Distressed women take contact tracing seriously

Editor—As a genitourinary physician, I give unexpected diagnoses to young women every working day in my clinic. They do not expect to have chlamydia or gonorrhoea in a stable relationship—it could come from the previous boyfriend. They do not expect to have a sexual infection if they do not currently have a sexual partner—chronic infection does not have to hurt. They may be yearning for a baby, and they are terribly distressed when they realise that their tubal infection could have been overlooked for years because of a lack of screening.

Of course having a sexual infection is upsetting. But even though they are upset, most women actively cooperate with contact tracing and thus reduce transmissible infection in the community.¹

Our health advisers reviewed the effectiveness of contact tracing for gonorrhoea in our genitourinary medicine clinic during 1999-2000. Only one of 28 women index patients declared her contact untraceable, in contrast with 39 out of 73 male index patients (R Chown et al, spring meeting of the Medical Society for the Study of Venereal Diseases, Belfast, May 2001). The infected women found in the survey of France et al also showed a commendably high success rate in contact tracing despite their distress.²

Healthcare workers and others concerned with putative chlamydia screening programmes can work with distressed women to a constructive end point—reducing the prevalence of chlamydia—and hence remove a source of distress to their sisters in the future. We can be sympathetic, but fear of upsetting women by an unpalatable truth should not deter the screening process.