Take the sex out of STI screening! Views of young women on implementing chlamydia screening in General Practice

Abstract

BackgroundAustralia is developing a chlamydia screening program. This study aimed to determine the attitudes of young women to the introduction of chlamydia screening in Australian General Practice.MethodsIn-depth face-to-face interviews with 24 young women from across Victoria, Australia, attending a randomly selected sample of general practices.ResultsYoung women reported that they would accept age-based screening for chlamydia in general practice, during both sexual-health and non-sexual-health related consultations. Trust in their general practitioner (GP) was reported to be a major factor in the acceptability of chlamydia screening. The women felt chlamydia screening should be offered to all young women rather than targeted at "high risk" women based on sexual history and they particularly emphasised the importance of normalising chlamydia screening. The women reported that they did not want to be asked to provide a sexual history as part of being asked to have a chlamydia test. Some reported that they would lie if asked how many partners they had hadConclusionWomen do not want a sexual history taken when being asked to have a chlamydia test while attending a general practitioner. They prefer the offer of chlamydia screening to be based on age rather than assessment of sexual risk. Chlamydia screening needs to be normalised and destigmatised.

“Something We'd Rather Not Talk About”: Findings from CDC Exploratory Research on Sexually Transmitted Disease Communication with Girls and Women

“…8 This highlights the need to normalize and routinize Chlamydia screening to increase public acceptability. 19,20 Missed opportunities for reaching young women with meaningful STD information were uncovered in clinical and school settings, as well as in their home and social environments. As many as 28% of participants asked had never discussed STDs with a healthcare provider, even though providers were identified as both a primary and preferred source of STD information.…”

“…4 Chlamydia screening programs for women have demonstrated success in reducing the incidence of PID by as much as 60% in certain settings, yet only about 40% of eligible young women are screened annually in commercial care settings, with higher rates in Medicaid settings and among older segments of these women (21-24 year-olds compared to [16][17][18][19][20] year-olds). Systems-level and provider-level barriers must be addressed to improve these rates, 7 and challenges have also been identified at the consumer level.…”

“Express testing” in STI clinics: extant literature and preliminary implementation data

“…For one, knowledge about STI/HIV transmission affects testing (Balfe et al, 2010;Lichtenstein, 2003;Lindenberg et al, 2006;Pavlin et al, 2008). Additionally, self-identifying as needing testing can induce feelings of embarrassment or shame, and accessing testing requires persons to selfidentify as being susceptible to STIs/HIV, which is something some men appear to be reluctant to do (Balfe et al, 2011;Chacko et al, 2008;Hogben, 2004;Pavlin et al, 2008;Shoveller et al, 2010;Tilson et al, 2004).…”

Sexual risk and healthcare seeking behaviour in young Aboriginal and Torres Strait Islander people in North Queensland

“…This finding supports AMS-based initiatives to engage young Indigenous men in regular testing. Age-based screening programs for STIs are acceptable to young women, particularly if a sexual history is not explored (31), and could also be considered for young men. Intensive population-based screening programs, such as mass annual screening events, have also proven effective for engaging young Indigenous people in STI testing.…”

“…(30) so that they are more inclined to engage in protective behaviours such as condom use. Community education initiatives would assist in destigmatising sexual health (31) allowing for an open dialogue between young people and service providers regarding preventative practices. A number of factors have previously been identified that impact on the effectiveness of sexual health promotion programs in Australia, such as lack of community engagement and cultural sensitivity.…”