ArticleEpidemiology (Cambridge, Mass.)2020
Understanding Relationships Between Chlamydial Infection, Symptoms, and Testing Behavior: An Analysis of Data from Natsal-3.
Article in Epidemiology (Cambridge, Mass.), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
2 citing papers in PubMed, 3 citations in OpenAlex.
- Interpreting declines in HIV test positivity: an analysis of routine data from Zimbabwe's national sex work programme, 2009-2019.Journal of the International AIDS Society · 2022Article
- Controversies and evidence on Chlamydia testing and treatment in asymptomatic women and men who have sex with men: a narrative review.BMC infectious diseases · 2022Review
Corrections and comments
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Authors and funding
2 authors at 1 institution in 1 country.
Funding
Abstract
backgroundGenital chlamydia is the most commonly diagnosed sexually transmitted infection worldwide and can have serious long-term sequelae. Numerous countries invest substantially in testing but evidence for programs' effectiveness is inconclusive. It is important to understand the effects of testing programs in different groups of people.
methodsWe analyzed data on sexual behavior and chlamydia tests from 16-to 24-year olds in Britain's third National Survey of Sexual Attitudes and Lifestyles, considering test setting, reason, and result. We conducted descriptive analysis accounting for survey design and nonresponse, and Bayesian analysis using a mathematical model.
resultsMost men testing due to symptoms tested in sexual health settings (63%; 95% confidence interval 43%-84%) but most women testing due to symptoms were tested by general practitioners (59%; 43%-76%). Within behavioral groups, positivity of chlamydia screens (tests not prompted by symptoms or partner notification) was similar to population prevalence. Screening rates were higher in women and in those reporting more partners: median (95% credible interval) rates per year in men were 0.30 (0.25-0.36) (0 new partners), 0.45 (0.37-0.54) (1 new partner), and 0.60 (0.50-0.73) (≥2 new partners). In women, they were 0.61 (0.53-0.69) (0 new partners), 0.89 (0.75-1.04) (1 new partner), and 1.2 (1.0-1.4) (≥2 new partners).
conclusionsProportion of testing occurring in sexual health is not a proxy for proportion prompted by symptoms. Test positivity depends on a combination of force of infection and screening rate and does not simply reflect prevalence or behavioral risk. The analysis highlights the value of recording testing reason and behavioral characteristics to inform cost-effective control.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.