Opportunistic testing for chlamydial infection in people attending a sexual medicine clinic for HIV tests

Patients presenting for an HIV test alone represent an opportunity for scre ening for Chlamydia trachoomatis. This audit was designed to assess the upt ake of chlamydial screening by urinary ligase chain reaction (LCR) in adult s attending a genitourinary clinic. All patients requesting an HIV Lest wer e offered full genital screening in the first audit period, if they decline d they were offered chlamydial LCR. During the second period patients who r efused full, screening were asked to provide a urine sample for LCR testing unless they declined. Nine hundred and forty-two patients presented for HI V tests alone during the first audit period. Two hundred (22%) agreed to pr ovide a urine sample for LCR testing, 7 (3.5%) were positive for chlamydia. During the second audit period 794 patients presented for HIV tests alone, 426 (55.1%)! provided urine for LCR testing, 15 (3.4%) were positive. The uptake of urinary LCR a non-invasive test for a potentially serious infecti on remained disappointingly low despite changes to the audit protocol. Reas ons for this are discussed.