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Chlamydia trachomatis infection and sexual behaviour among female tertiary students in the Republic of Ireland

Background: There is no prevalence data relating to female tertiary students available for the Republic of Ireland. This data is required to guide on the necessity for Chlamydia screening programmes in tertiary education settings. Thus this research aimed to determine the prevalence of and predictive risk factors for Chlamydia trachomatis genital infection among a female tertiary student population in Ireland. Methods: All females presenting during one-day periods at Student Health Units in 3 tertiary education institutions in 2 cities in the Republic of Ireland were invited to participate. Participants completed a questionnaire on lifestyle and socio-demographic factors and provided a urine sample. Samples were tested for C. trachomatis DNA by a PCR based technique (Cobas Amplicor, Roche). To examine possible associations between a positive test and demographic and lifestyle risk factors, a univariate analysis was performed. All associations with a p value <0.05 were included in a multivariate logistic regression analysis. Results: Of the 460 sexually active participants 22 tested positive (prevalence 4.8%; 95% CI 3.0 to 7.1%). Variables associated with significantly increased risk were current suggestive symptoms, two or more one night stands and three or more lifetime sexual partners. The students displayed high-risk sexual behaviour. Conclusions: The prevalence of C. trachomatis infection and the lack of awareness of the significance of suggestive symptoms among sexually experienced female students demonstrate the need for a programme to test asymptomatic or non-presenting tertiary students. The risk factors identified by multivariate analysis may be useful in identifying those who are most likely to benefit from screening. Alcohol abuse, condom use, sexual behaviour (at home and abroad) and, knowledge of STIs (including asymptomatic nature or relevant symptoms) were identified as target areas for health promotion strategies. These strategies are needed in view of the high-risk sexual activity identified.