Chlamydia screening practices among physicians and community nurses in Yukon, Canada

• Published in: International Journal of Circumpolar Health
• Main Authors: Karolina Machalek, Brendan E. Hanley, Joy N. Kajiwara, Paula E. Pasquali, Cathy J. Stannard
• Format: Article in Journal/Newspaper
• Language: English
• Published: Taylor & Francis Group 2013
• Subjects: chlamydia; Yukon Territory; Canada; sexually transmitted diseases; screening; physicians; general practitioners; public health nursing; adolescent; Arctic medicine. Tropical medicine; RC955-962; Arctic; Yukon; Circumpolar Health; International Journal of Circumpolar Health
• Online Access: https://doi.org/10.3402/ijch.v72i0.21607; https://doaj.org/article/9478e83a1835488fb780ec7aba09c94a

Background . Yukon, a territory in northern Canada, has one of the highest reported sexually transmitted chlamydia infection rates in the country. Objective . We examined screening practices among physicians and community nurses to elucidate factors that may be contributing to the high rates. Design . Cross-sectional survey. Methods . A questionnaire was distributed to all physicians in Yukon and all community nurses in Yukon&#x0027;s communities. We surveyed sexual health assessment frequency, chlamydia testing frequency and barriers to screening. Comparison of physician testing practices was performed to another Canadian jurisdiction, which previously undertook a similar survey. Survey results were compared to the available laboratory data in Yukon. Results . Eligible physicians and nurses, 79% and 77%, respectively, participated in the survey. Physicians tested 15 to 24-year-old females more frequently than 15 to 24-year-old males for chlamydia (p=0.007). Physicians who asked sexual health assessment questions were more likely to test for chlamydia in both females (p<0.001) and males (p=0.032). More physicians screened females based on risk factors compared to males. General practice physicians in Yukon were more likely to test females for chlamydia than general practice physicians in Toronto, Canada (p<0.001). Community nurses had different testing patterns than physicians, with a lower overall frequency of testing, equal frequency of testing males and females, and in applying risk factor-based screening to both males and females. Barriers to screening included testing causing patient discomfort, patients reluctant to discuss screening, health provider uncomfortable conducting sexually transmitted infection tests and sexual health assessments, among others. Laboratory data in Yukon appear to confirm provider screening patterns. Conclusions . This survey provides valuable information on health provider screening patterns. We have some evidence which suggests that chlamydia testing rates may be ...