Mailed urine samples are not an effective screening approach for Chlamydia trachomatis case finding among young men

J Eur Acad Dermatol Venereol. 2007 Jul;21(6):789-94. doi: 10.1111/j.1468-3083.2006.02088.x.


Background: Frequency of testing is known to be low for sexually transmitted infections (STIs) in men aged 20-24 years. The use of mailed, home-obtained urine specimens could increase the uptake of young men and facilitate screening programmes for the detection of asymptomatic Chlamydia trachomatis.

Objective: The aim of the present study is to evaluate the home screening approach as a tool for recruitment of asymptomatic men for screening of genital C. trachomatis infections.

Methods: Men aged 19-24 years old (n = 1936) were invited to participate in home-based testing for genital C. trachomatis infection. Persons who agreed to be tested were provided with a testing kit. Self-collected first void urine was sent for testing to the microbiology laboratory. The test result was accessible on the study's web-page 1 week after testing. Individuals with a diagnosed infection were instructed to contact the venereal disease department.

Results: The response rate was 24% (462/1936). The responders' main reason for not participating was a feeling of being safe regarding STIs (87%; 159/182). The primary reason for this feeling of safety was that the responders were in a steady relationship (59%; 107/159). Having sex outside a steady relationship was reported by 36% (90/250) of the responders. The prevalence of C. trachomatis infection among the responders was 2.02% and the reported history of chlamydial infection was 36% (34/95). Out of the responders, 92% (229/249) were, to varying degrees, concerned about getting STIs; however, the majority (72%; 174/242) estimated the risk to be low.

Conclusion: Home screening using web-based answer management is a feasible tool for STI screening, which lowers the threshold for people at risk. In this particular population, however, the response rate was too low to be routinely introduced.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Chlamydia Infections / epidemiology
  • Chlamydia Infections / urine*
  • Chlamydia trachomatis*
  • Home Care Services*
  • Humans
  • Internet
  • Male
  • Male Urogenital Diseases / epidemiology
  • Male Urogenital Diseases / urine*
  • Mass Screening / methods*
  • Postal Service*
  • Specimen Handling / methods*
  • Surveys and Questionnaires
  • Sweden / epidemiology