Factors associated with anxiety in patients attending a sexually transmitted infection clinic: qualitative survey

Abstract

We used qualitative methods to explore factors, which might explain increased anxiety in patients attending a sexually transmitted infection (STI) clinic. Twenty patients, who scored significantly for anxiety on the Hospital Anxiety and Depression Scale (HADS) attended a 20-minute interview. This explored factors contributing to their current psychological symptoms. Transcripts revealed three main themes. First were factors related to possible STIs and the clinic visit. These included health anxieties about HIV or fertility and clinic factors, including staff attitudes and clinic location. Second were factors unrelated to the clinic, including previous emotional difficulties or substance misuse. Third were issues concerning stigma, embarrassment and shame. The origins of anxiety in STI patients are multifactorial and difficult to identify during brief appointments. Despite modern clinics and attitudes, stigma and embarrassment remain prominent. Interventions to address these factors could improve psychological health in this patient group.

Gender differences in the well-being of patients diagnosed with Chlamydia trachomatis: a cross-sectional study

“…Knowledge of having exposed oneself to the risk of infection, unprotected contacts that one might regret, worry of being coinfected with another STI such as HIV and risk of future infertility also troubled the patients 23 24. Patients with STI have described feelings of being judged for having done ‘something stupid’, both by personnel at the reception and by other patients 24. The gender difference observed in our study may, at least partially, be due to the fact that men are not aware of the possibility that CT may also affect male fertility.…”

Engagement of Traditional Healers and Birth Attendants as a Controversial Proposal to Extend the HIV Health Workforce

“…In addition to their timely referral, healers could be a resource for clinicians and provide pertinent details about patients’ medical history that may point to a diagnosis. This can be particularly important for people who are too embarrassed or think it inappropriate to disclose certain symptoms (including STIs, HIV and depression), sexual behavior, and/or adherence to medications [52, 53]. …”

Alarmingly poor performance in Chlamydia trachomatis point-of-care testing

“…The use of nucleic acid amplification tests (NAAT) with self-taken vaginal swabs (SVS) or urine have made CT testing more sensitive, specific and acceptable 6. Nevertheless, case finding and case recognition is hampered first, by the limited willingness of patients at risk to undergo STI testing because of fear of pelvic examination and stigmatisation, and second owing to the frequently asymptomatic nature of these infections 7. Moreover, with the use of NAAT, there is still a time delay between first consultation and treatment, usually around 1–2 weeks 8.…”