Open Access Research article

Does population screening for Chlamydia trachomatis raise anxiety among those tested? Findings from a population based chlamydia screening study

Rona Campbell1*, Nicola Mills1, Emma Sanford2, Anna Graham3, Nicola Low4, Tim J Peters3 and the Chlamydia Screening Studies (ClaSS) Group

Author Affiliations

1 Department of Social Medicine, University of Bristol, Canynge Hall, Whiteladies Road, BRISTOL BS8 2PR, UK

2 Bedfordshire and Hertfordshire Strategic Health Authority, 63-77 Victoria Street, St Albans, Herts. AL1 3ER, UK

3 Department of Community Based Medicine, University of Bristol, 1 The Grange, Woodland Road, Bristol, BS8 1AU, UK

4 Department of Social and Preventive Medicine, University of Berne, Finkenhubelweg 11, 3012 Berne, Switzerland

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BMC Public Health 2006, 6:106  doi:10.1186/1471-2458-6-106

Published: 25 April 2006



The advent of urine testing for Chlamydia trachomatis has raised the possibility of large-scale screening for this sexually transmitted infection, which is now the most common in the United Kingdom. The purpose of this study was to investigate the effect of an invitation to be screened for chlamydia and of receiving a negative result on levels of anxiety, depression and self-esteem.


19,773 men and women aged 16 to 39 years, selected at random from 27 general practices in two large city areas (Bristol and Birmingham) were invited by post to send home-collected urine samples or vulvo-vaginal swabs for chlamydia testing. Questionnaires enquiring about anxiety, depression and self-esteem were sent to random samples of those offered screening: one month before the dispatch of invitations; when participants returned samples; and after receiving a negative result.


Home screening was associated with an overall reduction in anxiety scores. An invitation to participate did not increase anxiety levels. Anxiety scores in men were lower after receiving the invitation than at baseline. Amongst women anxiety was reduced after receipt of negative test results. Neither depression nor self-esteem scores were affected by screening.


Postal screening for chlamydia does not appear to have a negative impact on overall psychological well-being and can lead to a decrease in anxiety levels among respondents. There is, however, a clear difference between men and women in when this reduction occurs.