Patterns of sexual behaviour associated with repeated chlamydia testing and infection in men and women: a latent class analysis

Inga Veličko; Alexander Ploner; Lena Marions; Pär Sparén; Björn Herrmann; Sharon Kühlmann-Berenzon

doi:10.1186/s12889-021-12394-0

Patterns of sexual behaviour associated with repeated chlamydia testing and infection in men and women: a latent class analysis

BMC Public Health. 2022 Apr 5;22(1):652. doi: 10.1186/s12889-021-12394-0.

Authors

Inga Veličko^{1

2}, Alexander Ploner³, Lena Marions^{4

5}, Pär Sparén³, Björn Herrmann^{6

7}, Sharon Kühlmann-Berenzon⁸

Affiliations

¹ Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, P.O. Box 281, Nobels väg 12A, 171 65, Solna, Sweden. inga.velicko@ki.se.
² Department of Public Health Analysis and Data Management, Public Health Agency of Sweden, Nobels väg 18, 171 82, Solna, Sweden. inga.velicko@ki.se.
³ Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, P.O. Box 281, Nobels väg 12A, 171 65, Solna, Sweden.
⁴ Department of Clinical Science and Education, Karolinska Institute, Stockholm, Sweden.
⁵ Section of Obstetrics and Gynaecology, Stockholm South General Hospital, Stockholm, Sweden.
⁶ Section of Clinical Bacteriology, Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
⁷ Department of Clinical Microbiology, Uppsala University Hospital, Uppsala, Sweden.
⁸ Department of Public Health Analysis and Data Management, Public Health Agency of Sweden, Nobels väg 18, 171 82, Solna, Sweden.

Abstract

Background: Adolescents and young adults are at higher risk of acquiring Chlamydia trachomatis infection (chlamydia), so testing is promoted in these populations. Studies have shown that re-testing for chlamydia is common amongst them. We investigated how sexual risk behaviour profiles are associated with repeated testing for chlamydia.

Methods: We used baseline data from a cohort of 2814 individuals recruited at an urban STI -clinic. We applied latent class (LC) analysis using 9 manifest variables on sexual behaviour and substance use self-reported by the study participants. We fitted ordered logistic regression to investigate the association of LC membership with the outcomes repeated testing during the past 12 months and lifetime repeated testing for chlamydia. Models were fit separately for men and women.

Results: We identified four LCs for men and three LCs for women with increasing gradient of risky sexual behaviour. The two classes with the highest risk among men were associated with lifetime repeated testing for chlamydia: adjOR = 2.26 (95%CI: 1.50-3.40) and adjOR = 3.03 (95%CI: 1.93-4.74) as compared with the class with lowest risk. In women, the class with the highest risk was associated with increased odds of repeated lifetime testing (adjOR =1.85 (95%CI: 1.24-2.76)) and repeated testing during past 12 months (adjOR = 1.72 (95%CI: 1.16-2.54)). An association with chlamydia positive test at the time of the study and during the participant's lifetime was only found in the male highest risk classes.

Conclusion: Prevention messages with regard to testing for chlamydia after unprotected sexual contact with new/casual partners seem to reach individuals in highest risk behaviour classes who are more likely to test repeatedly. Further prevention efforts should involve potentially more tailored sex-specific interventions taking into consideration risk behaviour patterns.

Keywords: Latent class analysis; Ordered logistic regression; Sexual behaviour patterns; Stratified analysis by sex; Sweden; Testing for Chlamydia trachomatis.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Chlamydia Infections* / diagnosis
Chlamydia Infections* / epidemiology
Chlamydia Infections* / prevention & control
Chlamydia trachomatis
Chlamydia*
Female
Humans
Latent Class Analysis
Male
Sexual Behavior
Sexual Partners
Young Adult