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'Test n Treat' (TnT): a cluster randomized feasibility trial of on-site rapid Chlamydia trachomatis tests and treatment in ethnically diverse, sexually active teenagers attending technical colleges.

Oakeshott, P; Kerry-Barnard, S; Fleming, C; Phillips, R; Drennan, VM; Adams, EJ; Majewska, W; Harding-Esch, EM; Cousins, EC; Planche, T; et al. Oakeshott, P; Kerry-Barnard, S; Fleming, C; Phillips, R; Drennan, VM; Adams, EJ; Majewska, W; Harding-Esch, EM; Cousins, EC; Planche, T; Green, A; Bartholomew, RI; Sadiq, ST; Reid, F (2019) 'Test n Treat' (TnT): a cluster randomized feasibility trial of on-site rapid Chlamydia trachomatis tests and treatment in ethnically diverse, sexually active teenagers attending technical colleges. Clin Microbiol Infect, 25 (7). pp. 865-871. ISSN 1469-0691 https://doi.org/10.1016/j.cmi.2018.10.019
SGUL Authors: Oakeshott, Philippa Kerry-Barnard, Sarah Ruth Drennan, Vari MacDougal Harding-Esch, Emma Michele Planche, Timothy David Sadiq, Syed Tariq

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Abstract

Objectives We conducted a cluster-randomized feasibility trial of 90-minute Chlamydia trachomatis tests and same day on-site treatment (‘Test n Treat/TnT’) in six technical colleges in London, England, to assess TnT uptake rates; follow-up rates; prevalence of C. trachomatis at baseline and 7 months; time to treatment; acceptability of TnT. Methods Participants completed questionnaires and provided genitourinary samples at baseline and 7 months. Participants were informed that baseline samples would not be tested for 7 months and were advised to get screened independently. Colleges were randomly allocated 1:1 to intervention (TnT) or control (no TnT). One month and 4 months post recruitment, participants at intervention colleges were texted invitations for on-site free C. trachomatis tests. A purposive sample of students who did/did not attend for screening were interviewed (n = 26). Results Five hundred and nine sexually active students were recruited: median age 17.9 years, 47% male, 50% black ethnicity, 55% reporting two or more sexual partners in the previous year. TnT uptake was 13% (33/259; 95% CI 8.9–17.4%) at 1 month and 10% (26/259; 6.7–14.4%) at 4 months with overall C. trachomatis positivity 5.1% (3/59; 1.1–14.2%). Follow-up at 7 months was 62% (317/509) for questionnaires and 52% (264/509) for samples. C. trachomatis prevalence was 6.2% (31/503) at baseline and 6.1% (16/264) at 7 months. Median time from test to treatment was 15 h. Interviews suggested low test uptake was associated with not feeling at risk, perceptions of stigma, and little knowledge of sexually transmitted infections (STIs). Conclusions Despite high C. trachomatis rates at baseline and follow-up, uptake of testing was low. Like many countries, England urgently needs better sex education, including making STI testing routine/normal. Trial registration ISRCTN58038795

Item Type: Article
Additional Information: © 2019 The Authors. Published by Elsevier Ltd on behalf of European Society of Clinical Microbiology and Infectious Diseases. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
Keywords: Cluster randomized, Feasibility trial, Rapid C. trachomatis tests, Screening, Technical colleges, Test and treat, Young people, 1103 Clinical Sciences, Microbiology
SGUL Research Institute / Research Centre: Academic Structure > Infection and Immunity Research Institute (INII)
Academic Structure > Population Health Research Institute (INPH)
Journal or Publication Title: Clin Microbiol Infect
ISSN: 1469-0691
Language: eng
Dates:
DateEvent
July 2019Published
1 November 2018Published Online
25 October 2018Accepted
Publisher License: Creative Commons: Attribution 4.0
Projects:
Project IDFunderFunder ID
PB-PG-1014-35007National Institute for Health Researchhttp://dx.doi.org/10.13039/501100000272
G0901608Medical Research Councilhttp://dx.doi.org/10.13039/501100000265
UNSPECIFIEDBiotechnology and Biological Sciences Research Councilhttp://dx.doi.org/10.13039/501100000268
PubMed ID: 30391581
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/110299
Publisher's version: https://doi.org/10.1016/j.cmi.2018.10.019

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