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Background: The Centers for Disease Control and Prevention traditionally assess national chlamydia prevalence in women tested in family planning clinics. An Internet recruitment approach, along with use of a home-sampling kit, has been shown to be acceptable to women.
Objectives: To determine whether women who self-collected vaginal swabs at home and mailed them to a laboratory demonstrated a higher prevalence of chlamydia than women screened in family planning clinics.
Methods: Collection kits for vaginal swabs were requested via Internet, collected at home, and mailed to a laboratory for testing. Age-specific prevalences were compared to those tested in family planning (FP) clinics in Baltimore and Maryland during 2004-8.
Results: Total chlamydia Internet prevalence was 10.3% for 1,171 females mailing swabs; prevalences for FP for Baltimore/MD ranged from 3.3-5.5%. For example, 2008 prevalence for Internet participants in Baltimore was 14.7%; for MD Internet, 12.4%. The 2008 prevalence for FP participants in Baltimore was 5.5%, for MD FP was 4.3%. Median age for all years for Internet users and for FP clients in Baltimore and Maryland combined was 23 years. For all Internet participants by age group, 0.8% were age 14 years, all uninfected; 25.9% were ages 15-19 years, 16.4% infected; 33.9% were 20-24 years, 10.8% infected; 17.8% were 25-29 years, 6.3% infected; and 21.7% were > 30 years, 1.7% infected. In summary, by year, the prevalence was higher among Internet participants than FP ages 15-19 yr, 20-24 yr, and 25-29 yr.
Conclusions: Internet-recruited women demonstrated higher prevalences of chlamydia than those in FP in every age group except 10-14 yr, where very few women were screened via the Internet. Recruiting women via the Internet provides new options for chlamydia screening programs.
Implications for Programs, Policy, and/or Research: More Internet outreach research may indicate new methods to provide more screening of at-risk women.