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Australian Journal of Primary Health Australian Journal of Primary Health Society
The issues influencing community health services and primary health care
REVIEW

Narrative review of the barriers and facilitators to chlamydia testing in general practice

Anna Yeung A E , Meredith Temple-Smith B , Christopher Fairley C D and Jane Hocking A
+ Author Affiliations
- Author Affiliations

A Melbourne School of Population and Global Health, L3, 207 Bouverie Street, The University of Melbourne, Vic. 3010, Australia.

B General Practice and Primary Health Care Academic Centre, 200 Berkeley Street, The University of Melbourne, Vic. 3010, Australia.

C Melbourne Sexual Health Centre, 580 Swanston Street, Carlton, Vic. 3053, Australia.

D Central Clinical School, Monash University, Alfred Hospital, 55 Commercial Road, Melbourne, Vic. 3004, Australia.

E Corresponding author. Email: ayeung@unimelb.edu.au

Australian Journal of Primary Health 21(2) 139-147 https://doi.org/10.1071/PY13158
Submitted: 23 November 2013  Accepted: 16 July 2014   Published: 14 August 2014

Abstract

As the cornerstone of Australian primary health care, general practice is a setting well suited for regular chlamydia testing but testing rates remain low. This review examines the barriers and facilitators to chlamydia testing in general practice. Six databases – Medline, PubMed, Meditext, PsycInfo, Scopus and Web of Science – were used to identify peer-reviewed publications that addressed barriers and facilitators to chlamydia testing in general practice using the following terms: ‘chlamydia test*’, ‘STI test*’’general practice’, ‘primary care’, ‘family medicine’, ‘barriers’, ‘facilitators’ and ‘enablers’ from 1997 until November 2013. Data about the study design and key findings were extracted from the publications. A framework method was used to manage the data and organise publications into three categories –patient, general practitioner, and general practice. Key findings were then classified as a barrier or facilitator. Sixty-nine publications were included, with 41 quantitative studies, 17 qualitative studies, and 11 using mixed methods. Common barriers identified in all three groups included a lack of knowledge, awareness or training, demands on time and workload, and the social context of testing. Facilitators included the normalisation of testing, the use of nurses and other practice staff, education and incentives. Numerous barriers and facilitators to chlamydia testing in general practice have been identified. While the barriers are well studied, many of the facilitators are not as well researched, and highlight areas for further study.

Additional keywords: general practitioner, primary health care.


References

Aghaizu A, Adams EJ, Turner K, Kerry S, Hay P, Simms I, Oakeshott P (2011) What is the cost of pelvic inflammatory disease and how much could be prevented by screening for Chlamydia trachomatis? Cost analysis of the Prevention Of Pelvic Infection (POPI) trial. Sexually Transmitted Infections 87, 312–317.
What is the cost of pelvic inflammatory disease and how much could be prevented by screening for Chlamydia trachomatis? Cost analysis of the Prevention Of Pelvic Infection (POPI) trial.Crossref | GoogleScholarGoogle Scholar | 21444333PubMed |

Armstrong B, Kinn S, Scoular A, Wilson P (2003) Shared care in the management of genital Chlamydia trachomatis infection in primary care. Sexually Transmitted Infections 79, 369–370.
Shared care in the management of genital Chlamydia trachomatis infection in primary care.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3srgslKhug%3D%3D&md5=5ca64d0d4f5eb5b9c34b3e2c8847b765CAS | 14573830PubMed |

Bailey AC, Dean G, Hankins M, Fisher M (2008) Attending an STI Foundation course increases chlamydia testing in primary care, but not HIV testing. International Journal of STD & AIDS 19, 633–634.
Attending an STI Foundation course increases chlamydia testing in primary care, but not HIV testing.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD1crktlWhtw%3D%3D&md5=57298a8bdb0966cc487fc0ce753d3ce5CAS |

Balfe M, Brugha R (2009) What prompts young adults in Ireland to attend health services for STI testing? BMC Public Health 9, 311
What prompts young adults in Ireland to attend health services for STI testing?Crossref | GoogleScholarGoogle Scholar | 19709430PubMed |

Balfe M, Brugha R (2011) What concerns do young adults in Ireland have about attending health services for STD testing? Deviant Behavior 32, 320–350.
What concerns do young adults in Ireland have about attending health services for STD testing?Crossref | GoogleScholarGoogle Scholar |

Balfe M, Brugha R, O’Connell E, McGee H, O’Donovan D, Vaughan D (2010a) Why don’t young women go for chlamydia testing? A qualitative study employing Goffman’s stigma framework. Health Risk & Society 12, 131–148.
Why don’t young women go for chlamydia testing? A qualitative study employing Goffman’s stigma framework.Crossref | GoogleScholarGoogle Scholar |

Balfe M, Brugha R, O’Donovan D, O’Connell E, Vaughan D (2010b) Young women’s decisions to accept chlamydia screening: influences of stigma and doctor-patient interactions. BMC Public Health 10, 425
Young women’s decisions to accept chlamydia screening: influences of stigma and doctor-patient interactions.Crossref | GoogleScholarGoogle Scholar | 20642845PubMed |

Bangor-Jones RD (2011) Sexual health in general practice: do practitioners comply with the sexually transmitted infections guidelines for management of suspected chlamydial infections? International Journal of STD & AIDS 22, 523–524.
Sexual health in general practice: do practitioners comply with the sexually transmitted infections guidelines for management of suspected chlamydial infections?Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BC3MfhtFSmsw%3D%3D&md5=381a8375c629b6b68df6932dac200f4dCAS |

Bennett S, McNicholas A, Garrett N (2001) Screening and diagnostic practices for chlamydia infections in New Zealand. The New Zealand Medical Journal 114, 349–352.

Bilardi JE, Fairley CK, Temple-Smith MJ, Pirotta MV, McNamee KM, Bourke S, Gurrin LC, Hellard M, Sanci LA, Wills MJ, Walker J, Chen MY, Hocking JS (2010) Incentive payments to general practitioners aimed at increasing opportunistic testing of young women for chlamydia: a pilot cluster randomised controlled trial. BMC Public Health 10, 70–78.
Incentive payments to general practitioners aimed at increasing opportunistic testing of young women for chlamydia: a pilot cluster randomised controlled trial.Crossref | GoogleScholarGoogle Scholar | 20158918PubMed |

Bowden FJ, Currie MJ, Toyne H, McGuiness C, Lim LL, Butler JR, Glasgow NJ (2008) Screening for Chlamydia trachomatis at the time of routine Pap smear in general practice: a cluster randomised controlled trial. The Medical Journal of Australia 188, 76–80.

Brugha R, Balfe M, Jeffares I, Conroy RM, Clarke E, Fitzgerald M, O’Connell E, Vaughan D, Coleman C, McGee H, Gillespie P, O’Donovan D (2011) Where do young adults want opportunistic chlamydia screening services to be located? Journal of Public Health 33, 571–578.
Where do young adults want opportunistic chlamydia screening services to be located?Crossref | GoogleScholarGoogle Scholar | 21486871PubMed |

Burack R (2000) Young teenagers’ attitudes towards general practitioners and their provision of sexual health care. The British Journal of General Practice 50, 550–554.

Cates W, Wasserheit JN (1991) Genital chlamydial infections: epidemiology and reproductive sequelae. American Journal of Obstetrics and Gynecology 164, 1771–1781.
Genital chlamydial infections: epidemiology and reproductive sequelae.Crossref | GoogleScholarGoogle Scholar | 2039031PubMed |

Commonwealth of Australia (2005) ‘National sexually transmissible infections strategy 2005–2008.’ (Department of Health and Ageing, Commonwealth of Australia: Canberra)

Doherty L (2000) New approaches to sexual health services in a rural health board area: involving service users and primary care professionals. International Journal of STD & AIDS 11, 594–598.
New approaches to sexual health services in a rural health board area: involving service users and primary care professionals.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3MvotlehtA%3D%3D&md5=b35ce7a4fa59018fad4b2cd6ce1234f5CAS |

Freedman E, Britt H, Harrison CM, Mindel A (2006) Sexual health problems managed in Australian general practice: a national, cross sectional survey. Sexually Transmitted Infections 82, 61–66.
Sexual health problems managed in Australian general practice: a national, cross sectional survey.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD28%2Fnslartw%3D%3D&md5=6d91102bd080f3101f9eb424523812f1CAS | 16461607PubMed |

Freeman E, Howell-Jones R, Oliver I, Randall S, Ford-Young W, Beckwith P, McNulty C (2009) Promoting chlamydia screening with posters and leaflets in general practice–a qualitative study. BMC Public Health 9, 383
Promoting chlamydia screening with posters and leaflets in general practice–a qualitative study.Crossref | GoogleScholarGoogle Scholar | 19821964PubMed |

Giles ML, Pedrana A, Jones C, Garland S, Hellard M, Lewin SR (2009) Antenatal screening practice for infectious diseases by general practitioners in Australia. Australian and New Zealand Journal of Obstetrics and Gynaecology 49, 39–44.
Antenatal screening practice for infectious diseases by general practitioners in Australia.Crossref | GoogleScholarGoogle Scholar | 19281578PubMed |

Griffiths C, Cuddigan A (2002) Clinical management of chlamydia in general practice: a survey of reported practice. The Journal of Family Planning and Reproductive Health Care 28, 149–152.
Clinical management of chlamydia in general practice: a survey of reported practice.Crossref | GoogleScholarGoogle Scholar | 16259835PubMed |

Grulich AE, de Visser RO, Smith AMA, Risse CE, Richters J (2003) Sex in Australia: sexually transmissible infection and blood-borne virus history in a representative sample of adults. Australian and New Zealand Journal of Public Health 27, 234–241.
Sex in Australia: sexually transmissible infection and blood-borne virus history in a representative sample of adults.Crossref | GoogleScholarGoogle Scholar | 14696717PubMed |

Harris DI (2005) Implementation of chlamydia screening in a general practice setting: a 6-month pilot study. The Journal of Family Planning and Reproductive Health Care 31, 109–112.
Implementation of chlamydia screening in a general practice setting: a 6-month pilot study.Crossref | GoogleScholarGoogle Scholar | 15921545PubMed |

Heritage J, Jones M (2008) A study of young peoples’ attitudes to opportunistic chlamydia testing in UK general practice. Reproductive Health 5, 11
A study of young peoples’ attitudes to opportunistic chlamydia testing in UK general practice.Crossref | GoogleScholarGoogle Scholar | 19099571PubMed |

Hinchliff S, Gott M, Galena E (2005) ‘I daresay I might find it embarrassing’: general practitioners’ perspectives on discussing sexual health issues with lesbian and gay patients. Health & Social Care in the Community 13, 345–353.
‘I daresay I might find it embarrassing’: general practitioners’ perspectives on discussing sexual health issues with lesbian and gay patients.Crossref | GoogleScholarGoogle Scholar |

Hocking JS, Lim MSC, Vidanapathirana J, Read TRH, Hellard M (2006) Chlamydia testing in general practice – a survey of Victorian general practitioners. Sexual Health 3, 241–244.
Chlamydia testing in general practice – a survey of Victorian general practitioners.Crossref | GoogleScholarGoogle Scholar | 17112434PubMed |

Hocking JS, Parker RM, Pavlin N, Fairley CK, Gunn JM (2008) What needs to change to increase chlamydia screening in general practice in Australia? The views of general practitioners. BMC Public Health 8, 425–432.
What needs to change to increase chlamydia screening in general practice in Australia? The views of general practitioners.Crossref | GoogleScholarGoogle Scholar | 19115998PubMed |

Hogan AH, Howell-Jones RS, Pottinger E, Wallace LM, McNulty CA (2010) “… they should be offering it”: a qualitative study to investigate young peoples’ attitudes towards chlamydia screening in GP surgeries. BMC Public Health 10, 616
“… they should be offering it”: a qualitative study to investigate young peoples’ attitudes towards chlamydia screening in GP surgeries.Crossref | GoogleScholarGoogle Scholar | 20955570PubMed |

Hope SC, Theobald JA, McOwan A (2002) Sexual health provision and the Sexual Health and HIV Strategy for England: a questionnaire survey of general practitioners’ views. International Journal of STD & AIDS 13, 230–233.
Sexual health provision and the Sexual Health and HIV Strategy for England: a questionnaire survey of general practitioners’ views.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD387lsVKksw%3D%3D&md5=62bdbfa0e52ad9d92bbf90ecf140e520CAS |

Kalwij S, French S, Mugezi R, Baraitser P (2012) Using educational outreach and a financial incentive to increase general practices’ contribution to chlamydia screening in South-East London 2003–2011. BMC Public Health 12, 802
Using educational outreach and a financial incentive to increase general practices’ contribution to chlamydia screening in South-East London 2003–2011.Crossref | GoogleScholarGoogle Scholar | 22984897PubMed |

Khan A, Plummer D (2008) Are printed sexually transmissible infection materials for patients appropriate? A physician perspective. Sexual Health 5, 307–308.
Are printed sexually transmissible infection materials for patients appropriate? A physician perspective.Crossref | GoogleScholarGoogle Scholar | 18771649PubMed |

Khan A, Schofield MJ (2009) General practice management of psychological distress in patients with sexually transmissible infection. Australian Journal of Primary Health 15, 17–23.
General practice management of psychological distress in patients with sexually transmissible infection.Crossref | GoogleScholarGoogle Scholar |

Khan A, Hussain R, Plummer D, Minichiello V (2006) Willingness to offer chlamydia testing in general practice in New South Wales. Australian and New Zealand Journal of Public Health 30, 226–230.
Willingness to offer chlamydia testing in general practice in New South Wales.Crossref | GoogleScholarGoogle Scholar | 16800198PubMed |

Khan A, Plummer D, Hussain R, Minichiello V (2008a) Preventing sexually transmissible infections in Australian general practice. International Journal of STD & AIDS 19, 459–463.
Preventing sexually transmissible infections in Australian general practice.Crossref | GoogleScholarGoogle Scholar |

Khan A, Plummer D, Hussain R, Minichiello V (2008b) Does physician bias affect the quality of care they deliver? Evidence in the care of sexually transmitted infections. Sexually Transmitted Infections 84, 150–151.
Does physician bias affect the quality of care they deliver? Evidence in the care of sexually transmitted infections.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD1c3htVSqsg%3D%3D&md5=611e3818e2d7511cef7bcb6e63ee417eCAS | 17974595PubMed |

Kong FYS, Guy RJ, Hocking JS, Merritt T, Pirotta M, Heal C, Bergeri I, Donovan B, Hellard ME (2011) Australian general practitioner chlamydia testing rates among young people. The Medical Journal of Australia 194, 249–252.

Lawton BA, Rose SB, Elley CR, Bromhead C, MacDonald EJ, Baker MG (2010) Increasing the uptake of opportunistic chlamydia screening: a pilot study in general practice. Journal of Primary Health Care 2, 199–207.

Lusk MJ, Uddin R, Ferson M, Rawlinson W, Konecny P (2009) Primary health care providers surveyed commonly misinterpret ‘first void urine’ for chlamydia screening. Sexual Health 6, 91–93.
Primary health care providers surveyed commonly misinterpret ‘first void urine’ for chlamydia screening.Crossref | GoogleScholarGoogle Scholar | 19254499PubMed |

Ma R, Clark A (2005) Chlamydia screening in general practice: views of professionals on the key elements of a successful programme. The Journal of Family Planning and Reproductive Health Care 31, 302–306.
Chlamydia screening in general practice: views of professionals on the key elements of a successful programme.Crossref | GoogleScholarGoogle Scholar | 16274554PubMed |

Markham WA, Bullock AD, Matthews P, Firmstone VR, Kelly S, Field SJ (2005) Sexual health care training needs of general practitioner trainers: a regional survey. The Journal of Family Planning and Reproductive Health Care 31, 213–218.
Sexual health care training needs of general practitioner trainers: a regional survey.Crossref | GoogleScholarGoogle Scholar | 16105286PubMed |

Mason L (2005) Knowledge of sexually transmitted infections and sources of information amongst men. The Journal of the Royal Society for the Promotion of Health 125, 266–271.
Knowledge of sexually transmitted infections and sources of information amongst men.Crossref | GoogleScholarGoogle Scholar | 16353457PubMed |

McNulty CAM, Freeman E, Bowen J, Shefras J, Fenton KA (2004a) Barriers to opportunistic chlamydia testing in primary care. The British Journal of General Practice 54, 508–514.

McNulty CAM, Freeman E, Bowen J, Shefras J, Fenton KA (2004b) Diagnosis of genital chlamydia in primary care: an explanation of reasons for variation in chlamydia testing. Sexually Transmitted Infections 80, 207–211.
Diagnosis of genital chlamydia in primary care: an explanation of reasons for variation in chlamydia testing.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD2czgtVyqtA%3D%3D&md5=f3192ca1d6e1de3e10f3295d8ef10f1cCAS |

McNulty CAM, Freeman E, Oliver I, Ford-Young W, Randall S (2008a) Strategies used to increase chlamydia screening in general practice: a qualitative study. Public Health 122, 845–856.
Strategies used to increase chlamydia screening in general practice: a qualitative study.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD1crmvFyruw%3D%3D&md5=b449e1da8af65020740e7961793276b4CAS |

McNulty CA, Thomas M, Bowen J, Buckley C, Charlett A, Gelb D, Foy C, Sloss J, Smellie S (2008b) Interactive workshops increase chlamydia testing in primary care—a controlled study. Family Practice 25, 279–286.
Interactive workshops increase chlamydia testing in primary care—a controlled study.Crossref | GoogleScholarGoogle Scholar | 18579709PubMed |

McNulty CAM, Freeman E, Howell-Jones R, Hogan A, Randall S, Ford-Young W, Beckwith P, Oliver I (2010) Overcoming the barriers to chlamydia screening in general practice—a qualitative study. Family Practice 27, 291–302.
Overcoming the barriers to chlamydia screening in general practice—a qualitative study.Crossref | GoogleScholarGoogle Scholar |

Merritt TD, Durrheim DN, Hope K, Byron P (2007) General practice intervention to increase opportunistic screening for chlamydia. Sexual Health 4, 249–251.
General practice intervention to increase opportunistic screening for chlamydia.Crossref | GoogleScholarGoogle Scholar | 18082068PubMed |

Morgan J, Haar J (2009) General practice funding to improve provision of adolescent primary sexual health care in New Zealand: results from an observational intervention. Sexual Health 6, 203–207.
General practice funding to improve provision of adolescent primary sexual health care in New Zealand: results from an observational intervention.Crossref | GoogleScholarGoogle Scholar | 19653956PubMed |

Morgan J, Donnell A, Bell A (2012) Does a clinical guideline change chlamydia testing? Report from the Waikato Chlamydia Project. Journal of Primary Health Care 4, 45–51.

NNDSS Annual Report Writing Group (2010) Australia’s Notifiable Disease Status, 2010: Annual Report of the National Notifiable Diseases Surveillance System. Surveillance Branch: Office of Health Protection. Canberra. Communicable Diseases Intelligence 36, 1–69.

NNDSS Annual Report Writing Group (2012) Australia’s Notifiable Disease Status, 2010: Annual Report of the National Notifiable Diseases Surveillance System. Office of Health Protection. Surveillance Branch. Canberra. Communicable Diseases Intelligence 36, 1–69.

Oakeshott P, Hay P, Hay S, Steinke F, Rink E, Thomas B, Oakeley P, Kerry S (2002) Detection of Chlamydia trachomatis infection in early pregnancy using self-administered vaginal swabs and first pass urines: a cross-sectional community-based survey. The British Journal Of General Practice: The Journal Of The Royal College Of General Practitioners 52, 830–832.

Overton GK, McCalister P, Kelly D, Macvicar R (2009) Practice-based small group learning: how health professionals view their intention to change and the process of implementing change in practice. Medical Teacher 31, e514–e520.
Practice-based small group learning: how health professionals view their intention to change and the process of implementing change in practice.Crossref | GoogleScholarGoogle Scholar | 19909029PubMed |

Pavlin NL, Parker R, Fairley CK, Gunn JM, Hocking J (2008) Take the sex out of STI screening! Views of young women on implementing chlamydia screening in general practice. BMC Infectious Diseases 8, 62
Take the sex out of STI screening! Views of young women on implementing chlamydia screening in general practice.Crossref | GoogleScholarGoogle Scholar | 18471280PubMed |

Peipert JF (2003) Genital chlamydial infections. The New England Journal of Medicine 349, 2424–2430.
Genital chlamydial infections.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BD3sXpvFGqur0%3D&md5=6e10cfefef16f1b89a5b293f0484560cCAS | 14681509PubMed |

Penney GC, Brace V, Cameron S, Tucker J (2005) An evaluation of the impact of a national health demonstration project on testing and management for Chlamydia trachomatis infections in two regions of Scotland. Public Health 119, 1031–1038.
An evaluation of the impact of a national health demonstration project on testing and management for Chlamydia trachomatis infections in two regions of Scotland.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD2MrjvFyqtg%3D%3D&md5=543f4850111a94699528e76b90f9c52bCAS | 16084540PubMed |

Perkins E, Carlisle C, Jackson N (2003) Opportunistic screening for chlamydia in general practice: the experience of health professionals. Health & Social Care in the Community 11, 314–320.
Opportunistic screening for chlamydia in general practice: the experience of health professionals.Crossref | GoogleScholarGoogle Scholar |

Pimenta JM, Catchpole M, Rogers PA, Hopwood J, Randall S, Mallinson H, Perkins E, Jackson N, Carlisle C, Hewitt G, Underhill G, Gleave T, McLean L, Ghosh A, Tobin J, Harindra V (2003a) Opportunistic screening for genital chlamydial infection. II: prevalence among healthcare attenders, outcome, and evaluation of positive cases. Sexually Transmitted Infections 79, 22–27.
Opportunistic screening for genital chlamydial infection. II: prevalence among healthcare attenders, outcome, and evaluation of positive cases.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3s%2FptlGmug%3D%3D&md5=f500fdd50de1fc3655babc6a785ca1baCAS | 12576608PubMed |

Pimenta JM, Catchpole M, Rogers PA, Perkins E, Jackson N, Carlisle C, Randall S, Hopwood J, Hewitt G, Underhill G, Mallinson H, McLean L, Gleave T, Tobin J, Harindra V, Ghosh A (2003b) Opportunistic screening for genital chlamydial infection. I: acceptability of urine testing in primary and secondary healthcare settings. Sexually Transmitted Infections 79, 16–21.
Opportunistic screening for genital chlamydial infection. I: acceptability of urine testing in primary and secondary healthcare settings.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3s%2FptlGmtQ%3D%3D&md5=1b43ebe74edaebf3565405277cb566f7CAS | 12576607PubMed |

Regan DG, Wilson DP, Hocking JS (2008) Coverage is the key for effective screening of Chlamydia trachomatis in Australia. The Journal of Infectious Diseases 198, 349–358.
Coverage is the key for effective screening of Chlamydia trachomatis in Australia.Crossref | GoogleScholarGoogle Scholar | 18588484PubMed |

Richards JE, Pattman RS (2008) Does the sexually transmitted infections foundation course deliver and change practice? Feedback from delegates 2002–2006. International Journal of STD & AIDS 19, 810–813.
Does the sexually transmitted infections foundation course deliver and change practice? Feedback from delegates 2002–2006.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD1cjot1SqtQ%3D%3D&md5=b75b2d992bad3bad0f1bd8fc9f8dd201CAS |

Robertson P, Williams OE (2005a) A care pathway for chlamydia, what’s happening in primary care 12 months on? International Journal of STD & AIDS 16, 433–437.
A care pathway for chlamydia, what’s happening in primary care 12 months on?Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD2MzitFektQ%3D%3D&md5=bf79ae8294cf2f1d780381ec2c47d572CAS |

Robertson P, Williams OE (2005b) Young, male, and infected: the forgotten victims of chlamydia in primary care. Sexually Transmitted Infections 81, 31–33.
Young, male, and infected: the forgotten victims of chlamydia in primary care.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD2M%2FlsVWluw%3D%3D&md5=0c3c64739980b3cf0c17f55d2b66ad06CAS | 15681719PubMed |

Rogstad KE, Henton L (2004) General practitioners and the National Strategy on Sexual Health and HIV. International Journal of STD & AIDS 15, 169–172.
General practitioners and the National Strategy on Sexual Health and HIV.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD2c7ks1agtQ%3D%3D&md5=c7bee8f517620e1ebc3b13a803416825CAS |

Santer M, Warner P, Wyke S, Sutherland S (2000) Opportunistic screening for chlamydia infection in general practice: can we reach young women? Journal of Medical Screening 7, 175–176.
Opportunistic screening for chlamydia infection in general practice: can we reach young women?Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3M7pt1Wnuw%3D%3D&md5=20ff3ad4787fa770c42923273cc6e20cCAS | 11202582PubMed |

Santer M, Wyke S, Warner P (2003) Women’s experiences of chlamydia screening. Qualitative interviews with women in primary care. The European Journal of General Practice 9, 56–61.
Women’s experiences of chlamydia screening. Qualitative interviews with women in primary care.Crossref | GoogleScholarGoogle Scholar | 14611017PubMed |

Saunders JM, Mercer CH, Sutcliffe LJ, Hart GJ, Cassell J, Estcourt CS (2012) Where do young men want to access STI screening? A stratified random probability sample survey of young men in Great Britain. Sexually Transmitted Infections 88, 427–432.
Where do young men want to access STI screening? A stratified random probability sample survey of young men in Great Britain.Crossref | GoogleScholarGoogle Scholar | 22510331PubMed |

Sawleshwarkar S, Harrison C, Britt H, Mindel A (2010) Chlamydia testing in general practice in Australia. Sexual Health 7, 484–490.
Chlamydia testing in general practice in Australia.Crossref | GoogleScholarGoogle Scholar | 21062591PubMed |

Senok A, Wilson P, Reid M, Scoular A, Craig N, McConnachie A, Fitzpatrick B, MacDonald A (2005) Can we evaluate population screening strategies in UK general practice? A pilot randomised controlled trial comparing postal and opportunistic screening for genital chlamydial infection. Journal of Epidemiology and Community Health 59, 198–204.
Can we evaluate population screening strategies in UK general practice? A pilot randomised controlled trial comparing postal and opportunistic screening for genital chlamydial infection.Crossref | GoogleScholarGoogle Scholar | 15709078PubMed |

Sohal H, Creighton S, Figueroa J, Gibb A (2008) The impact of establishing a local-enhanced service for treating sexually transmitted infections in primary care. Sexually Transmitted Infections 84, 235–238.
The impact of establishing a local-enhanced service for treating sexually transmitted infections in primary care.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD1czkt12htQ%3D%3D&md5=924724381403a5cbe9fb8171443b988bCAS | 18192294PubMed |

Sutcliffe LJ, Sadler KE, Low N, Cassell JA (2011) Comparing expectations and experiences of care for sexually transmitted infections in general practice: a qualitative study. Sexually Transmitted Infections 87, 131–135.
Comparing expectations and experiences of care for sexually transmitted infections in general practice: a qualitative study.Crossref | GoogleScholarGoogle Scholar | 21084438PubMed |

Temple-Smith MJ, Mulvey G, Keogh L (1999) Attitudes to taking a sexual history in general practice in Victoria, Australia. Sexually Transmitted Infections 75, 41–44.
Attitudes to taking a sexual history in general practice in Victoria, Australia.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK1MznslCmsg%3D%3D&md5=01f5cc129d42ec2005507568be380274CAS | 10448341PubMed |

Temple-Smith MJ, Mak D, Watson J, Bastian L, Smith A, Pitts M (2008) Conversant or clueless? Chlamydia-related knowledge and practice of general practitioners in Western Australia. BMC Family Practice 9, 17
Conversant or clueless? Chlamydia-related knowledge and practice of general practitioners in Western Australia.Crossref | GoogleScholarGoogle Scholar | 18307819PubMed |

Temple-Smith M, Pirotta M, Kneebone J, McNamee K, Fairley C, Bilardi J, Hocking J (2012) A missed opportunity – lessons learnt from a chlamydia testing observation study in general practice. Australian Family Physician 41, 413–416.

Thompson K, Casson K, Fleming P, Dobbs F, Parahoo K, Armstrong J (2008) Sexual health promotion in primary care – activities and views of general practitioners and practice nurses. Primary Health Care Research & Development 9, 319–330.
Sexual health promotion in primary care – activities and views of general practitioners and practice nurses.Crossref | GoogleScholarGoogle Scholar |

Trojian TH, Lishnak TS, Heiman D (2009) Epididymitis and orchitis: an overview. American Family Physician 79, 583–587.

Walker J, Fairley CK, Walker SM, Gurrin LC, Gunn JM, Pirotta MV, Carter R, Hocking JS (2010) Computer reminders for chlamydia screening in general practice: a randomized controlled trial. Sexually Transmitted Diseases 37, 445–450.

Walker J, Walker S, Fairley CK, Bilardi J, Chen MY, Bradshaw CS, Urban E, Pirotta M, Birden H, Kaldor JM, Gunn J, Hocking JS, Donovan B (2013) What do young women think about having a chlamydia test?: views of women who tested positive compared with women who tested negative. Sexual Health 10, 39–42.

Wallace L, McNulty C, Hogan A, Bayley J (2012) Exploring attitudes and practices of general practice staff towards offers of opportunistic screening for chlamydia: a UK survey. Primary Health Care Research & Development 13, 255–268.
Exploring attitudes and practices of general practice staff towards offers of opportunistic screening for chlamydia: a UK survey.Crossref | GoogleScholarGoogle Scholar |

Walleser S, Salkeld G, Donovan B (2006) The cost effectiveness of screening for genital Chlamydia trachomatis infection in Australia. Sexual Health 3, 225–234.
The cost effectiveness of screening for genital Chlamydia trachomatis infection in Australia.Crossref | GoogleScholarGoogle Scholar | 17112432PubMed |

Wray L, Law C, Barrie SC (1998) A general practitioner STD training programme: meeting education and service provision needs. International Journal of STD & AIDS 9, 731–735.
A general practitioner STD training programme: meeting education and service provision needs.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK1M%2FovFGitw%3D%3D&md5=8e73931828121f4ef08ab19f97e9f0f7CAS |

Zakher B, Kang M (2008) Attitudes to chlamydia screening in general practice among Australian university students: a pilot study. Sexual Health 5, 359–363.
Attitudes to chlamydia screening in general practice among Australian university students: a pilot study.Crossref | GoogleScholarGoogle Scholar | 19061556PubMed |

Zenner D, Molinar D, Nichols T, Riha J, Macintosh M, Nardone A (2012) Should young people be paid for getting tested? A national comparative study to evaluate patient financial incentives for chlamydia screening. BMC Public Health 12, 261
Should young people be paid for getting tested? A national comparative study to evaluate patient financial incentives for chlamydia screening.Crossref | GoogleScholarGoogle Scholar | 22471791PubMed |