Chlamydia Monday  2003 – 2007  A preventive intervention in Stockholm County, Sweden Marta Hansson Bocangel Midwife Lafa –...
  Lafa’s objectives <ul><li>Prevent the spread of HIV and other sexually transmitted infections, STI </li></ul><ul><li>Pre...
Lafa´s target groups <ul><li>Teenagers/young adults </li></ul><ul><li>Immigrants  </li></ul><ul><li>Men who have sex with ...
The Lafa model <ul><li>Training programme </li></ul><ul><li>Method material </li></ul><ul><li>Information centre </li></ul...
Youth Clinics in Sweden <ul><li>Promote physical and mental health </li></ul><ul><li>Strengthen young people in the  </li>...
The work at the Youth Clinic  is based on <ul><li>Respect for the individual </li></ul><ul><li>Professional secrecy </li><...
Youth Clinics <ul><li>230 in Sweden, 36 in the Stockholm area </li></ul><ul><li>Staffed by midwives, social workers, docto...
Chlamydia trend in Sweden 1990 - 2007 <ul><li>Figure 1. Number of chlamydia cases per 100,000 inhabitants in Sweden 1989–2...
 
 
<ul><li>Changed sexual habits  </li></ul><ul><li>Delayed family formation </li></ul><ul><li>Less knowledge about STIs </li...
CHLAMYDIA MONDAY 2003 - 2007 in Stockholm County
The goals of Chlamydia monday <ul><li>Bring attention and spread knowledge about the infection </li></ul><ul><li>Offer ext...
Implementation <ul><li>Step one:  invitation to participate to medical centres, gynaecological clinics and antenatal clini...
Chlamydia Monday 2003-2007, number of positive and negative test results
Participants by age and sex, 2007, number n=1,234
Patient oriented questions <ul><li>Had chlamydia before: 20 – 25% </li></ul><ul><li>Been tested before: about 50% </li></u...
Reason for getting tested, 2007, number (n=1,237)
Attitudes and knowledge <ul><li>90 % think chlamydia is a serious infection, but more than half state unprotected sex as t...
 
 
 
Summary of Chlamydia Monday <ul><li>Follow-up a key component  </li></ul><ul><li>Accessibility important </li></ul><ul><li...
Summary of Chlamydia Monday <ul><li>Behaviour has not changed but </li></ul><ul><li>A small decline in the first half of 2...
 
Summary of Chlamydia Monday <ul><li>“ A change process begins with knowledge enhancement and is followed by a change in at...
Cost benefit analysis <ul><li>Evaluating chlamydia Monday 2007 </li></ul><ul><li>Health gains measured in QUALYs – quality...
Concluding thoughts <ul><li>Young people are not a homogeneous group – preventive interventions must be adapted </li></ul>...
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Chlamydia Monday Marta Hansson

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  • Chlamydia Monday Marta Hansson

    1. 1. Chlamydia Monday 2003 – 2007 A preventive intervention in Stockholm County, Sweden Marta Hansson Bocangel Midwife Lafa – Unit for Sexuality and Health Stockholm County Council
    2. 2. Lafa’s objectives <ul><li>Prevent the spread of HIV and other sexually transmitted infections, STI </li></ul><ul><li>Prevent unwanted pregnancies </li></ul><ul><li>Promote sexual health and well-being </li></ul><ul><li>Marta Hansson Bocangel </li></ul><ul><li> Lafa 2008 </li></ul>
    3. 3. Lafa´s target groups <ul><li>Teenagers/young adults </li></ul><ul><li>Immigrants </li></ul><ul><li>Men who have sex with men </li></ul><ul><li>Patients in the primary care system </li></ul>
    4. 4. The Lafa model <ul><li>Training programme </li></ul><ul><li>Method material </li></ul><ul><li>Information centre </li></ul><ul><li>Insight – magazine </li></ul><ul><li>Websites </li></ul><ul><li>Free condoms for young people </li></ul><ul><li>Statistics on births, abortions, STIs </li></ul><ul><li>Mentoring and support </li></ul>
    5. 5. Youth Clinics in Sweden <ul><li>Promote physical and mental health </li></ul><ul><li>Strengthen young people in the </li></ul><ul><li>development of their identity so that </li></ul><ul><li>they can handle and enjoy their </li></ul><ul><li>sexuality </li></ul><ul><li>Prevent unwanted pregnancies and </li></ul><ul><li>STIs </li></ul><ul><li>Policy programme for Sweden´s Youth Clinics 2002 </li></ul>
    6. 6. The work at the Youth Clinic is based on <ul><li>Respect for the individual </li></ul><ul><li>Professional secrecy </li></ul><ul><li>Voluntary participation </li></ul><ul><li>Services free of charge </li></ul><ul><li>High accessability </li></ul>
    7. 7. Youth Clinics <ul><li>230 in Sweden, 36 in the Stockholm area </li></ul><ul><li>Staffed by midwives, social workers, doctors </li></ul><ul><li>Different sizes </li></ul><ul><li>Outreach efforts and individual visits </li></ul><ul><li>Majority of clients are young women </li></ul>
    8. 8. Chlamydia trend in Sweden 1990 - 2007 <ul><li>Figure 1. Number of chlamydia cases per 100,000 inhabitants in Sweden 1989–2007. </li></ul><ul><li>Source: Swedish Institute for Infectious Disease Control </li></ul>
    9. 11. <ul><li>Changed sexual habits </li></ul><ul><li>Delayed family formation </li></ul><ul><li>Less knowledge about STIs </li></ul><ul><li>Less fear of HIV </li></ul><ul><li>Low condom usage </li></ul><ul><li>Less effective partner tracing and notification due to lack of time </li></ul><ul><li>Higher alcohol and drug consumption </li></ul>Possible factors underlying the increase in chlamydia .
    10. 12. CHLAMYDIA MONDAY 2003 - 2007 in Stockholm County
    11. 13. The goals of Chlamydia monday <ul><li>Bring attention and spread knowledge about the infection </li></ul><ul><li>Offer extended testing </li></ul><ul><li>Testing at many different sites </li></ul><ul><li>Encourage condom-use </li></ul>
    12. 14. Implementation <ul><li>Step one: invitation to participate to medical centres, gynaecological clinics and antenatal clinics Youth clinics and Sesam (sexual health) clinics have been obvious participants all five years </li></ul><ul><li>Step two: production of the information campaign </li></ul><ul><li>Step three: coordination before and during Chlamydia Monday </li></ul><ul><li>Step four: distribution of informational materials and surveys to all participating clinics </li></ul><ul><li>Step five: processing of statistics and survey responses at Lafa </li></ul>
    13. 15. Chlamydia Monday 2003-2007, number of positive and negative test results
    14. 16. Participants by age and sex, 2007, number n=1,234
    15. 17. Patient oriented questions <ul><li>Had chlamydia before: 20 – 25% </li></ul><ul><li>Been tested before: about 50% </li></ul><ul><li>Reason for getting a test: unprotected sex </li></ul><ul><li>Wouldn`t get tested if not for C.M: </li></ul><ul><li>2003 – 15% </li></ul><ul><li>2007 - 22% </li></ul>
    16. 18. Reason for getting tested, 2007, number (n=1,237)
    17. 19. Attitudes and knowledge <ul><li>90 % think chlamydia is a serious infection, but more than half state unprotected sex as their reason for getting tested </li></ul><ul><li>A great change in knowledge about the side-effects of chlamydia </li></ul><ul><li>Young men tested at youth clinics is the group that is both mainly untested and has the least knowledge about chlamydia. </li></ul>
    18. 23. Summary of Chlamydia Monday <ul><li>Follow-up a key component </li></ul><ul><li>Accessibility important </li></ul><ul><li>Clinics more alert on STIs in general and in chlamydia in particular </li></ul><ul><li>More people in the primary care system become condom distributors, training in condom awareness </li></ul><ul><li>Increasing knowledge </li></ul>
    19. 24. Summary of Chlamydia Monday <ul><li>Behaviour has not changed but </li></ul><ul><li>A small decline in the first half of 2008 in the number of chlamydia cases </li></ul>
    20. 26. Summary of Chlamydia Monday <ul><li>“ A change process begins with knowledge enhancement and is followed by a change in attitude, which finally leads to a change in behaviour” </li></ul>
    21. 27. Cost benefit analysis <ul><li>Evaluating chlamydia Monday 2007 </li></ul><ul><li>Health gains measured in QUALYs – quality adjusted life years </li></ul><ul><li>Cost effective intervention </li></ul>
    22. 28. Concluding thoughts <ul><li>Young people are not a homogeneous group – preventive interventions must be adapted </li></ul><ul><li>Make it possible to talk about condoms </li></ul><ul><li>Find the risk-takers and use effective dialogue to influence them to practise safer sex </li></ul><ul><li>Talk to teenage boys and young men about fatherhood </li></ul>
    23. 29. THANK YOU

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