The C-project: use of self-collection kits to screen for Chlamydia trachomatis in young people in a community-based health promotion project

Background: The present study aimed to ascertain the acceptability to at-risk young people of self-collected urine samples as a means of testing for Chlamydia trachomatis (chlamydia); to determine the effectiveness of drop-off and outreach collection methods as a means of detecting and treating chlamydia; and to determine the rate of positive chlamydia tests in a sample of the target group. Methods: Participants requested postal testing kits from the project website, the NSW Sexual Health Infoline or at an outreach event and either returned urine samples at selected drop-off locations or directly to the researchers during active outreach events. Results: A total of 413 kits were requested - 196 (47.5%) via email, 204 (49.4%) during outreach events and nine (2.2%) via the NSW Sexual Health Infoline. A total of 195 samples (47.2% of ordered kits) were returned. Participants were less likely to return samples if they had been requested by email (odds ratio = 9.6; 95% confidence interval: 6.0-15.0) or via telephone (odds ratio = 22.0; 95% confidence interval: 2.7-181.0) compared with directly obtaining a kit at an outreach event. The number of specimens positive for chlamydia in the targeted age range was 4, giving a 3.1% positive rate (95% confidence interval: 1.0-8.0). Conclusions: This study identified that free testing kits and online communication worked well as a means of engaging young people and raising awareness of sexual health. However, the requirement to drop-off urine samples at selected locations was not well accepted.