Chlamydia and Young People: Knowledge, Behaviour and Risk Taking:Public Health Perspectives.

Abstract

Abstract

Background
Chlamydia screening is an international strategy used to reduce rates of infection in a target population. This thesis set out to explore the behaviour of young people against the principles of this government strategy for infection control and self-empowerment. The work was set in County Durham and Darlington where I led a service for improved awareness and screening for Chlamydia for young people aged 15 – 24 years.

Aims
This research was based on interviews with Chlamydia screening service users in order to understand the factors that influenced their risk taking behaviours and to generate theory for public health practice. An analysis of outcomes from a large sample of over 20,000 subjects and observations of young people in settings where Chlamydia testing and advice was available gave context and background to this study.

Findings
Chlamydia screening was used as a strategy to offset risk taking that enabled young people to continue behaviours that they valued. This finding is a new and unexpected contribution to Chlamydia screening literature, and also supports the developing theory of edgework. Knowledge and awareness of Chlamydia did not change as a result of screening activities, and this did not have a major influence on preventative behaviour. The national messages that one in 10 young people are infected, and that infection is easily detected and managed, was interpreted by some that nine in 10 young people were not infected, and that this was not a significant health threat. Incentives were found to significantly increase screening uptake although this did not lead to a change in risk taking. There was an increased likelihood to have sex with the perception of knowing a partner, although this was not necessarily based upon factual information. Most participants demonstrated lethal patterns of alcohol consumption that commonly led to sexual encounters and all those who stated that they were aware of safe drinking limits demonstrated lethal patterns of alcohol consumption. All participants with a positive test result had a negative result within the previous year suggesting no change in risk taking following screening, and although all participants said that they would modify their behaviour in the future, when they were probed all stated that this would not happen giving reasons such failure to moderate alcohol use.

Conclusion
These findings led me to conclude that risk taking in relation to health and potential disease is a normal process in the development of young people. Young people value risk taking activities for promoting self-identity and supporting emotional and social well-being. Public health interventions need to consider the developmental needs of young people using an asset based approach in order to provide interventions that address the causes of risk taking behaviours.