Introduction Chlamydia is the most commonly diagnosed bacterial STI in Australia and is asymptomatic in approximately 80% of people. If untreated, potential consequences include pelvic inflammatory disease, ectopic pregnancy and infertility. Those experiencing recurrent infections are more likely to experience these unwanted complications, and as such consideration must be given to those who are very young when first infected.

Methods In 2014 we undertook a retrospective audit at a rural sexual health service to determine what proportion of patients attending the clinic were aged 12–16 years, tested for and infected with chlamydia and their reasons for attending the clinic.

Results There were 595 consultations for patients aged 12–16 years during the study period, with a total of 111 individual patients attending the clinic, 104 (95%) were female. 194 chlamydia tests were conducted with the proportion of individual patients having at least one test per year being 100% in 2011, 81% in 2012, 72% in 2013 and 78% in 2014. There was no difference in the proportion tested by age over the study period (p = 0.59). 46 tests were positive for chlamydia (23.7%; 95% CI: 17.8%, 30.9%) with the proportion decreasing with increasing age from 46.7% (95% CI: 16.4%, 79.5%) in those aged 12 or 13 years to 15.5% (95% CI: 9.4%, 24.2%) in those age 16 years (p = 0.02). The reasons for attending the clinic when a chlamydia test was ordered included i) pregnancy testing, request for emergency contraception and/or termination of pregnancy (18.3%, 34/185), ii) symptoms of anything (16.7%, 31/185), iii) a request for STI screening or treatment (32.4%, 60/185) and presenting for contraception (32.4%, 60/185). Only 29.7% (33/111) of these patients would have tested for chlamydia if symptoms or requesting a screen were the only reasons a test was ordered.

Conclusion Consideration should be given to amending the current chlamydia screening recommendation to annual screening of any sexually active person under 29 years.

Conflict of interest None declared.