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Sunday, April 4, 1999 Published at 22:54 GMT 23:54 UK


Health

Doubts over chlamydia test

Chlamydia is rising among the young

Routine screening of young women for the sexually transmitted disease chlamydia could disadvantage both men and women, say public health experts.

Chlamydia is the most common sexually transmitted infection in the UK and it is rising fast among the young.

It has few symptoms, but can lead to pelvic inflammatory disease, ectopic pregnancy and infertility.

The government has set up two pilot schemes to assess the feasibility of screening for chlamydia.

This follows a report by an expert advisory group which recommended screening for everyone with symptoms of infection, all people who attend sexually transmitted disease (STD) clinics, women seeking abortions, all sexually women under 25 and all women over 25 with a new sexual partner who have had two or more partners in the last year.

However, Barbara Duncan and Graham Hart, public health experts at the University of Glasgow, say that the concentration on women could have unintended consequences.

Gender inequalities

They say the rationale behind targeting women is based on health benefits, cost effectiveness and accessibilty.

Young women are more likely to access healthcare services and are therefore easier to screen.

But this could also be a drawback as it could promote gender inequalities.

They say experience from the cervical screening programme shows that women with positive smears report feelings of contamination and negative perceptions of their attractiveness and sexuality.

Cervical cancer has been linked to sexual activity.

The researchers say some women feel they have been labelled as promiscuous if they have a positive smear, while men's role in the disease is barely acknowledged.

They say men's role in contraception and abortions has also traditionally been minimised.

Responsibility

Writing in the British Medical Journal, they say that screening for chlamydia "may reinforce existing inequalities by tacitly acknowledging that it is just too difficult to ask men to take responsibility for their sexual health".

They believe this would be detrimental to both men and women because "very little is known about men's beliefs and attitudes" to sex.

"Including men in a chlamydia screening programme would provide benefits that would go beyond the obvious health gains from detection and treatment of infection," they write.

They also think an effective screening programme would have to be linked to a coordinated sex education programme, which is not currently on the government's agenda.



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