Young, deprived women are more at risk of testing positive for Chlamydia trachomatis: Results from a cross-sectional multicentre study in French health examination centres

Abstract

Objectives: Chlamydia Trachomatis (CT) is the most sexually transmitted infection in France. This study aimed to assess the feasibility of systematic screening for CT among people attending a preventive health examination in Health Examination Centres (HECs) and to compare positive CT cases according to deprivation. Design: A cross-sectional multicentre study in thirteen HECs in France in January 2018. Methods: Self-sampling CT screening was proposed among 18–25 years women and 18–30 years men, who were sexually active and without recent CT treatment. Related data and referred specimens were collected among attendees for the study, including deprivation and health status. CT positivity was estimated by genders. We explored association between CT infection and deprivation by univariate and multivariate modelling. Results: The CT screening was proposed to 1701 eligible young people. 90.1 % [88.6–91.5] accepted and participated with 43.6 % being women, 54.3 % being deprived people. 75.4 % [72.1–78.6] screened women performed self-taken vaginal swabs and others took urinary tests. Screening was conducted in 1486 people. Overall prevalence of CT infection was 4.7 % [3.7%–5.9 %], significantly higher for women than men (6.4 % vs 3.4 %, p=0.009). Among women, being deprived increased the likelihood of CT positivity (aOR 4.95; 95 % CI 2.02 to 12.00) more than it did for men. Conclusions: Individual deprivation was significantly associated with having a CT infection among women. The feasibility of CT screening in HECs was demonstrated, with a high acceptance, and led to the implementation of CT screening in all HECs. Promoting access to CT screening to deprived population might contribute to reduce social inequalities in health.

Keywords

• Chlamydia trachomatis
• Screening
• Deprived people
• Sexually transmitted infections
• Young people