Where do sexually active female London students go to access healthcare? Evidence from the POPI (Prevention of Pelvic Infection) chlamydia screening trial

Green, Ruth; Kerry, Sally; Reid, Fiona; Hay, Phillip; Kerry, Sally; Aghaizu, Adamma; Oakeshott, Pippa

doi:10.1136/sextrans-2011-050452

Cited by 8 publications

(11 citation statements)

References 9 publications

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“…In the UK, during follow-up of a chlamydia screening study, around four-fifths of women in the study had paid at least one visit to the GP in a 12-month period, but only 14% had visited a specialised genitourinary medicine (GUM) clinic. With increased STI risk, that is, the number of reported sexual partners, women were more likely to have visited a GUM clinic 16. Opportunistic STI testing at the GP is an important tool in STI control in several countries (USA, Sweden and the UK), and could also work in the Netherlands, since annually about 78% of Dutch people visit their GP 17.…”

Section: Discussionmentioning

confidence: 99%

Consultations for sexually transmitted infections in the general practice in the Netherlands: an opportunity to improve STI/HIV testing

et al. 2013

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ObjectivesIn the Netherlands, sexually transmitted infection (STI) care is provided by general practitioners (GPs) as well as by specialised STI centres. Consultations at the STI centres are monitored extensively, but data from the general practice are limited. This study aimed to examine STI consultations in the general practice.DesignProspective observational patient survey.SettingGeneral practices within the nationally representative Dutch Sentinel GP network (n=125 000 patient population), 2008–2011.Outcome measuresGPs were asked to fill out a questionnaire at each STI consultation addressing demographics, sexual behaviour and laboratory test results. Patient population, testing practices and test positivity are reported.ParticipantsPatients attending a consultation concerning an STI/HIV-related issue.ResultsOverall, 1 in 250 patients/year consulted their GP for STI/HIV-related problems. Consultations were concentrated among young heterosexuals of Dutch origin. Laboratory testing was requested for 83.3% of consultations. Overall consult positivity was 33.4%, highest for chlamydia (14.7%), condylomata (8.7%) and herpes (6.4%). 32 of 706 positive patients (4.5%) were diagnosed with multiple infections. Main high-risk groups were patients who were <25 years old (for chlamydia), >25 years old (syphilis), men who have sex with men (MSM; for gonorrhoea/syphilis/HIV) or having symptoms (for any STI). Adherence to guideline-recommendations to test for multiple STI among high-risk groups varied from 15% to 75%.ConclusionsThis study found that characteristics of patients who consulted a GP for STIs were comparable to those of patients attending STI centres regarding age and ethnicity; however, consultations of high-risk groups like MSM and (clients of) commercial sex workers were reported less by the general practice. Where the STI centres routinely test all patients for chlamydia/syphilis/HIV/gonorrhoea, GPs tested more selectively, even more restricted than advised by GP guidelines. Test positivity was, therefore, higher in general practice, although it is unknown how many STIs are missed (particularly among high-risk groups). Opportunities for a more proactive role in STI/HIV testing at general practices in line with current guidelines should be explored.

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Section: Discussionmentioning

confidence: 99%

Consultations for sexually transmitted infections in the general practice in the Netherlands: an opportunity to improve STI/HIV testing

et al. 2013

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“…This reflects recent research with young people in the UK, which has revealed willingness to undertake STI self-testing, with general practice the most popular test collection point. [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.…”

Section: Discussionmentioning

confidence: 99%

“…Other possible avenues for interventions include public health messages for the general population, targeted campaigns, and one-to-one discussions in general practice. [17][18][19][20] Although intentions have been shown to predict behaviour, there is not always a direct link between the two. [3][4][5][6] To increase rates of STI testing, it is not enough to simply strengthen intentions: people must also act on these intentions.…”

Section: Discussionmentioning

confidence: 99%

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

Visser

O'Neill

2013

Sex. Health

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(2013) Identifying and understanding barriers to sexually transmissible infection testing among young people. Sexual Health, 10. pp. 553-558. ISSN 1448-5028 This version is available from Sussex Research Online: http://sro.sussex.ac.uk/49734/ This document is made available in accordance with publisher policies and may differ from the published version or from the version of record. If you wish to cite this item you are advised to consult the publisher's version. Please see the URL above for details on accessing the published version. Copyright and reuse:Sussex Research Online is a digital repository of the research output of the University.Copyright and all moral rights to the version of the paper presented here belong to the individual author(s) and/or other copyright owners. To the extent reasonable and practicable, the material made available in SRO has been checked for eligibility before being made available.Copies of full text items generally can be reproduced, displayed or performed and given to third parties in any format or medium for personal research or study, educational, or not-for-profit purposes without prior permission or charge, provided that the authors, title and full bibliographic details are credited, a hyperlink and/or URL is given for the original metadata page and the content is not changed in any way.

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“…A 2001 qualitative study of female GUM clinic attenders by DixonWoods et al identified five prompts for presenting for testing: own symptoms, partner's symptoms, partner's behaviour, own behaviour and health maintenance, including being traced as a contact 12. These prompts are similar to the responses given in the present study.Although most women attend primary care each year, general practitioners may miss opportunities for encouraging testing, even in women at higher risk 13. …”

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confidence: 99%

Which sexually active female students get themselves tested for Chlamydia trachomatis? A cohort study

et al. 2015

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Using data from the Prevention of Pelvic Infection (POPI) chlamydia screening trial, we compared the characteristics of female students who did or did not get tested for chlamydia outside the trial during 12 months' follow-up. Of the 2529 women in the trial, we excluded 68 chlamydia positives in the intervention group who were referred for treatment at baseline. Of the remaining 2461 women, 1980 (80%) answered the question about testing during follow-up on their 12 months' questionnaire and were included in the cohort. Of 1980 respondents, 529 (27%) reported having an independent chlamydia test, including 30 (48%) of 63 women with undiagnosed chlamydia at baseline. Predictors of testing included having undiagnosed chlamydia at baseline (adjusted odds ratio 2.44; 95% confidence interval 1.39-4.28), ≥2 sexual partners in the year prior to baseline (OR 1.99; 95% CI 1.60-2.48), history of sexually transmitted infection (1.63: 1.20-2.22); symptoms of pelvic discomfort, dyspareunia, abnormal vaginal discharge or inter-menstrual bleeding (1.38; 1.09-1.73); and black ethnicity (1.37, 1.06-1.76). Although more women with risk factors got tested, half of women with undiagnosed chlamydia did not get tested. To optimise detection of chlamydia, testing should be offered routinely.

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Where do sexually active female London students go to access healthcare? Evidence from the POPI (Prevention of Pelvic Infection) chlamydia screening trial

Abstract: This is the first UK study of healthcare attendance in multiethnic female students recruited outside healthcare settings. The high attendance in general practice may represent a valuable opportunity for screening for sexually transmitted infections.

Cited by 8 publications

References 9 publications

Consultations for sexually transmitted infections in the general practice in the Netherlands: an opportunity to improve STI/HIV testing

Consultations for sexually transmitted infections in the general practice in the Netherlands: an opportunity to improve STI/HIV testing

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

Which sexually active female students get themselves tested for Chlamydia trachomatis? A cohort study

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