Is chlamydia testing of unders 25s working?

Have you been checked for chlamydia? National testing has begun for the UK's most common STI but is it effective?

Until the recent national screening programme began, most men thought that chlamydia was a Greek island rather than the most common sexually-transmitted infection in the country. But now questions are being raised about the value of the screening.

Studies suggest that one in eight men carry the chlamydia infection (and one in 10 women). To meet this challenge the government has been rolling out a programme under which people under 25 attending their GP or genito-urinary medicine (GUM) clinic are also offered a chlamydia test.

One of the most dangerous effects of chlamydia is female PID (or pelvic inflammatory disease) which, if untreated, can lead to pain, ectopic pregnancy and infertility. Systematic or proactive screening whereby communities are screened regularly can halve rates of PID. However there is a question over whether 'opportunistic' screening of the type being offered under the government scheme will be as effective.

In the British Medical Journal, Dr Nicola Low, an epidemiologist at the University of Berne in Switzerland, said it was not clear if opportunistic screening would produce the same benefits.

'I'm suggesting that we need to find the evidence to support what we're doing,' she told the BBC. 'I think (screening) was introduced before we had a proper understanding.'

Dr Low said someone who received a negative result under the opportunistic screening programme might be given a false sense of security, when people actually needed to be tested regularly. she cvalled for more trials.

In the pilot scheme in two GP practices, about 50% of patients were screened but it is doubtful if the national programme will have the same impact since unlike in the pilot, GPs are not compelled to participate and are not paid for the work.

In an editorial in the BMJ, Dr Rachael Jones, consultant in GUM at Chelsea and Westminster NHS Foundation Trust, said rates of chlmaydia infection were continuing to increase.

"Most people who are affected are unlikely to seek sexual health testing and may only be assessed via a proactive approach rather than the opportunistic screening programme currently offered," she said.

Dr Richard Ma, a GP in Islington and member of the Royal College of GPs' sex, drugs and HIV task group said that while it wasn't ideal, opportunitic screening was better than nothing. he said GPs wanted to do proactive screening but there was no funding. He told the BBC: 'Even finding a case of someone who has chlamydia who wouldn't have otherwise known is very positive, and on that basis the programme is a success.'The Department of Health have pointed out that opportunistic screening remained the only strategy recommended by the World Health Organisation for chlamydial screening in those aged 25 and under who had access sexual health services or primary care. the Department said: over 270,000 screens have been performed to date, and around one in 10 young people are testing positive.