Population screening for Chlamydia trachomatis infection in the UK: a qualitative study of the experiences of those screened.

BACKGROUND Screening for Chlamydia trachomatis in selected health care settings is underway in the UK despite insufficient evidence about the personal impact of screening. OBJECTIVES To describe men and women's experiences of being screened for chlamydia as part of the Chlamydia Screening Studies (ClaSS) project, a population-based UK study of postal screening for chlamydia. METHODS We conducted in-depth interviews with 45 purposively sampled participants in the ClaSS project using a checklist of topics relating to their experiences of the screening process. Interviews were audio-tape recorded, transcribed verbatim and analysed using the constant comparison method. RESULTS Four main themes emerged: initial discomfort with screening arising from an unease with sexual health issues; anxiety, especially after receiving a positive test result, due to the fear of informing sexual partners, the risk of infertility and the possibility of having other undetected infections; women's concern about being stigmatised for having been infected with chlamydia, which affected how they felt about themselves and how they thought others would perceive them; and recognising the need to balance the harms of screening with the benefits. Despite some reported adverse effects, no one regretted their decision to be screened. CONCLUSIONS Public education and discussion of sexually transmitted infections should help to increase the acceptability of chlamydia screening and destigmatise a diagnosis of chlamydia. Those working in primary care settings are likely to become increasingly involved in chlamydia screening and so must be suitably trained to inform individuals of the potential adverse effects and to deal with their consequences.