Masuma Novak^1,, Avneet Dayal¹, Daniel Novak²

The utilization rate between social groups of a free Internet based Chlamydia trachomatis (C. trachomatis) testing service in Sweden is unknown. This study examined variations in use of this service according to the participants’ age, gender, educational levels and their parents’ educational levels. In 2004, Sweden introduced the first free Internet-based C. trachomatis testing service for both men and women of all ages. During three consecutive years (2005-2007), the questionnaire that accompanied the ordered test contained questions regarding participants’ level of education and other socio-demographic information. A total of 6025 participants completed the questionnaires and provided urine samples. The response rate was 77% (2256/2923) for men and 93% (3769/4055) for women. In both gender, about 46% tests were accessed by those with high education (≥ 14 years) as compared to only 2% by those with low education (≤ 9 years) (p <0.001). With one exception, a similar trend was seen when parental educational levels were used where 35% to 40% of the tests were taken by participants whose parents had a high level of education and 18% to 26% of the tests were taken by participants whose parents had a low level of education. No significant trend was seen in terms of proportion of men accessing the service according to their mothers’ education. This study demonstrates an existence of inequality in utilization of an Internet-based C. trachomatis infection testing service as more men and women with a high level of education utilized this service than men and women with a low level of education. Future studies should aim to find a reason for this discrepancy which will help researchers and policy makers to find ways to promote the equal utilization of Internet-based health service between different socio-economic groups.

C. trachomatis, health care service, utilization, equality, Sweden