‘Catching chlamydia’: combining cash incentives and community pharmacy access for increased chlamydia screening, the view of young people

Abstract

In Australia and elsewhere, chlamydia screening rates for those aged between 16 and 30 years continue to be low. Innovative, age-appropriate approaches are necessary to increase chlamydia screening among this target group to prevent short- and long-term consequences of the infection such as pelvic inflammatory disease, chronic pelvic pain, ectopic pregnancy and infertility. Studies have demonstrated that offering chlamydia screening in community pharmacies may be a useful adjunct to current screening services. Approximately 90% of Australians visit a pharmacy at least once a year. Chlamydia screening and education in community pharmacies with remuneration may provide another option for opportunistic testing as part of a national chlamydia screening scheme. Compensation is an accepted practice in the field of research and has been demonstrated to improve adherence to health promotion activities. In 2011, a cross-sectional study of community pharmacy-based chlamydia screening offered in conjunction with an A$10 cash incentive to participate was conducted in the Australian Capital Territory. As part of this study young people were asked about their experience of, and views about, pharmacy-based chlamydia screening. The views of consented participants were collected using the one-page questionnaire consisting of 10 closed questions and one open-ended question. Participants completed the questionnaire when they returned their urine sample and before being given the cash incentive. Overall participants were highly satisfied with the pharmacy-based chlamydia screening service. Over 60% of questionnaire respondents felt that the payment did affect their decision to have the chlamydia test, and 23% stated that it made no difference. Young people reported that pharmacy-based screening is acceptable and convenient. Accessibility and the small cash incentive played significant roles in increasing participation.

Pharmacy-based sexual health services: a systematic review of experiences and attitudes of pharmacy users and pharmacy staff

“…Users found pharmacies convenient, easy and quick to access and use. They liked that compared to other providers, no appointments needed to be organised (25)(26)(27)(28)(29)(30)(31)(32)(33). However, a barrier to service delivery experienced by some users was that trained staff were not always available to provide the service (32).…”

“…All five studies evaluating 'privacy' did so in relation to EC or chlamydia screening. Users perceptions of experience conflicted within and between studies: While some were not concerned and stated that privacy was something they liked about pharmacies, others had privacy concerns and were worried about being overheard at the counter (25)(26)(27)(28)(29)(30)(31). In one study 98.9% of users of clinical services such as family planning services and General practices (82/83) were satisfied with the level of privacy provided, a significantly lower percentage (p ≤.001) of pharmacy users (44%; 22/50) were satisfied (25).…”

“…With the exception of some younger individuals, pharmacy users generally had a positive counselling experience, felt comfortable discussing sexual health (26)(27)(28)(29)(30)(31)(32)(33)(34)(35) and found that appropriate advice was provided (26)(27)(28)30,31,(33)(34)(35). However, in two quantitative studies, pharmacy users found counselling on EC less informative and satisfactory compared to users of other sexual health providers (25,34,35): Whereas 95% of users of clinical services (78/83) agreed that adequate advice on EC was provided, fewer pharmacy users (82%; 41/50) did so (25).…”

“…While some pharmacy healthcare assistants generally thought that users appeared unconcerned about their privacy, most pharmacy staff felt that privacy was highly important to users requesting sexual health services (30,31,37,38,41). Thus, staff preferred to discuss sexual health in private consultation rooms (27,28); where none were available, they tried to counsel in private areas away from other users (37,38,42).…”

“…Staff were generally comfortable counselling users and tried to be youth-friendly and nonjudgemental. Dealing with groups and asking sensitive questions were perceived as difficult (27,28,30,31,36,38,40,43,44). According to staff, pharmacy users with the exception of young users and women counselled by male staff, felt comfortable during counselling (40,44).…”