A prospective study of the psychosocial impact of a positive Chlamydia trachomatis laboratory test

Sex Transm Dis. 2011 Nov;38(11):1004-11. doi: 10.1097/OLQ.0b013e31822b0bed.


Background: Few data exist on potential harms of chlamydia screening. We assessed the psychosocial impact of receiving a positive Chlamydia trachomatis test result.

Methods: We prospectively studied women ≥16 years of age undergoing chlamydia testing in 2 Midwestern family planning clinics. We surveyed women at baseline and about 1 month after receiving test results, using 9 validated psychosocial scales/subscales and chlamydia-specific questions. Changes in scale scores were calculated for each woman. Mean percent changes in scores for chlamydia-positive and -negative women were compared using a t test.

Results: We enrolled 1807 women (response rate, 84%). Of the 1688 women with test results, 149 (8.8%) tested positive. At follow-up, chlamydia-positive women (n = 71) had a 75% increase in anxiety about sexual aspects of their life on the Multidimensional Sexual Self-Concept Questionnaire (P < 0.001), significantly greater than the 26% increase among 280 randomly selected chlamydia-negative women (P = 0.02). There were no differences for the other 8 scales/subscales, including general measures of anxiety, depression, and self-esteem. Chlamydia-positive women were more likely than chlamydia-negative women to be "concerned about chlamydia" (80% vs. 40%, P < 0.001) and to report breaking up with a main partner (33% vs. 11%, P < 0.001) at follow-up. Women testing positive reported a range of chlamydia-specific concerns.

Conclusions: Chlamydia-positive women had significant increases in anxiety about sex and concern about chlamydia, but did not have marked changes in more general measures of psychosocial well-being about 1 month after diagnosis. Chlamydia diagnoses were associated with some disruption of relationships with main partners. Chlamydia-specific concerns may guide counseling messages to minimize psychosocial impact.

MeSH terms

  • Adolescent
  • Adult
  • Ambulatory Care Facilities
  • Anxiety
  • Chlamydia Infections / diagnosis*
  • Chlamydia Infections / psychology*
  • Chlamydia trachomatis*
  • Family Planning Services
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Mass Screening / psychology
  • Missouri
  • Prospective Studies
  • Psychology
  • Self Concept
  • Sexual Behavior
  • Sexual Partners
  • Surveys and Questionnaires
  • Young Adult