Home-based chlamydia testing of young people attending a music festival - who will pee and post?

We offered home-based chlamydia testing kits to participants in a sexual behaviour cross-sectional survey conducted at a music festival in Melbourne, Australia. Those who consented received a testing kit and were asked to return their urine or vaginal swab sample via post.Nine hundred and two sexually active music festival attendees aged 16-29 completed the survey; 313 (35%) opted to receive chlamydia testing kits, and 67 of 313 (21%) returned a specimen for testing. One participant was infected with chlamydia (1% prevalence). Independent predictors of consenting to receive a testing kit included older age, knowing that chlamydia can make women infertile, reporting more than three lifetime sexual partners and inconsistent condom use. Independent predictors of returning a sample to the laboratory included knowing that chlamydia can be asymptomatic, not having had an STI test in the past six months and not living with parents.A low proportion of participants returned their chlamydia test, suggesting that this model is not ideal for reaching young people. Home-based chlamydia testing is most attractive to those who report engaging in sexual risk behaviours and are aware of the often asymptomatic nature and potential sequelae of chlamydia infection.Chlamydia (Chlamydia trachomatis) is the most prevalent bacterial sexually transmitted infection (STI) in the western world[1] and the most common notifiable infectious disease in Australia[2]. Rates of chlamydia infection are increasing worldwide, and Australian notification rates quadrupled from 1999 to 2008[2]. Infection is concentrated in youth, with approximately 80% of notifications being among those aged 15 to 29 years[2]. Chlamydia infection can cause significant morbidity, particularly for women: up to two-thirds of cases of tubal infertility and one-third of cases of ectopic pregnancy may be attributable to chlamydia infection[3]. Over 80% of infections are asymptomatic,[3] making screening necessary to detect and t