Australian Chlamydia Control Effectiveness PIlot: a trial to determine whether annual chlamydia testing in general practice can lead to a reduction in chlamydia prevalence.

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The overall design of ACCEPT for the purposes of the Department of Health and Ageing (DoHA) contract has been finalised and approved by ethics committees. The trial uses a cluster randomised controlled trial (RCT) design. Cluster randomisation is required because chlamydia is an infectious disease; randomising a group of people in the same geographic area (postcode) will allow the intervention to be delivered to people within the same social/sexual networks. The intervention aims to maximise the rate of regular chlamydia testing in people in the target age group who attend primary care services. The intervention will be randomised at the postcode level and all GP clinics and Aboriginal Community Controlled Health Services (ACCHS) in each postcode (estimated at 2-3 clinics on average) will be invited to participate. Overall, about 80% of postcodes will be selected from rural/regional areas based on the Rural, Remote and Metropolitan Areas classification (RRMA 3-7) so that the intervention can be applied to whole communities of people more likely to be in the same social/sexual network. Further, because young people often attend multiple clinics, randomising postcodes in rural areas and recruiting all clinics in the postcode, will allow the intervention to be applied to whole communities and facilitate data collection. The fundamental premise of this trial is that increased levels of testing can be achieved by providing a supportive intervention and that once levels of testing are increased high enough (more than 30%), the prevalence of chlamydia will fall.