Men and teens dodging STI test

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It’s the most common STI, and easily treatable, but one in five young people aren’t heeding their GP’s advice to get a chlamydia test. Research in the Medical Journal of Australia suggests this might be because of socio-economic reasons, or the inconvenience of off-site pathology clinics.

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MICHAEL BRISSENDEN: One in five young people are failing to get tested for the most common sexually transmitted infection, Chlamydia, after being directed by their GP.

Research in the Medical Journal of Australia finds that more than 80,000 Australians are diagnosed each year, but many of those most at risk won’t be tested.

Rachael Brown has our report.

RACHAEL BROWN: It’s not the most comfortable subject, but unless it’s broached and treated, Chlamydia can be quite painful.

The head of Melbourne University’s sexual health unit, Professor Jane Hocking, says only one in five people directed by their GP to get tested actually do so, and the biggest culprits are men and teenagers.

JANE HOCKING: Men were about 40 per cent less likely to follow through and have a test compared with women.

We also found that those aged 16 to 19 were considerably less likely. We found that those living in areas of socio-economic disadvantage were less likely. And we also found that if a GP clinic had a pathology collection centre on-site or allowed for patients to leave specimens on site – if the GP clinic didn’t have that, then the patients were less likely to be tested for Chlamydia.

RACHAEL BROWN: Further testing is needed to discover just why these patients aren’t taking their GP’s advice, but Professor Hocking says having pathology clinics off-site may leave some teenagers thinking it may be too costly or inconvenient.

JANE HOCKING: If you’re a 16 or 17-year-old and your GP’s written you a test request and said “here you go and have a Chlamydia test,” if you’ve got to leave the GP clinic and find a pathology collection site that could be several blocks away, that’s a big disincentive for a young person to follow through and have a test.

Now it’s obviously not possible for pathology collection sites to be based at all GP clinics, but it is potentially possible for clinics to allow patients to leave specimens there that pathology labs can courier up afterwards.

MARCUS CHEN: I think there’s good sense in making something that is apparently so simple easier to encourage Chlamydia testing.

RACHAEL BROWN: Dr Marcus Chen from the Alfred Hospital Sexual Health Centre says this could also help ease the embarrassment factor.

MARCUS CHEN: Young males in particular – so those under the age of 25 – are at increased risk for Chlamydia, but that is a group that we have found is in general not that well engaged in their sexual health.

RACHAEL BROWN: Do they think many dismiss it as a woman’s issue?

MARCUS CHEN: That’s certainly something that you hear anecdotally, that often males think that Chlamydia is a female problem. I mean a major problem is that most men with Chlamydia don’t have any symptoms.

RACHAEL BROWN: A woman can walk into a GP for a pap smear, for example, or to ask for the pill, and then they might be recommended to get a Chlamydia test in the course of that examination. But for men, is it a case that they would have to deliberately go in for that check?

MARCUS CHEN: Correct. Correct, you’ve hit the nail on the head. And I think young females are just better engaged in their healthcare, but also their sexual health, because they go to GPs for the reasons you’ve mentioned.

Whereas young men have actually fewer reasons to go, and so to actually expect GPs to do opportunistic testing for Chlamydia is actually somewhat challenging, and that’s what GPs are being asked to actually do.

RACHAEL BROWN: So they are being asked that?

MARCUS CHEN: Yes that’s right.

RACHAEL BROWN: So if a 19-year-old comes in with a broken ankle, for example?

MARCUS CHEN: That’s right. To offer a Chlamydia test and the easiest way to do that is to say something like, “We recommend Chlamydia testing at least once a year in sexually active men under the age of 25 or 30. Would you like to have a Chlamydia test?”

RACHAEL BROWN: Dr Chen suggests more could be done in terms of public health awareness.

MARCUS CHEN: I think that message actually needs to get out to that population at a school age, and so this all begins with education at school.

ELEANOR HALL: That’s Dr Marcus Chen from the Alfred Hospital’s Sexual Health Centre ending that report by Rachael Brown.

Men and teens dodging STI test