HIV testing of patients diagnosed with genital Chlamydia trachomatis in Victoria

In the context of call-back to diagnosing doctors for extra epidemiological information about notified cases of Chlamydia trachomatis, information was sought about 200 patients in relation to whether they had been offered, accepted or had been tested for HIV. Testing was offered to two thirds of males but less than half of the women (OR 2.61, 95% CI 1.26-5.44). All those who were thought to have acquired their chlamydia infection overseas were offered an HIV test. The most common reason for not offering a test was that the doctor did not think about it or consider the patient to be at risk. Of those to whom HIV testing was offered, 72% accepted HIV testing. If testing was delayed until after the window period, many patients who had accepted HIV testing when the diagnosis was discussed did not return for testing. There was no association between previous HIV testing and whether an HIV test was offered at the time of chlamydia diagnosis. Lack of access to free HIV testing was a reason why some people were not tested. Genital chlamydia was often not seen by either patients or doctors to indicate risk for HIV infection. However, knowledge of socio- geographic space in relation to chlamydia is poor. Given the potential for heterosexual transmission of HIV, it would seem prudent to discuss HIV testing with all patients with genital chlamydia and provide counselling about sexual risk. (author abstract)