The findings and conclusions in these presentations have not been formally disseminated by the Centers for Disease Control and Prevention and should not be construed to represent any agency determination or policy.

Tuesday, May 9, 2006 - 10:00 AM
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Self-reported Risk History in Women Using an Internet-based Screening Program for Chlamydia trachomatis Using Self-collected Vaginal Swabs Returned by Mail

Charlotte Gaydos1, Karen Dwyer2, Mathilda Barnes1, Toni Flemming3, Patricia Rizzo-Price1, and Terry Hogan1. (1) Division of Infectious Diseases, Medicine, Johns Hopkins University, 1159 Ross Bldg, 720 Rutland Ave, Baltimore, MD, USA, (2) FASgen, Inc. Alpha Center, FASgen, Inc, 5210 Eastern Ave, Suite 234, Baltimore, MD, USA, (3) Division of Health Promotion and Disease Prevention, STD/HIV Prevention Program, Baltimore City Health Department, 620 N. Caroline Street, Baltimore, MD, USA


Background:
A website (www.iwantthekit.org) offering C. trachomatis screening and education provided women the opportunity to obtain a home-sampling kit for self-collecting vaginal specimens.

Objective:
To determine risk history in infected and uninfected women who used the home-sampling kit.

Method:
From July 2004 to Dec 2005, 567 women returned self-collected vaginal specimens by mail; swabs were tested by NAATs. The kit included a questionnaire, which could also be taken on the website. Questionnaire data from infected and un-infected women were analyzed for sexual risk behavior.

Result:
A total of 8.8% (50/567) were chlamydia positive. Analysis of 567 participants demonstrated that of infected women, 68% and 48% reported having multiple or a new partner, respectively, compared to 3.2% and 5.0%, respectively, of the uninfected women. Of all women, 15.4% reported >4 partners in the previous year (20% of infected women compared to 15% of un-infected women). Median age at first sex for infected women was 15 yr (range 11-26 yr) compared to 16 yr (range 8-39 yr) for uninfected women. Condom use among the infected women was reported as: always 16%, never 14%, most of the time 50%, some of the time 18%, compared to uninfected women: always 12.2%, never 20.6%, most of the time 34.7%, some of the time 29.7%. Oral sex and anal sex were reported by 72.9% and 38.8%, respectively, by infected women compared to 90.7% and 29.2%, respectively, for uninfected women. Previous chlamydia infection was reported by 28.6% of infected women and 37.4% of uninfected women.

Conclusion:
The Internet-based screening program reached a group of women, who reported high-risk sexual behavior, regardless of their infection status for chlamydia.

Implications:
Internet-based screening programs are an effective tool for recruiting women at risk for chlamydia. The anonymity and privacy afforded may enhance veracity and participation.