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Karolinska Institute

1. Nielsen, Anna. Chlamydia among youth in Stockholm : testing habits and evaluation of a mobile phone intervention to promote safe sexual practices .

Degree: 2019, Karolinska Institute

Background. The World Health Organization (WHO) estimates that 350 million new cases of curable sexually transmitted infections (STIs) occur each year. Prevention of STIs include both primary and secondary prevention strategies: sexual education, condom distribution, testing and treatment services. Sweden has a long tradition of widespread testing for Chlamydia Trachomatis (C.trachomatis), an opportunistic screening approach. Sexual education in school is mandatory and a national network of Youth Health Clinics (YHC) enables health care access for youth. Still, infection rates of C.trachomatis have increased over the past decades since opportunistic screening was introduced, and moreover continue to stay high. In addition, national surveys indicate low condom use among youth. The overall aim of this thesis was to look deeper into the screening services to understand why this approach does not seem to have the sought for effect and to compare the effectiveness of a mobile phone application to improve sexual health among youth of Stockholm County in addition to routine care offered at the YHCs. Methods and Results. Study I: Register based study performed from data obtained from three laboratories in Stockholm County. All tests for C.trachomatis done at the YHCs in Stockholm over a three year period were included in the study. The aim of the study was to describe testing behavior for genital C.trachomatis among youth in Stockholm County. Specifically to (1) study positivity rates among single and repeat testers, (2) to estimate the incidence of repeat testing and the rates of infection on repeat testing episodes and (3) to estimate time to repeat testing and factors associated with repeat testing. In total 65 951 persons underwent 119 699 tests. Repeat testing was found among 42% of all study participants included in the study (ranging from 2 to 18 tests). Higher rates of C.trachomatis among repeat testers compared to single testers were found at baseline, especially among men. Incidence of repeat testing was higher than previously reported. Study II: A qualitative study. We interviewed 15 repeat testers at the YHCs about motives behind testing repeatedly and subsequent sexual risk-taking. Data was analyzed using a constructivist grounded theory approach. We found that youth perceive repeated testing for C.trachomatis equally protective as using a condom. The testing episode, test result or encounter with the clinic personnel did not steer sexual health preferences towards more protective sexual practices. A major motivation for the retesting process was the fear of infecting a peer leading to social stigma. The results of this study provide new information that will allow the C.trachomatis screening programs to introduce more appropriate interventions for youth retesting frequently and to streamline routines. In addition, lessons learned from our study could be helpful in other screening programs with high re-testing rates. Study III: Interview study. Twelve health care providers in YHCs in…

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APA · Chicago · MLA · Vancouver · CSE | Export to Zotero / EndNote / Reference Manager

APA (6th Edition):

Nielsen, A. (2019). Chlamydia among youth in Stockholm : testing habits and evaluation of a mobile phone intervention to promote safe sexual practices . (Thesis). Karolinska Institute. Retrieved from http://hdl.handle.net/10616/46677

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

Chicago Manual of Style (16th Edition):

Nielsen, Anna. “Chlamydia among youth in Stockholm : testing habits and evaluation of a mobile phone intervention to promote safe sexual practices .” 2019. Thesis, Karolinska Institute. Accessed April 22, 2019. http://hdl.handle.net/10616/46677.

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

MLA Handbook (7th Edition):

Nielsen, Anna. “Chlamydia among youth in Stockholm : testing habits and evaluation of a mobile phone intervention to promote safe sexual practices .” 2019. Web. 22 Apr 2019.

Vancouver:

Nielsen A. Chlamydia among youth in Stockholm : testing habits and evaluation of a mobile phone intervention to promote safe sexual practices . [Internet] [Thesis]. Karolinska Institute; 2019. [cited 2019 Apr 22]. Available from: http://hdl.handle.net/10616/46677.

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

Council of Science Editors:

Nielsen A. Chlamydia among youth in Stockholm : testing habits and evaluation of a mobile phone intervention to promote safe sexual practices . [Thesis]. Karolinska Institute; 2019. Available from: http://hdl.handle.net/10616/46677

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

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