Public Health England (PHE) has announced changes to the National Chlamydia Screening Programme (NCSP) following a public consultation in 2020. NCSP is to shift its focus from screening and prevention to reducing harm from untreated infections on young women’s reproductive health and, as such, tests will now only be proactively offered to women (outside of specialist sexual health/sexual and reproductive healthcare services).
The Royal College of Obstetricians and Gynaecologists (RCOG) and the Faculty of Sexual and Reproductive Healthcare (FSRH) support the goal of preventing the adverse consequences of untreated chlamydia. However, we believe that the NCSP should aim to improve outcomes for everyone affected by chlamydia, not only women.
Dr Zara Haider, spokesperson from the FSRH, said: "We acknowledge that there is no strong empirical evidence that screening of women and men has resulted in a fall in prevalence. As such, we understand that prevention of harm from untreated chlamydia infection is likely to be a more measurable and appropriate goal than prevention of ongoing transmission. However, we are concerned that the changes to the NCSP may inadvertently bias public perception that chlamydia is a sexually transmitted infection primarily affecting and transmitted by women, effectively discouraging men from taking responsibility for their own sexual and reproductive health.
“Opportunistic screening of men was originally included in the NCSP programme because it was deemed necessary to highlight men’s role in preventing onward transmission, encouraging both women’s and men’s ownership of their sexual and reproductive health.
“There is a marked difference in health-seeking behaviours,and young men may be less likely than women to seek testing. Evidence suggests that young men often lack knowledge about chlamydia and screening for the infection, and further evidence from PHE shows that chlamydia screening has a positive impact on awareness and health-seeking behaviours generally. The wider benefits of screening to normalise, destigmatise and change knowledge and attitudes to STIs and health-seeking behaviours may well be lost if men are not offered opportunistic screening any longer.”
Dr Edward Morris, President of the RCOG, said: “We remain unconvinced about the new approach to opportunistic chlamydia screening, and believe that a focus on health outcomes should not come at the expense of shifting responsibility for sexual and reproductive healthcare away from men, creating unhelpful myths about sexually transmitted infection transmission and further stigmatising women’s health”.
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Notes to Editors
The Faculty of Sexual and Reproductive Healthcare (FSRH) is the largest UK professional membership organisation working at the heart of sexual and reproductive health (SRH), supporting healthcare professionals to deliver high quality care. It works with its 15,000 members, to shape sexual reproductive health for all. It produces evidence-based clinical guidance, standards, training, qualifications and research into SRH. It also delivers conferences and publishes the journal BMJ Sexual & Reproductive Health in partnership with the BMJ.
The RCOG is a medical charity that champions the provision of high-quality women’s healthcare in the UK and beyond. It is dedicated to encouraging the study and advancing the science and practice of obstetrics and gynaecology. It does this through postgraduate medical education and training and the publication of clinical guidelines and reports on aspects of the specialty and service provision.