'Test n Treat' (TnT): a cluster randomized feasibility trial of on-site rapid Chlamydia trachomatis tests and treatment in ethnically diverse, sexually active teenagers attending technical colleges
'Test n Treat' (TnT): a cluster randomized feasibility trial of on-site rapid Chlamydia trachomatis tests and treatment in ethnically diverse, sexually active teenagers attending technical colleges
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DOI：
10.1016/j.cmi.2018.10.019
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发表时间：
2019-07-01
影响因子：
14.2
通讯作者：
Reid, F.
中科院分区：
文献类型：
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作者：
Oakeshott, P.;Kerry-Barnard, S.;Reid, F.
目标：我们在英国伦敦的六所技术学院进行了 90 分钟沙眼衣原体测试和当天现场治疗（“Test n Treat/TnT”）的整群随机可行性试验，以评估 TnT 摄取率；随访率；基线和 7 个月时沙眼衣原体的患病率；治疗时间； TnT 的可接受性。方法：参与者填写了问卷并提供了基线和 7 个月时的泌尿生殖样本。参与者被告知，基线样本在 7 个月内不会进行检测，并建议进行独立筛查。学院以 1:1 的比例随机分配到干预组 (TnT) 或对照组（无 TnT）。招募后 1 个月和 4 个月，干预学院的参与者收到短信邀请，邀请他们进行现场免费沙眼衣原体测试。对参加/未参加筛查的学生进行了有目的的抽样调查（n = 26）。 结果：招募了 509 名性活跃的学生：中位年龄 17.9 岁，47% 为男性，50% 为黑人，55% 的学生报告在前一年有两个或多个性伴侣。 1 个月时 TnT 摄取率为 13%（33/259；95% CI 8.9-17.4%），4 个月时为 10%（26/259；6.7-14.4%），总体沙眼衣原体阳性率为 5.1%（3/59；1.1-14.2%）。 7 个月时，问卷随访率为 62% (317/509)，样本随访率为 52% (264/509)。沙眼衣原体患病率在基线时为 6.2% (31/503)，在 7 个月时为 6.1% (16/264)。从测试到治疗的中位时间为 15 小时。访谈表明，检测采用率低与感觉不到风险、耻辱感以及对性传播感染 (STI) 知之甚少有关。结论：尽管基线和随访时沙眼衣原体感染率较高，但检测采用率较低。与许多国家一样，英国迫切需要更好的性教育，包括使性传播感染检测成为常规/常态。 (C) 2019 年作者。由爱思唯尔有限公司代表欧洲临床微生物学和传染病学会出版。
Objectives: We conducted a cluster-randomized feasibility trial of 90-minute Chlamydia trachomatis tests and same day on-site treatment ('Test n Treat/TnT') in six technical colleges in London, England, to assess TnT uptake rates; follow-up rates; prevalence of C. trachomatis at baseline and 7 months; time to treatment; acceptability of TnT.Methods: Participants completed questionnaires and provided genitourinary samples at baseline and 7 months. Participants were informed that baseline samples would not be tested for 7 months and were advised to get screened independently. Colleges were randomly allocated 1:1 to intervention (TnT) or control (no TnT).One month and 4 months post recruitment, participants at intervention colleges were texted invitations for on-site free C. trachomatis tests. A purposive sample of students who did/did not attend for screening were interviewed (n = 26).Results: Five hundred and nine sexually active students were recruited: median age 17.9 years, 47% male, 50% black ethnicity, 55% reporting two or more sexual partners in the previous year. TnT uptake was 13% (33/259; 95% CI 8.9-17.4%) at 1 month and 10% (26/259; 6.7-14.4%) at 4 months with overall C. trachomatis positivity 5.1% (3/59; 1.1-14.2%). Follow-up at 7 months was 62% (317/509) for questionnaires and 52% (264/509) for samples. C. trachomatis prevalence was 6.2% (31/503) at baseline and 6.1% (16/264) at 7 months. Median time from test to treatment was 15 h. Interviews suggested low test uptake was associated with not feeling at risk, perceptions of stigma, and little knowledge of sexually transmitted infections (STIs).Conclusions: Despite high C. trachomatis rates at baseline and follow-up, uptake of testing was low. Like many countries, England urgently needs better sex education, including making STI testing routine/ normal. (C) 2019 The Authors. Published by Elsevier Ltd on behalf of European Society of Clinical Microbiology and Infectious Diseases.