Telehealth for sexual and reproductive health issues: a qualitative study of experiences of accessing care during COVID-19

Abstract

Background. Medicare, the health insurance system underpinning free healthcare in Australia, introduced free telehealth items in 2020 in response to the coronavirus disease 2019 (COVID-19) pandemic. Their uptake among healthcare providers was significant, including among general practitioners and sexual health services. Here, we report people's experiences of accessing sexual and reproductive health (SRH)-related care via telehealth collected as part of a survey exploring the impact of COVID on SRH health. Methods. This study utilises qualitative data from two online surveys conducted in 2020. Surveys were advertised through social media and professional and personal networks. Anyone aged ≥18 years and living in Australia was eligible to participate. Respondents were asked whether they accessed care for their SRH via telehealth. A free-text question asking for further detail about their experience was analysed using content analysis. Results. A total of 114/1070 respondents (10.7%) accessed healthcare services via telehealth for SRH-related reasons within the previous 4 weeks. Three themes were identified from 78 free-text comments: (1) accessibility and convenience of telehealth; (2) appropriateness of telehealth for SRH issues; and (3) connecting and communicating with clinicians via telehealth. Respondents had a wide range of experiences. Telehealth improved access to services for some participants, and it was appropriate for some, but not all SRH issues. Difficulties connecting with clinicians on both an interpersonal and technical level was a key barrier to a satisfactory patient experience. Conclusions. Telehealth can offer a viable alternative to face-to-face care, providing patients can overcome key connection and communication barriers.

Moving Toward Online-Based Sexually Transmitted Infection Testing and Treatment Services for Young People: Who Will Use It and What Do They Want?

“…Although the distribution of participants was similar to national averages for several sociodemographic characteristics (Aboriginal and Torres Strait Islander identity, rural residence, CALD), 35 we had an overrepresentation of sexually and gender diverse individuals and underrepresentation of heterosexual men and individuals with diploma-level education, which may limit applicability to these groups. However, recent surveys of Australian young adults are finding similarly high representation of sexually and gender-diverse individuals, potentially indicating population changes in identity among young people 36,37 . Furthermore, we used hypothetical scenarios to ask about preferences and included those with and without prior testing experience; however, the findings remain broadly consistent during subanalysis of those with previous testing experience.…”

“…However, recent surveys of Australian young adults are finding similarly high representation of sexually and gender-diverse individuals, potentially indicating population changes in identity among young people. 36,37 Furthermore, we used hypothetical scenarios to ask about preferences and included those with and without prior testing experience; however, the findings remain broadly consistent during subanalysis of those with previous testing experience. Because multinomial analysis compares 2 or more categories against a referent category, our analysis compares various alternatives against the current standard of service delivery (referent category).…”

Effect of COVID-19 pandemic restrictions on chlamydia and gonorrhoea notifications and testing in Queensland, Australia: an interrupted time series analysis

“…From a survey of 1058 Australians younger than 30 years of age, 262 (24.8%) responded that they delayed seeking sexual or reproductive health services during the pandemic due to concerns about contracting COVID-19 13. Australian respondents of another online survey reported ‘difficulties connecting with clinicians’ as a barrier to accessing sexual health services via telehealth during the pandemic 14. Most people will not experience symptoms with a chlamydia infection5 and the changed practices for asymptomatic testing likely contributed to the immediate decline in notifications and testing.…”

“…13 Australian respondents of another online survey reported 'difficulties connecting with clinicians' as a barrier to accessing sexual health services via telehealth during the pandemic. 14 Most people will not experience symptoms with a chlamydia infection 5 and the changed practices for asymptomatic testing likely contributed to the immediate decline in notifications and testing. The increased chlamydia notification to test ratio in April and May 2020 could also be explained by a shift in testing practices to symptomatic testing.…”

STI pathogens in the oropharynx: update on screening and treatment

“…Although some guidelines consider screening oropharyngeal infections based on risk, it is sometimes not practical as the risk for oropharyngeal infections (e.g. kissing and oral-genital sex) is often not collected and individuals may not feel comfortable discussing this with healthcare providers outside STI clinics [98]. A few STI clinics have changed their policy to include selective oropharyngeal STI screening in women and heterosexual men [99,100,101 ▪ ,102,103 ▪ ,104].…”