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Over the counter tests for chlamydia – an old story that counts as ‘news’ for the Daily Mail

August 6th, 2008

Dr Petra

We’re all familiar with the Daily Mail’s take on health stories. They’re super keen on promoting quackery, bad science and misunderstanding evidence. If you want some examples pop over to Ben Goldacre’s Bad Science Blog and search for the Daily Mail.

Today there’s another great example of bad health reporting from the Mail with their so-called expose on over the counter chlamydia testing and treatment. In the piece the Mail describe over the counter testing/treatment as not only a new phenomena, but one that will ‘increase promiscuity’.

It fits with their usual agenda of sex negative coverage and moralising about relationships. They have a track record of opposing everything from promoting homosexuality to providing school sex education. Today they’re opposing people managing their own sexual health.

Let’s look at the evidence that the Daily Mail decided to ignore.

Chlamydia is a highly prevalent infection in the UK with 1 in 10 people aged under 25 affected. It is often symptomless and can lead to problems with infertility in later life if left untreated. It is also easily prevented by condom use and can be diagnosed with a simple urine test and treated effectively with antibiotics.

So although it is very common, it is easily preventable and easily treated.

Currently if you think you may have chlamydia (or any sexually transmitted infection) you can get tested (and treated if needed) at your GU clinic or some GP surgeries. Testing and treatment is free although there may be a waiting list to get treated and to recieve results of tests.

Our sexual health services are overstretched, and current thinking in sexual health care suggests that for many infections people can ‘self manage’. Meaning if you have something that can be detected with a urine test and treated with a course of antibiotics then there’s no reason why this has to be dealt with in a clinical setting. It can be managed within a community setting.

Which is where the pharmacy comes in. There have been numerous trials of delivering testing and treatment schemes for chlamydia via pharmacy settings which have all shown that it is a feasible means of offering sexual health care. People prefer the intimate setting of the pharmacy and are happy to talk to the pharmacist about their sexual health. As well as being tested and offered treatment where necessary there is also the opportunity to provide additional sexual health advice, condoms and a referral to GU services if it seems necessary.

These schemes have been published in scientific journals and many Primary Care Trusts are now encouraging chlamydia testing and treatment within the community. So the Daily Mail story isn’t exactly cutting edge news.

Okay, so they’re talking about a paid-for service but again these have been available for many years. People can arrange testing and treatment through private clinics or through websites. If you want to find a clinic near you then visit Condom Essential Wear.

The Mail story incorrectly suggests that having over the counter testing/treatment will lead to an increase in promiscuity – but we already have an epidemic of STIs we need to sort out. Having self testing/treatment methods available should reduce STIs and make it more likely people will use condoms in future as they’ll be brought into contact with services to advise them.

Moreover it wrongly implies that 16 year olds (and upwards) will be using the test/treatment package. This is nonsensical since it’s a paid for service – and services to test/treat teenagers and young adults already exist for free! It is more likely that older adults will use the paid for service, but we still need to advertise the availability of free services for testing and treatment.

Finally the Mail quotes a practitioner who claims that people with Chlamydia should be tested for other STIs. This is a real worry as it indicates the practitioner is not up to date with our knowledge of STIs. We used to believe it was right to test for all STIs routinely. So if someone presented at a clinic with Chlamydia we’d test them for everything including Syphillis and HIV. The overwhelming evidence showed that most people presenting with symptomless infections like Chlamydia only had that infection – so testing for everything was overkill and wasted important staff time and funds.

Having a test over the counter does not prevent someone getting further testing in a clinic if they are worried. But it does mean they get to talk to a practitioner quickly and can be given safer sex advice that could prevent them getting infections in the future.

The Mail is simply scaremongering with this feature. They’ve not read the evidence or understood how sexual health care is developing. We won’t get more promiscuous youngsters as a result of having services available over the counter – but having an additional way to get testing/treatment could remove pressure on overstretched services and allow people to take control over their sexual health – and what can be so wrong with that?

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