Impact of reduced chlamydia testing on STI testing and provider preferences in the Netherlands: an experimental vignette study
Bibliographic record
Abstract
OBJECTIVES: The restrictive chlamydia testing guidelines for asymptomatic individuals at Dutch sexual health centres (SHCs) since January 2025 may influence perceptions and attitudes towards testing for sexually transmitted infections (STIs). This study aimed to assess the potential impact of this guideline change on STI testing preferences among young people and to examine determinants and underlying motivations of these preferences. METHODS: Heterosexuals aged 16-34 in the Netherlands, recruited via social media and SHCs, completed an online survey (April-June 2024). STI testing preferences (SHCs, general practitioners (GPs), commercial self-sampling tests or not testing) before and after the anticipated guideline change were assessed in a hypothetical scenario involving condomless sex with a new partner without having STI-related symptoms after. Participants initially preferring SHCs were grouped according to post-change preferences. We used logistic regression to identify factors associated with preferences and thematic analysis to explore motivations. RESULTS: Of 1179 participants, 68% (95% CI 65% to 71%) initially preferred SHCs as a testing provider. After the guideline change, among this group, 24.2% (95% CI 21% to 27%) still preferred SHCs, 51.5% (95% CI 48% to 55%) switched to a preference for testing at GPs, 18% (95% CI 16% to 21%) to self-sampling and 6.2% (95% CI 5% to 8%) opted out. Switching to GPs was associated with younger age and high self-efficacy and control beliefs; choosing self-sampling with older age (>24) and university education; and opting out with inconsistent condom use and low health goals compared with preferring SHCs. Motivations included test costs, symptom absence and perceived chlamydia prevalence. CONCLUSION: Changing chlamydia testing guidelines at SHCs may cause a shift in testing preferences to GPs or self-sampling and may discourage some from testing. These findings underscore the need for targeted communication and ongoing monitoring of STI testing behaviour to maintain STI testing uptake and are relevant for countries facing similar changes to chlamydia testing guidelines.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".