Stigma prevents young people from seeking testing for sexually transmitted infections

The stigma associated with sexually transmitted infections (STI ) is the main barrier preventing young people from seeking tests for the conditions, according to new research.

This stigma was greatest among women, especially those from rural and urban working class areas, who feared that requesting a STI test would “publicly expose” them to their families and peers.

The study carried out by researchers from NUI Galway, the Royal College of Surgeons in Ireland and the HSE found that a national screening campaign for chlamydia - one of the most commonly reported bacterial STIs in Ireland which can cause major complications, such as infertility and ectopic pregnancy - in young people would not be cost effective. However it recommends a national action plan to promote sexual health.

Despite the stigma associated with an STI test, there was a high level of willingness among young men and women to take a chlamydia test if offered by a health professional. Some 95 per cent said it would be acceptable to be offered the test and 75 per cent of students said they would accept the test if offered. The research also found that 80 per cent of those involved in the study said they would inform their current partner if they tested positive for chlamydia but this rate fell to 55 to 60 per cent in the case of previous partners.

The Chlamydia Screening in Ireland Pilot Study, which was funded by the Health Protection Surveillance Centre and supported by the Health Research Board, examined the feasibility of opportunistic screening in a GP setting for chlamydia.

Like other countries, Ireland is experiencing a steady increase in the numbers of young women and men with STIs. The annual number of chlamydia cases rose from 1,000 in 1997 to about 6,000 in 2008/2009.

Dr Emer O’Connell, a consultant in public health medicine in the HSE presented study findings at Ireland’s first ever Sexual Health Awareness Week, which was officially launched in the Royal College of Physicians of Ireland today. “Screening for chlamydia is available in many countries. However, some countries such as Australia are reviewing the effectiveness of this measure. In Ireland, due to our small population and the strain already on our health service, a screening programme for chlamydia would not be cost effective because it would be difficult to achieve the necessary coverage levels to reduce the level of infection.”

Dr Diarmuid O’Donovan of NUI Galway’s College of Medicine, Nursing and Health Sciences, says the study’s findings provide evidence of how to protect the sexual health of young Irish people.

“Given these findings, a national sexual health plan should include primary prevention activities such as sex education, condom distribution and the provision of information on how to seek care for STIs. Therefore, we recommend the inclusion of primary care-delivered chlamydia detection and case management services as part of a national action plan to promote sexual health.”

Professor Ruairi Brugha, the head of the department of epidemiology and public health medicine at the RCSI outlines while this study demonstrated that a national chlamydia screening programme would not be cost-effective in Ireland it reports important positive findings.

“Young people are aware of the risks and are anxious that STI testing services be made accessible and acceptable. We also found that there are primary care providers who are willing to provide such services.”

The research from The Chlamydia Screening in Ireland Pilot Study was presented earlier this week during Ireland’s first national Sexual Health Awareness Week hosted by the Royal College of Physicians of Ireland.

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