Imperial College London
Alternate

ProfessorPeterWhite

Faculty of Medicine, School of Public Health

Professor of Public Health Modelling
 
 
 
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Contact

 

p.white Website

 
 
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Location

 

Praed StreetSt Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{Lewis:2020:10.1097/EDE.0000000000001150,
author = {Lewis, J and White, PJ},
doi = {10.1097/EDE.0000000000001150},
journal = {Epidemiology},
pages = {263--271},
title = {Understanding relationships between chlamydial infection, symptoms and testing behavior: an analysis of data from Natsal-3},
url = {http://dx.doi.org/10.1097/EDE.0000000000001150},
volume = {31},
year = {2020}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Background: Genital chlamydial infection 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.  The effects of testing programs in different groups of people need to be understood. Methods: We analyzed data on sexual behavior and chlamydia testing from 16-24-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 the survey design using design  variables and nonresponse weightings, and Bayesian analysis using a mathematical model of  chlamydial infection and testing.  Results: Most men testing due to symptoms tested in sexual health settings (63.1%; 95%  confidence interval 42.5-83.6%) but most women testing due to symptoms were tested by GPs  (59.3%; 42.9-75.8%). 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 those reporting 0, 1 and ≥2 new partners in the last year were 0.30(0.24-0.35), 0.45(0.37-0.53) and 0.59(0.48-0.71) (men) and 0.59(0.52-0.68), 0.88(0.74-1.03) 20 and 1.16(0.97-1.39) (women).  Conclusions: The proportion of testing occurring in sexual health is not a proxy for the  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.
AU  - Lewis,J
AU  - White,PJ
DO  - 10.1097/EDE.0000000000001150
EP  - 271
PY  - 2020///
SN  - 1044-3983
SP  - 263
TI  - Understanding relationships between chlamydial infection, symptoms and testing behavior: an analysis of data from Natsal-3
T2  - Epidemiology
UR  - http://dx.doi.org/10.1097/EDE.0000000000001150
UR  - https://journals.lww.com/epidem/FullText/2020/03000/Understanding_Relationships_Between_Chlamydial.15.aspx
UR  - http://hdl.handle.net/10044/1/72741
VL  - 31
ER  -
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