Abstract
Objectives: We conducted a cluster-randomized feasibility trial of 90-minute Chlamydia trachomatis tests and same day on-site treatment (‘Test n Treat/TnT’) in six technical colleges in London, England, to assess TnT uptake rates; follow-up rates; prevalence of C. trachomatis at baseline and 7 months; time to treatment; acceptability of TnT. Methods: Participants completed questionnaires and provided genitourinary samples at baseline and 7 months. Participants were informed that baseline samples would not be tested for 7 months and were advised to get screened independently. Colleges were randomly allocated 1:1 to intervention (TnT) or control (no TnT). One month and 4 months post recruitment, participants at intervention colleges were texted invitations for on-site free C. trachomatis tests. A purposive sample of students who did/did not attend for screening were interviewed (n = 26). Results: Five hundred and nine sexually active students were recruited: median age 17.9 years, 47% male, 50% black ethnicity, 55% reporting two or more sexual partners in the previous year. TnT uptake was 13% (33/259; 95% CI 8.9–17.4%) at 1 month and 10% (26/259; 6.7–14.4%) at 4 months with overall C. trachomatis positivity 5.1% (3/59; 1.1–14.2%). Follow-up at 7 months was 62% (317/509) for questionnaires and 52% (264/509) for samples. C. trachomatis prevalence was 6.2% (31/503) at baseline and 6.1% (16/264) at 7 months. Median time from test to treatment was 15 h. Interviews suggested low test uptake was associated with not feeling at risk, perceptions of stigma, and little knowledge of sexually transmitted infections (STIs). Conclusions: Despite high C. trachomatis rates at baseline and follow-up, uptake of testing was low. Like many countries, England urgently needs better sex education, including making STI testing routine/normal. Trial registration ISRCTN58038795
| Original language | English |
|---|---|
| Pages (from-to) | 865-871 |
| Number of pages | 7 |
| Journal | Clinical Microbiology and Infection |
| Volume | 25 |
| Issue number | 7 |
| DOIs | |
| Publication status | Published - Jul 2019 |
Bibliographical note
Funding Information:This paper presents independent research funded by the National Institute for Health Research (NIHR) under its Research for Patient Benefit (RfPB) Programme (Grant Reference Number PB-PG- 1014-35007 ). Value in kind funding was received from the UKCRC Translational Infection Research Initiative supported by the Medical Research Council (Grant Number G0901608) with contributions from the Biotechnology and Biological Sciences Research Council and the NIHR. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health. The funding body had no role in the design of the study, the collection, analysis or interpretation of the data, or the write-up of the manuscript. Data and materials may be obtained from the trial manager S.K.B. Pippa Oakeshott is a member of the NIHR South London Collaboration for Leadership in Applied Health Research and Care. P.O., S.T.S., E.H.E., and E.C. are members of the e STI 2 consortium funded under the UKCRC Translational Infection Research Initiative. S.T.S., E.H.E., and E.C. are members of the Applied Diagnostic Research and Evaluation Unit and have received funding for projects from Cepheid, Atlas Genetics, TwistDx. Elisabeth Adams is employed by Aquarius Population Health that receives grants and other funding to work on projects relating to STIs and point of care tests. Fiona Reid is supported by the National Institute for Health Research (NIHR) Biomedical Research Centre based at Guy's and St Thomas' NHS Foundation Trust and King's College London.
Funding Information:
This paper presents independent research funded by the National Institute for Health Research (NIHR) under its Research for Patient Benefit (RfPB) Programme (Grant Reference Number PB-PG- 1014-35007). Value in kind funding was received from the UKCRC Translational Infection Research Initiative supported by the Medical Research Council (Grant Number G0901608) with contributions from the Biotechnology and Biological Sciences Research Council and the NIHR. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health. The funding body had no role in the design of the study, the collection, analysis or interpretation of the data, or the write-up of the manuscript. Data and materials may be obtained from the trial manager S.K.B. Pippa Oakeshott is a member of the NIHR South London Collaboration for Leadership in Applied Health Research and Care. P.O., S.T.S., E.H.E., and E.C. are members of the eSTI2 consortium funded under the UKCRC Translational Infection Research Initiative. S.T.S., E.H.E., and E.C. are members of the Applied Diagnostic Research and Evaluation Unit and have received funding for projects from Cepheid, Atlas Genetics, TwistDx. Elisabeth Adams is employed by Aquarius Population Health that receives grants and other funding to work on projects relating to STIs and point of care tests. Fiona Reid is supported by the National Institute for Health Research (NIHR) Biomedical Research Centre based at Guy's and St Thomas' NHS Foundation Trust and King's College London. We thank Georgie Timson and Alice Bonnissent of Cepheid International for providing the rapid C. trachomatis/N. gonorrhoeae tests, and Agata Lesniewska for doing C. trachomatis/N. gonorrhoeae tests on the stored baseline samples. We confirm Cepheid had no role in the design of the study, the collection, analysis or interpretation of the data, or the write-up of the manuscript. The Clinical Research Network nurses helped with consenting participants. Preventx tested postal samples. We also thank students and staff at the participating London FE colleges: Lambeth, Kingston, Merton, Wandsworth, Southwark, and Lewisham.
Publisher Copyright:
© 2019 The Authors
Keywords
- Cluster randomized
- Feasibility trial
- Rapid C. trachomatis tests
- Screening
- Technical colleges
- Test and treat
- Young people
