randomly assigned more than 1,000 women age 16 and older to two groups following antibiotic treatment.

One group was asked to return to the clinic in three months for another chlamydia test. The other was mailed a home-based "vaginal swab" testing kit and told to send it back for evaluation.

All participants were reminded about follow-up testing through phone calls from the clinics.

Women who went to family planning clinics were more likely to do the retest than those who had their first appointments at STD clinics. In both types of clinic-goers, retesting was more common in women who were assigned to take their second test at home.

Among women going to family planning clinics, 41 percent assigned to take the test at home did so, while 21 percent of those asked to come back into the office returned for testing. At STD clinics, those numbers were 27 percent versus 19 percent, again in favor of home testing, according to findings published in Obstetrics & Gynecology.

That shows that women "like taking their own sample, they like doing it in the privacy of their own home," said Gaydos, who wasn't involved in the new study.

"Most people feel fine (after chlamydia treatment) and don't find getting tested for STDs to be a pleasant experience," said Dr. Robert Cook, who studies STD prevention at the University of Florida in Gainesville. The take-home test "is more acceptable to the patients and less expensive -- it seems like a great strategy," he told Reuters Health.

Cook, who also wasn't linked to the new research, said that the take-home tests currently aren't available to women outside of studies because they haven't been approved by the Food and Drug Administration.

Despite that barrier, Gaydos said that using the internet to recruit young people to test and retest themselves for STDs at home might also increase the chances that they will get screened, while saving them the trouble and cost of going to a doctor's appointment.

But she added that those methods only apply to people who don't have chlamydia symptoms -- such as discharge and burning while urinating. "If you're having symptoms, you need to go in and see a doctor," she said.

SOURCE: bit.ly/nxdAuT Obstetrics & Gynecology, August 2011.

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