Socioeconomic, behavioural and health factors associated with chlamydia testing in sexually active young women: an Australian observational cohort study

Abstract

Background Chlamydia trachomatis is the most frequently notified sexually transmitted infection in Australia. Untreated infections in women can cause health problems. Professional guidelines encourage opportunistic testing of young people. To increase understanding of who is being tested, we investigated factors associated with testing in a population of young women. Methods In total, 14 002 sexually active women, aged 18–23 years at baseline (2013), from the Australian Longitudinal Study on Women’s Health, were included. We used random intercepts, mixed-effects binary logistic regression with robust standard errors to assess associations between socioeconomic, health and behavioural factors and chlamydia testing. Results Associations between chlamydia testing and partner status varied by a woman’s body mass index (BMI). Compared to women with a stable partner/BMI <25 kg/m2, women with a stable partner/BMI ≥25 kg/m2 were less likely to be tested (adjusted odds ratios [AOR] = 0.79, 95% CI: 0.71–0.88). In contrast, although women without a partner were more likely to be tested irrespective of BMI, the odds were higher for those with a BMI <25 kg/m2 (AOR = 2.68, 95% CI: 2.44–2.94) than a BMI ≥25 kg/m2 (AOR = 1.65, 95% CI: 1.48–1.84). Women who reported a prior chlamydia infection were also more likely to be tested (AOR = 2.01, 95% CI: 1.83–2.20), as were women engaging in any combination of cannabis use and/or heavy episodic drinking compared to doing neither of these activities. Conclusions Women without a partner, women with a prior chlamydia infection and those engaging in risk-taking behaviours are more likely to have chlamydia testing. Additional research is needed to understand whether there are deficits in testing among overweight/obese women.