Acceptability of the internet-based Chlamydia screening implementation in the Netherlands and insights into nonresponse

Sex Transm Dis. 2011 Jun;38(6):467-74. doi: 10.1097/OLQ.0b013e318204546e.


Background: The study assessed the acceptability of internet-based Chlamydia screening using home-testing kits among 16- to 29-year-old participants and nonparticipants in the first year of a Chlamydia Screening Implementation program in the Netherlands.

Methods: Questionnaire surveys were administered to randomly selected participants (acceptability survey) and nonparticipants (nonresponse survey) in 3 regions of the Netherlands where screening was offered. Participants received email invitations to an online survey; nonparticipants received postal questionnaires. Both surveys enquired into opinions on the screening design, reasons for (non-) participation and future willingness to be tested.

Results: The response rate was 63% (3499/5569) in the acceptability survey and 15% (2053/13,724) in the nonresponse survey. Primary motivation for participating in the screening was "for my health" (63%). The main reason for nonresponse given by sexually active nonparticipants was "no perceived risk of infection" (40%). Only 2% reported nonparticipation due to no internet access. Participants found the internet (93%) and home-testing (97%) advantages of the program, regardless of test results. Two-thirds of participants would test again, 92% via the screening program. Half of nonparticipants were appreciative of the program design, while about 1 in 5 did not like internet usage, home-testing, or posting samples.

Conclusions: The screening method was highly acceptable to participants. Nonparticipants in this survey were generally appreciative of the program design. Both groups made informed choices about participation and surveyed low-risk nonparticipants accurately perceived their low-risk status. Although many nonparticipants were not reached by the nonresponse survey, current insights on acceptability and nonresponse are undoubtedly valuable for evaluation of the current program.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Chlamydia Infections / diagnosis*
  • Chlamydia Infections / epidemiology
  • Chlamydia Infections / prevention & control
  • Female
  • Health Care Surveys
  • Humans
  • Internet*
  • Male
  • Mass Screening / methods*
  • Netherlands / epidemiology
  • Patient Acceptance of Health Care*
  • Patient Participation
  • Reagent Kits, Diagnostic
  • Refusal to Participate / psychology*
  • Sexual Behavior
  • Sexually Transmitted Diseases, Bacterial / diagnosis
  • Sexually Transmitted Diseases, Bacterial / epidemiology
  • Sexually Transmitted Diseases, Bacterial / prevention & control
  • Surveys and Questionnaires
  • Young Adult


  • Reagent Kits, Diagnostic