Worries about stigmatisation, embarrassment and misconceptions about what the test involves are stopping young people undergoing chlamydia screening.

Young men and women were recruited at educational institutions in South East England where chlamydia screening is available. Individuals who declined a test were invited to participate in the study.

The first 14 who volunteered for the study were invited for an interview. The interview schedule was semistructured, but questions were open-ended and interviews were transcribed verbatim; the data were then coded into themes. Ten women and four men were recruited into the study. The median age was 17 (range 16-22).

The themes drawn out from the interviews that could have implications for future screening and health promotion were:

• stigmatisation of young people with chlamydia and those who take the test
• beliefs about what the test involves
• perception of risk
• feelings of embarrassment

These beliefs and feelings were pervasive and explained why the study participants had chosen not to accept a test.

The National Chlamydia Screening Programme has been in operation since 2003 and is now rolled out throughout England. Screening uptake is a key performance target for PCTs. Despite a high level of awareness and ease of access, chlamydia screening is still declined by many young people who might be

at risk.

The authors quite rightly suggest that strategies to help normalise and destigmatise chlamydia testing and diagnosis may help improve uptake of screening. It should also stress the positive side of getting tested such as being responsible.

Although the interviewees were drawn from a sample of students from educational establishments, the findings are also relevant for other screening venues such as general practice.

The recent sexual health campaigns in England, Sex.Worth Talking About, have focussed on contraception and chlamydia screening. Having seen the advertisements on television, I feel that they do help to destigmatise and normalise chlamydia screening. It also helps to reassure young people of effective treatment if diagnosed, and reinforce the notions of responsibility and empowerment for young people.

Dr Richard Ma