Will chlamydia screening reach young people in deprived areas in England? Baseline analysis of the English National Chlamydia Screening Programme delivery in 2008

• Published in: Sexually transmitted diseases Vol. 38; no. 8; p. 677
• Main Authors: Sheringham, Jessica, Simms, Ian, Riha, Johanna, Talebi, Alireza, Emmett, Lynsey, Macintosh, Mary, Raine, Rosalind
• Format: Journal Article
• Language: English
• Published: United States 01.08.2011
• Subjects: Adolescent; Age Factors; Chlamydia Infections - diagnosis; Chlamydia Infections - epidemiology; Chlamydia Infections - prevention & control; Data Collection; England - epidemiology; Female; Humans; Male; Mass Screening - methods; Mass Screening - statistics & numerical data; Socioeconomic Factors; Young Adult
• ISSN: 1537-4521
• DOI: 10.1097/OLQ.0b013e31821597ca

The National Chlamydia Screening Programme (NCSP) was established in England to control chlamydia in people <25 years. This study examined variations in NCSP delivery in 2008, its first full year of national coverage, by comparing the distribution of screening venues and coverage with the risk of testing positive in men and women by socioeconomic circumstances (SEC) and age. A total of 550,000 NCSP screening records from 2008 were linked to the Index of Multiple Deprivation 2007. NCSP provision (venues/1000 population aged 13-24 years) was examined by SEC. NCSP coverage (tests/target population) and chlamydial positivity (positive results/[positive + negative results]) were examined separately in men and women by SEC and age. Odds ratios for positivity were calculated, adjusted for socioeconomic quintile, age, ethnicity, behavior, and screening provider. NCSP coverage was just 4.1% (95% confidence interval [CI]: 4.0-4.1) in men and 9.6% (95% CI: 9.5-9.6) in women. Screening provision and coverage were highest in more socioeconomically deprived areas where chlamydia positivity was also highest. The adjusted odds for testing positive in the most deprived areas was 1.4 (95% CI: 1.3-1.5) times higher in men and 1.4 (95% CI: 1.4-1.5) times higher in women than the least deprived areas. In the first year in which all areas delivered screening, the NCSP's total coverage was low, particularly in men. However, coverage was higher in deprived populations, who were also at increased risk of testing positive for infection. This analysis provides a baseline by which to monitor social variations in NCSP delivery as coverage expands.