居住在维多利亚地区和农村的年轻女性对衣原体检测有何看法？一项定性研究。

Women's Health Goulburn North East (WHGNE), PO Box 853, Wangaratta, Vic. 3676, Australia; and Corresponding author. Email:

Melbourne School of Population and Global Health, The University of Melbourne, Level 4, 207 Bouverie Street, Parkville, Vic. 3010, Australia.

Sex Health. 2020 Apr;17(2):160-166. doi: 10.1071/SH19182.

UNLABELLED

Background Chlamydia trachomatis is the most commonly notified sexually transmissible infection in Australia, with almost 100000 cases diagnosed in 2018. Chlamydia is easy to diagnose and treat, but infections are underdiagnosed. Eighty per cent of chlamydia cases are asymptomatic. Without testing, infections will remain undetected. Several barriers to testing have been identified in previous research, including cost, privacy concerns for young rural people, knowledge gaps, embarrassment and stigma. The aim of this study was to investigate young regional and rural women's understanding of chlamydia and factors that may prevent or delay testing.

METHODS

Semistructured interviews were conducted with 11 women aged between 18 and 30 years residing in north-east Victoria, Australia. Interviews were transcribed verbatim and analysed thematically.

RESULTS

Themes were grouped under four categories: (1) chlamydia and stigma; (2) the application of stigma to self and others; (3) factors affecting testing; and (4) knowledge. A chlamydia infection was associated with stigma. The young women in this study anticipated self-stigma in relation to a positive diagnosis, but resisted stigmatising others. Increased knowledge about chlamydia prevalence was associated with reduced self-stigma. The most consistent factor affecting testing decisions was personal risk assessment. Knowledge gaps about symptoms, testing and treatment were also identified, with participants not always accessing information from reputable sources.

CONCLUSION

Chlamydia testing was viewed as a positive activity among this cohort. However, there is considerable perceived stigma about being diagnosed with an infection. Interventions that communicate prevalence, reduce stigma and provide factual information about testing and risk are still needed. Clinicians have an opportunity to convey this information at consultation. Health promotion workers should continue to develop and run campaigns at a community level to encourage regular screening.

背景

沙眼衣原体是澳大利亚最常见的性传播感染报告病例，2018 年诊断出近 100000 例。衣原体易于诊断和治疗，但感染被漏诊。80%的衣原体感染病例无症状。如果不进行检测，感染将无法被发现。在之前的研究中，已经确定了一些检测障碍，包括费用、年轻人对隐私的担忧、知识差距、尴尬和耻辱感。本研究的目的是调查年轻的地区和农村妇女对衣原体的理解以及可能预防或延迟检测的因素。

方法

对 11 名年龄在 18 至 30 岁之间居住在澳大利亚东北部维多利亚州的妇女进行了半结构式访谈。访谈记录被逐字转录，并进行了主题分析。

结果

主题分为四类：（1）衣原体和耻辱感；（2）耻辱感在自我和他人身上的应用；（3）影响检测的因素；（4）知识。衣原体感染与耻辱感有关。本研究中的年轻女性预计会因阳性诊断而产生自我耻辱感，但抵制对他人的污名化。对衣原体流行率的更多了解与自我耻辱感的降低有关。影响检测决策的最一致因素是个人风险评估。还发现了关于症状、检测和治疗的知识差距，参与者并不总是从可靠来源获取信息。