Young, male, and infected - the forgotten victims of Chlamydia

While young women are being targeted in the bid to curb the spread of Chlamydia in primary care, young men are all too frequently being ignored, suggests a small study of practice nurses in Sexually Transmitted Infections.

Practice nurses, who have a key role in monitoring sexual health, and thereby helping to reduce the spread of infection in primary care, seem reluctant to test young men for Chlamydia. They feel they have neither the time nor training to do so, the research indicates.

The research team surveyed 46 practice nurses working in 22 general practices in one area of North Wales, as part of a study to improve the quality of sexual health services in primary care.

The nurses were asked what circumstances would prompt them to test young men for Chlamydia infection, including age under 25, particular symptoms, or an infected partner. They were also asked if they routinely gave men an intimate examination, and if they would consider notifying a partner if the patient was infected (contact tracing).

Thirty three of the 46 nurses responded to the survey; all 22 general practices were represented in the responses.

Only one nurse said she routinely carried out intimate examinations on men; over 90% of respondents said they did not.

Around half to two thirds of the nurses did not answer the various questions about testing prompts. Only one nurse said she always tested young men under the age of 25 - an age group in which rates of Chlamydia infection are high. A further five said they "sometimes" did. But almost one in five said they "never" tested.

And few nurses routinely tested even in the presence of indicative symptoms.

One in three respondents said they tested men whose partners were infected, but almost one in 10 said they did not test in these circumstances. And only around one in 10 said they would always consider contact tracing. Most said they would "sometimes" consider it.

Interviews with seven of the nurses revealed that time constraints and insufficient training were among the key factors stopping practice nurses from targeting men for Chlamydia infection.

The authors point out that the failure of nurses to identify the signs and symptoms of Chlamydia among men not only means lost opportunities to curb the spread of what is often a symptomless infection, but also to prevent the risk of complications developing. These are as likely to damage men's fertility as they are women's.

"This study, while small, demonstrates the urgent need to support practice nurses to carry out male testing in primary care," conclude the authors. And they call for nurses to be given adequate training and support to enable them to carry out this important role.

Contact:
Dr Olwen Williams, Department of Genitourinary Medicine, Wrexham Maelor Hospital, Wrexham, Wales, UK.
Tel: + 44 (0) 1978 725 924/ (0)1734 534 455; (0) 7719 951 023 (m)
Email: [email protected]

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