Opportunistic screening for Chlamydia at a community based contraceptive service for young people.

Problem: The suspected high prevalence of Chlamydia infection that is undiagnosed and untreated among high risk women who attend a contraceptive service for young people.

Design: Cross sectional study from a community screening service.

Background And Setting: An inner city contraceptive and psychotherapy service for young people aged 12-21 years. KEY MEASURE FOR IMPROVEMENT: Prevalence of infection commensurate with or above findings from the national screening pilot (13.8% for > 16 year olds, 10.5% for 16-19 year olds, and 7.2% for 20 to 24 year olds).

Strategies For Change: Offering testing (of a first catch urine sample) for Chlamydia to all young people using the contraceptive service who were not previously screened; launching a publicity campaign about the new service; training medical staff and reception staff to deliver the service to maximise take up of screening and of treatment by infected cases; and surveying results from testing to monitor significant patterns of infection requiring further action.

Effects Of Change: Percentage of clients with infection exceeded targets for each age group, 76% with a positive or equivocal result returned for treatment, 87% of those treated returned for a test of cure, and 99% of tests of cure were negative. Prevention work was initiated in a school with a particularly heavy concentration of infected clients.

Lessons Learnt: A contraceptive service for young women is a highly acceptable location for effective Chlamydia screening.