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What about the screening process?
- Karen Lorimer (13 November 2006)
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Authors' response
- Nicola Mills (13 November 2006)
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Karen Lorimer, Research Assistant University of Glasgow, Public Health & Health Policy, 1 Lilybank Gardens, Glasgow, G12 8RZ
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Mills et al. provide useful qualitative evidence of the outcomes for men and women screened for chlamydia in a population-based approach. Widening the screening net to non-clinic settings is important to extend the offer of screening to at-risk populations who may not otherwise receive the offer of screening. But by going into community settings the question becomes how to engage these at-risk groups in screening? Given the largely asymptomatic nature of chlamydia, and the low knowledge of the infection among the most at-risk groups, it may be of more advantageous to gain an in-depth understanding of the screening process – why people do or do not participate, the barriers and supports to participation, and gender differences - than analyse the outcomes for those who participate. If there are gender differences in the response to the offer of screening that may require a gendered approach to screening. This may in turn alleviate these gendered outcomes. Conflict of Interest:None declared |
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Nicola Mills, MRC Research Fellow in HSR Department of Social Medicine, University of Bristol, Bristol, BS8 2PR, UK
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We would like to thank Dr Lorimer for her thought provoking comments. We agree that it is important to gain an understanding of the screening process, particularly why people do or do not participate and related barriers or supports to this. This was also one of our main objectives in the ClaSS project, and preliminary results will soon be available in the published project report [1]. A further in-depth analysis of the reasons why people choose to participate, or not, in population-based chlamydia screening are in preparation. In summary, we found that reasons for not taking part in screening included low perception of personal risk or relevance, and not wanting to take responsibility for their own or their partner’s health. Gender differences were again apparent - acceptance of screening was lower in men than women, with young men in particular being unable to assess the relevance of the invitation to them [1]. We agree that efforts are needed to increase chlamydia screening uptake in young men and that it is important to extend screening to non-clinic settings to reach those who may not otherwise be offered screening. Mixed models of opportunistic and population based chlamydia screening should therefore be evaluated in randomised trials to see if these increase the uptake of chlamydia screening. This could be done as part of the roll out of the National Chlamydia Screening programme in England. [1] Low N, McCarthy A, Macleod J et al. Epidemiological, social, diagnostic, and economic evaluation of population screening for genital chlamydial infection: the Chlamydia Screening Studies project. Health Technol Assess 2006 (In Press) Conflict of Interest:None declared |
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