Chlamydia and HIV testing, contraception advice, and free condoms offered in general practice: a qualitative interview study of young adults’ perceptions of this initiative

Abstract

BackgroundOpportunistic chlamydia screening is actively encouraged in English general practices. Based on recent policy changes, Public Health England piloted 3Cs and HIV in 2013–2014, integrating the offer of chlamydia testing with providing condoms, contraceptive information, and HIV testing (referred to as 3Cs and HIV) according to national guidelines.AimTo determine young adults’ opinions of receiving a broader sexual health offer of 3Cs and HIV at their GP practice.Design and settingQualitative interviews were conducted in a general practice setting in England between March and June 2013.MethodThirty interviews were conducted with nine male and 21 female patients aged 16–24 years, immediately before or after a routine practice attendance. Data were transcribed verbatim and analysed using a thematic framework.ResultsParticipants indicated that the method of testing, timing, and the way the staff member approached the topic were important aspects to patients being offered 3Cs and HIV. Participants displayed a clear preference for 3Cs and HIV to be offered at the GP practice over other sexual health service providers. Participants highlighted convenience of the practice, assurance of confidentiality, and that the sexual health discussion was appropriate and routine. Barriers identified for patients were embarrassment, unease, lack of time, religion, and patients believing that certain patients could take offence. Suggested facilitators include raising awareness, reassuring confidentiality, and ensuring the offer is made in a professional and non-judgemental way at the end of the consultation.ConclusionGeneral practice staff should facilitate patients’ preferences by ensuring that 3Cs and HIV testing services are made available at their surgery and offered to appropriate patients in a non-judgemental way.

Management of chlamydia and gonorrhoea infections diagnosed in primary care using a centralised nurse-led telephone-based service: mixed methods evaluation

“…Primary care can play an important role in opportunistic testing of at-risk individuals for chlamydia and gonorrhoea. Patients in our study valued consulting primary care for STIs in line with previous research (30), as GUM clinics may remain a stigmatised service for some (31). However, our ndings suggest opportunities may continue to be missed to diagnoses STIs in primary care,…”

Management of chlamydia and gonorrhoea infections diagnosed in primary care using a centralised nurse-led telephone-based service: mixed methods evaluation

“…Primary care can play an important role in opportunistic testing of at-risk individuals for chlamydia and gonorrhoea. Patients in our study valued consulting primary care for STIs in line with previous research (30), as GUM clinics may remain a stigmatised service for some (31). However, our ndings suggest opportunities to diagnoses STIs in primary care may continue to be missed ,…”

Application of the COM-B model to barriers and facilitators to chlamydia testing in general practice for young people and primary care practitioners: a systematic review

“…4 ) were identified at patient, provider, and service level (i.e., factors stemming from the broader healthcare system), with some factors spanning all three levels. Most studies did not use any theory, only seven studies used any behavioural theory; six used the Theory of Planned Behaviour [ 41 , 48 , 50 , 66 , 73 , 75 ] and one used Normalisation Process Theory [ 70 ]. Some studies were qualitative evaluations of trials that had used theory for intervention development [ 48 , 70 , 75 ], others used theory to guide interview questions and questionnaires [ 41 , 66 , 73 ] or provide a framework for results [ 50 , 70 ].…”

“…Most studies did not use any theory, only seven studies used any behavioural theory; six used the Theory of Planned Behaviour [ 41 , 48 , 50 , 66 , 73 , 75 ] and one used Normalisation Process Theory [ 70 ]. Some studies were qualitative evaluations of trials that had used theory for intervention development [ 48 , 70 , 75 ], others used theory to guide interview questions and questionnaires [ 41 , 66 , 73 ] or provide a framework for results [ 50 , 70 ]. When judged against the CASP criteria, the majority of studies were methodologically sound, except three [ 44 , 46 , 71 ] which lacked detail on several areas (e.g., recruitment strategies, rigour of data analysis).…”

“…Forgetfulness [ 41 , 48 , 75 ]. While young people expressed enthusiasm for self-sampling, forgetting to return samples was reported as a barrier.…”