Understanding patient choices for attending sexually transmitted infection testing services: a qualitative study

Abstract

ObjectivesTo establish which aspects of sexually transmitted infection (STI) testing services are important to STI testing service users.Methods10 focus groups consisting of previous or existing users of STI testing services were conducted in community settings in the south east of England. Groups were quota sampled based on age, gender and sexual orientation. Data were analysed using Framework Analysis.Results65 respondents (58% men) participated. Perceived expertise of staff was the key reason for attendance at genitourinary medicine services rather than general practice. Although some respondents voiced a willingness to test for STIs within general practice, the apparent limited range of tests available in general practice and the perceived lack of expertise around sexual health appeared to discourage attendance at general practice. The decision of where to test for STIs was also influenced by past experience of testing, existing relationships with general practice, method of receiving test results and whether the patient had other medical conditions such as HIV.ConclusionsNo one type of STI testing service is suitable for all patients. This is recognised by policymakers, and it now requires commissioners and providers to make services outside of genitourinary medicine clinics more acceptable and attractive to patients, in particular to address the perceived lack of expertise and limited range of STIs tests available at alternative testing sites.

Identifying and understanding barriers to sexually transmissible infection testing among young people

“…[19,20] However, there is also evidence that no one type of STI testing service is suitable to all patients: although some people identify general practitioners (GPs) as a preferred site for testing because it could reduce stigma and shame, many others prefer testing in specialist sexual health services because they appreciate the specialist expertise of staff. [23] The survey data suggest that regardless of where STI testing services are located, increased ease of access may increase testing rates, especially given that low perceived susceptibility results in low motivation for testing.…”

“…[21] In other behavioural domains, there is evidence that encouraging people to specify implementation intentions increases the likelihood of health behaviours such as cervical screening. [22,23] In the context of ST testing, it may be useful to encourage young people to formulate implementation intentions that address perceived barriers to testing.…”

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

“…services at STI clinics (e.g., anonymous and point-of-care testing); they had perceptions of specialized knowledge at STI clinics (compared to primary care or walk-in clinics); they reported not wanting to discuss their sexual practices with primary care practitioners; and they described being referred to STI clinics for second opinions or specialized treatments (Balfe et al, 2009;Llewellyn et al, 2012;Koester et al, 2012;Miners et al, 2012;Sutcliffe et al, 2011).…”

Overview of a gay men’s STI/HIV testing clinic in Ottawa: Clinical operations and outcomes

“…Rationales included: same-day access through walk-in services; perceived comprehensiveness of testing and specialized knowledge; desires not to discuss sexual practices with general practitioners (GPs); availability of anonymous or point-of-care testing; and referral, e.g., for a second opinion or specialized treatment. [22][23][24] In one study, obtaining testing for all STIs/HIV (comprehensiveness) and perceived specialized knowledge at STI clinics resulted in some persons who first sought care with their GPs subsequently visiting STI/HIV clinics to obtain the testing they felt their GPs missed. 25 In this study, STI/HIV testing with GPs resulted in duplicate service utilization.…”