Guidance

NCSP: talking with young people about changes to chlamydia screening

Published 7 March 2022

Applies to England

A guide for local areas to support the offer of opportunistic chlamydia testing outside sexual health services

The National Chlamydia Screening Programme (NCSP) is changing to focus on reducing reproductive harm of untreated infection in women and other people with a womb or ovaries who are under 25 years of age. This includes transgender men, and non-binary people assigned female at birth, and intersex people with a womb or ovaries. For the purpose of this guide, this group will be referred to as the NCSP designated group.

This guide has been developed to provide practical advice to local areas to support the offer of opportunistic NCSP testing outside sexual health services. This opportunistic testing, which is the proactive offer of a chlamydia test to young people without symptoms, should focus solely on the NCSP designated group. This will be combined with:

• reducing time to test results and treatment
• strengthening partner notification
• re-testing after treatment

Services provided by sexual health services are unchanged.

Everyone can still access chlamydia testing if they need to, but people outside the NCSP designated group will not be proactively offered a test unless an indication has been identified, such as being a partner of someone with chlamydia or having symptoms.

This guide contains suggestions for how to talk about the NCSP with different populations including:

1. Information to provide to the NCSP designated group:

• when offering an opportunistic chlamydia test
• if asked why chlamydia is now only a concern for the NCSP designated groups
• if asked about partners of the NCSP designated group who accept the offer of a test

2. Information to provide to people who are not in the NCSP designated group:

• if asked about the changes to the NCSP
• about STI testing

Offering an opportunistic chlamydia test to the NCSP designated group

To reduce the reproductive harm of untreated chlamydia infection, people in the NCSP designated group should now be routinely offered opportunistic chlamydia testing. This offer should be made when attending relevant services outside sexual health services, for example general practice and pharmacies.

The offer should be made regardless of the reason for the visit to the service but is particularly relevant when discussing or providing contraceptive services.

People belonging to the NCSP designated group have said that they value input from healthcare professionals to help them to make informed decisions about their sexual health. They are comfortable with the offer of an opportunistic chlamydia test being made to them. They also identified that it’s important that they are told that the test is easy to do themselves, confidential and that they do not need to be examined.

For staff, having chlamydia testing kits easily accessible is an important way to reduce barriers to their offering the test. It’s also helpful for copies of the NCSP patient information leaflet to be made available to those being offered a test.

Information to provide to the NCSP designated group when offering an opportunistic chlamydia test

A free chlamydia test is offered to all women and other people with a womb or ovaries, who are under 25 at this service.

This is because women and other people with a womb or ovaries under 25 years old in England who are sexually active should have a chlamydia test once a year, and when they have sex with new or casual partners.

While chlamydia may not have any noticeable signs or symptoms, if it is not treated, it can cause health complications for women and other people with a womb or ovaries. But complications are rare in men and other people who do not have a womb or ovaries.

For women and other people with a womb or ovaries, chlamydia can cause pain due to inflammation in the pelvis, an ectopic pregnancy (a pregnancy in the fallopian tubes) and infertility (being unable to have children). This risk increases each time a person gets chlamydia.

Diagnosing chlamydia as early as possible reduces the risk of health complications and of passing it on. Because of this a chlamydia test should be considered.

Young people can do the test themselves; it is confidential and does not require being examined.

The NCSP patient information leaflet provides more information on the test and what happens if you have chlamydia.

Information to provide if asked why chlamydia is now only a concern for the NCSP designated group

Taking responsibility for your own sexual health is important for everybody. Anybody of any age or gender who has symptoms of any STI including chlamydia or who has any concerns about their sexual health can contact a sexual health clinic for advice and testing. In some areas, they can also order a free test online.

The focus of the NCSP is on reducing reproductive harm of untreated infection in young women and other people with a womb or ovaries.

This is because untreated chlamydia can cause health complications in this group, but complications are rare in men and other people without a womb or ovaries.

For women and other people with a womb or ovaries chlamydia can cause pain in the pelvis, an ectopic pregnancy (a pregnancy in the fallopian tubes) and infertility (being unable to have children). This risk increases each time a person gets chlamydia.

Because of this women and other people with a womb or ovaries under 25 years old should be routinely offered and encouraged to take a chlamydia test.

Information to provide if asked about partners of the NCSP designated group who accepted the offer of a test

As chlamydia is passed on through sexual contact, if the test finds women and other people with a womb or ovaries have chlamydia, it is very important that the people they’ve had sex with recently be tested and treated for chlamydia as well as other STIs. Sexual health services can help to contact recent partners.

It’s recommended that anyone who is sexually active has an STI test once a year if not using condoms with new or casual partners. This STI test includes a chlamydia test and HIV test once a year.

To find local services, visit the NHS website, or call the Sexual Health Helpline: 0300 123 7123, minicom: 0800 521 361.

Talking about changes to the NCSP with people who are not in the NCSP designated group

People outside of the NCSP designated group should not be opportunistically offered a chlamydia test. However, the following is a guide to how you can answer any requests for a chlamydia test from people outside the NCSP designated group.

Information to provide about the changes to the NCSP if asked by people who are not in the NCSP designated group

The focus of the NCSP is on reducing reproductive harm of untreated infection in under-25-year-old women and other people with a womb or ovaries.

This is because chlamydia is most common among young people under the age of 25. Chlamydia can cause health complications for women and other people with a womb or ovaries. This includes pain in the pelvis, an ectopic pregnancy (a pregnancy in the fallopian tubes) and infertility (being unable to have children). This risk is increased if they get the infection again and again.

It is very rare for men and other people without a womb or ovaries to get any serious health complications from chlamydia.

Anybody of any age or gender who has symptoms of any STI including chlamydia or who has any concerns about their sexual health can contact a sexual health clinic for advice and testing. In some areas, they can also order a free test online.

To find local services, visit the NHS website, or call the Sexual Health Helpline: 0300 123 7123, minicom: 0800 521 361.

Information to provide to people who are not in the NCSP designated group about STI testing

It’s recommended that anyone who is sexually active has an STI test once a year if not using condoms with new or casual partners. This STI test includes a chlamydia test and HIV test once a year.

Gay, bisexual and other men who have sex with men should test for HIV and STIs annually or every 3 months if having condomless sex with new or casual partners.

Anybody who has symptoms of any STI of has any concerns about their sexual health can contact a sexual health clinic for advice and testing. In some areas, they can also order a free test online.

Visit the NHS website, to find local sexual health service and local internet testing options. Or call the Sexual Health Helpline: 0300 123 7123 , minicom: 0800 521 361.

Further Information

Young adults looking for information on chlamydia and chlamydia testing should:

• visit NHS – chlamydia
• email nscpteam@phe.gov.uk for any further information