Increasing chlamydia test of re-infection rates using SMS reminders and incentives.

BACKGROUND: Clients diagnosed and treated for Chlamydia trachomatis are a recognised high-risk group for subsequent infection. An estimated 8% of clients treated for chlamydia at Cairns Sexual Health Service return for re-testing within the recommended 3-4-month period. There is no recall or reminder system in place. This study assesses the effectiveness of using short messaging service (SMS) reminders with and without incentive payments to increase re-testing rates. METHODS: Eligible consenting clients were randomly allocated to one of three groups. Group 1 (controls) received the standard advice from the clinician to return for re-testing in 3-4 months. Group 2 received the standard advice and an SMS reminder at 10-12 weeks post-treatment. Group 3 received the standard advice and the SMS reminder, which also offered an incentive payment on clinic attendance. RESULTS: 32 participants were recruited to groups 1 and 2 and 30 participants to group 3. 62 SMS reminders were sent with 13 (21.0%) reported as undelivered. Re-testing rates were 6.3%, 28.1% and 26.7% for groups 1, 2 and 3, respectively. CONCLUSION: SMS reminders with or without an incentive payment increased re-testing rates in our clients who were diagnosed and treated for chlamydia. However, re-testing remained less than ideal, and the high rate of undelivered SMS reminders suggest that this intervention alone will not achieve desired re-testing rates and that a range of strategies will be required to increase re-testing in this population.

Three years on: a review of medical terminations of pregnancy performed in a sexual health service.

Access to abortion services is often limited in parts of regional Australia, including north Queensland. Since March 2006, the Cairns Sexual Health Service (CSHS) has provided medical termination of pregnancy (MToP) services for women up to 9 weeks gestation, using a regimen of methotrexate and misoprostol. We conducted a retrospective chart audit of all women undergoing an MToP at the CSHS between 1 March 2006 and 31 March 2009. In total, 147 medical terminations in 136 women were performed during this 3-year period. At the time of first presentation, the mean age was 27 years, 77 (57%) of the 136 women were of less than 7 weeks gestation and 86 (63%) had not had a previous termination. A successful medical termination of pregnancy was achieved in 69 of 85 (81%, 95% confidence interval (CI): 72, 88) women at less than 7 weeks gestation and in 43 of 62 (69%, 95% CI: 57, 80) women with gestation between 7 and 9 weeks. Provision of medical termination of pregnancy through sexual health services is one strategy to address access inequity in regional areas. Demand for this service in Cairns continues to rise; however, since late August 2009 MToP in Queensland is no longer available pending legal reform.