About the Project
Chlamydia re-infection is common in women and men. Chlamydia re-infections increase the risk of chlamydia-related sequelae such as pelvic inflammatory disease (PID) and infertility, when compared to initial infection,and in men who have sex with men (MSM) has been associated with an increased HIV seroconversion risk.Clinical guidelines in Australia recommend that for all people treated for chlamydia a repeat test is conducted in 6 weeks. A recent analysis of data collected from 19 sexual health clinics demonstrated that re-testing rates within 1-4 months of chlamydia infection were 8.6% in MSM, 11.9%in heterosexual males and 17.8% in heterosexual females.
To compare re-testing rate in three months after treatment for chlamydia among patients in the home group (SMS reminder + home-based self-collection) compared with the clinic group (SMS reminder and clinic testing).
To compare the chlamydia persistent positive test rate in patients in the home group compared with the clinic group;
To determine the acceptability of the SMS reminders and home-based testing; and
To assess the re-infection rate among patients who were re-tested.
To compare health provider costsof home-based specimen collection with routine (clinic based) re-testing
Design & Method
This randomised controlled trial will assess the effectiveness of a SMS reminder and home-based self-collected samples (home group) to increase the proportion of patients re-tested after a chlamydia infection, compared to an SMS reminder and clinic testing (clinic group). Approximately 600 patients diagnosed with chlamydia across two sexual health clinics will be randomised to the home group or the clinic group. In the home group, patients will receive a ‘collection kit’ containing the collection device, instructions, request form and pre-paid envelope. At three months the clinic will send a SMS reminder to encourage the patient to collect a sample using the collection kit and mail to the lab, or return to the clinic for re-testing if they prefer. Patients randomised to the clinic group will receive an SMS reminder at three months to encourage the patient to return to the clinic for re-testing. At four and five months, patients will be requested by SMS to complete an online survey to assess acceptability of the home testing, re-testing elsewhere, re-testing barriers and sexual behaviour.
Recruitment completed in September 2012. Follow-up to continue until February 2013
The study will contribute to the design of future chlamydia re-testing programs in Australia.
4 - 5 manuscripts expected
Poster (no. 158) presented at the 2012 IUSTI Conference Melbourne:
HOME-BASED RE-TESTING FOR CHLAMYDIA: WHAT DO PATIENTS THINK?
Smith KS, Hocking JS, Chen M, Read P, Fairley CK, McNulty A, Bradshaw CS, Wand H, Saville M, Jamil MS, Tabrizi S, Garland SM, Rawlinson W0, Wright S Worthington K, Morgan S, Rickard G, Donovan B, Kaldor JM,Guy R.
Associate Professor and Program Head
Ph +61 (0)2 9385 0900
Ph +61 (0)2 9385 0861
Professor and Program Head
Ph +61 (0)2 9385 9956
Professor and Program Head
Ph +61 (0)2 9385 0961
Senior Research Officer
Ph +61 (0)421 593 015
Dr Jane Hocking, Dr Anna McNulty, Dr Phil Read, Professor Christopher Fairley, A/Prof Marcus Chen, Dr Catriona Bradshaw, Professor Marion Saville, A/Prof Sepehr Tabrizi, Professor Suzanne Garland, Mr Simon Wright, Mr Bill Rawlinson, Mr Gary Rickard
Project Collaborators: External
Melbourne Sexual Health Centre
Sydney Sexual Health Centre
University of New South Wales
Victorian Cytology Service
Royal Women’s and Royal Children’s Hospitals