Simple Decision. Simple Test. Simple Cure: Findings From CDC Formative Research & Next Steps for a National Chlamydia Screening Campaign

Background: Chlamydia (CT) is a leading cause of pelvic inflammatory disease, which can lead to infertility. Over one million cases of CT were reported by CDC in 2007, with the highest rate among 15-to-24 year-old females.

Objectives: To inform a national CT screening campaign, CDC explored young women’s understanding of, and communication/messaging preferences regarding CT and STD/CT testing.

Methods: Two phases of open, ethnographic interviews were conducted with sexually active African-American, Caucasian & Hispanic females across four regions of the US. Participants were recruited through professional firms & segmented by age and working/in-school status. Phase 1 (phone interview) findings guided Phase 2 (in-person interviews), which in turn guided message and concept development. Interviews were transcribed and coded by three independent researchers using NVivo2.

Results: A total of 125 females were interviewed by phone (n=80) and in-person (n=45). Participants tended to dichotomize STDs as curable or incurable, with CT generally viewed as curable. Understandings of CT, STDs and CT/STD testing were very limited. Seven major barriers to testing, including lack of awareness, fear, and confidentiality/stigma concerns were identified. ‘Knowing your status’ was the main perceived benefit to testing.  Certain messages, including those highlighting CT’s asymptomatic nature, a simple diagnosis & cure, overcoming embarrassment/stigma, and empowerment/support, were reported to motivate intentions to seek testing across segments. Other themes and communication preferences varied by segment and STD experience/history.

Conclusions: Certain messages may have broad appeal to motivate CT testing across age, race/ethnicity, and lifestyle segments. Other, more targeted approaches may be more effective for specific segments. STD experience/history emerged as a potentially salient segmentation variable.

Implications for Programs, Policy, and/or Research: These findings led to the development of messages and concepts, which will be shared. Audience-tested communication strategies can be leveraged by state and local partners for the promotion of CT screening at the local level.