‘Do it yourself’ sexual health care: the user experience

Baraitser, Paula; Brown, Kirsty Collander; Gleisner, Zachary; Pearce, Vikki; Kumar, Uday; Brady, Michael

doi:10.1071/sh10029

Cited by 13 publications

(20 citation statements)

References 10 publications

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“…Self-management of one's own reproductive health is becoming more popular; and improvement in the efficiency and delivery of sexual health care with a focus on innovation may popularise ‘Do it yourself’ sexual healthcare 17. Baraitser et al 18 have reported on the user experience for patients collecting their own samples, reporting that “clients were grateful for the service and preferred the autonomy, privacy and speed that their programme offered”. This type of individual-driven testing for self and home collection of specimens also has been postulated to be cost-effective as measured in several reports 19–22…”

Section: Discussionmentioning

confidence: 99%

Use of a risk quiz to predict infection for sexually transmitted infections: a retrospective analysis of acceptability and positivity

et al. 2015

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Background Individuals who are sexually active may want to make a decision as to whether they are at risk for having a sexually transmitted infection (STI) such as Chlamydia trachomatis, Neisseria gonorrhoeae and Trichomonas vaginalis. Our goal was to develop and evaluate a simple self-taken sexual risk quiz for participants, ordering an online STI self-collection test kit to determine whether the score predicted infection status. Methods As part of the IWantTheKit programme for home sample self-collection for STIs, 2010–2013, the programme asked male and female users to voluntarily take a risk quiz. The six-question quiz was about risk behaviour and included an age question. Data analyses were stratified by gender as determined a priori. Scores 0–10 were stratified into risk groups for each gender based on similar risk score-specific STI prevalence. Retrospective analyses were performed to assess whether risk group predicted aggregate STI positivity. Urogenital/rectal mailed samples were tested by nucleic acid amplification tests. Results More females (N=836) than males (N=558) provided voluntary risk scores. The percentage of eligible participants who submitted scores was 43.9% for both females and males. There was a higher STI infection rate in females (14.0%) than in males (7.0%) for having any STI (p<0.001). Multivariate logistic analysis for females, which controlled for age and race, demonstrated that a higher risk score group independently predicted risk for having an STI (OR of 2.2 for risk scores 5–7 and 4.2 OR for scores of 8–10). For males, the multivariate model, which controlled for race, indicated that no risk score group was associated having an STI. Conclusions Results of a participant’s own sexual risk quiz score independently predicted STI positivity for women, but not for men. Further study of this simple risk quiz is required.

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Section: Discussionmentioning

confidence: 99%

Use of a risk quiz to predict infection for sexually transmitted infections: a retrospective analysis of acceptability and positivity

et al. 2015

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“…Given the option of home pregnancy testing, many women do not come to clinics for pregnancy tests. (20) When women make the effort to seek pregnancy testing from a family planning clinic they deserve the added value that clinic staff can provide with the use of a three-item checklist.…”

Section: Discussionmentioning

confidence: 99%

A checklist approach to caring for women seeking pregnancy testing: Effects on contraceptive knowledge and use

et al. 2015

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Objective To assess how a checklist reminding clinicians to deliver a bundled intervention affects contraceptive knowledge and use 3 months after women seek walk-in pregnancy testing. Methods Pre-intervention, an inner-city family planning clinic provided unstructured care; during the intervention period, clinic staff used a checklist to ensure women received needed services. Women seeking walk-in pregnancy testing who wished to avoid pregnancy for at least 6 months were asked to complete surveys about their contraceptive knowledge and use immediately after and 3-months after visiting the study clinic. To assess the significance of changes over time, we used logistic regression models. Results Between January 2011 and May 2013, over 1500 women sought pregnancy testing from the study clinic; 323 completed surveys (95 pre-intervention and 228 during the intervention period). With this checklist intervention, participants were more likely to receive emergency contraception (EC) (22% vs. 5%, aOR=4.64, 95% CI 1.77-12.17), have an intrauterine device or implant placed at the time of their clinic visit (5% vs. 0%, p=0.02), or receive a contraceptive prescription (23% vs. 10%, p<0.001). Three months after visiting the study clinic, participants from the intervention period were more knowledgeable about intrauterine and subdermal contraception and were more likely to be using intrauterine, subdermal or injectable contraception (aOR=2.18, 95% CI 1.09-4.35). Conclusions Women seeking walk-in pregnancy testing appear more likely to receive EC and to have switched to a more effective form of birth control in 3 months following their visit when clinic staff used a 3-item checklist and provided scripted counseling. Implications A checklist reminding clinic staff to assess pregnancy intentions, provide scripted counseling about both emergency and highly-effective reversible contraception, and offer same-day contraceptive initiation to women seeking walk-in pregnancy testing appears to increase use of more effective contraception.

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“…However, it is not recommended for replacing clinic testing, but rather as a supplementary strategy 7. Furthermore, some service users prefer seeing a staff member20 and these pathways have been criticised due to the need for hepatitis B vaccination and safer sex promotion among MSM 21. The ability for referral to, or request to see, a qualified practitioner is therefore an important feature of our service.…”

Section: Discussionmentioning

confidence: 99%

How to do it: setting up an asymptomatic screening pathway for men who have sex with men

Cook

Lomax

2017

Sex Transm Infect

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Many STIs are known to disproportionately affect men who have sex with men (MSM) in the UK; therefore, regular asymptomatic screening that is easy to access is vital among this group. Asymptomatic screening pathways can reduce long clinic waits, which may encourage more people to attend for screening. We therefore developed and trialled an asymptomatic pathway for MSM within our service. This extended our previous pathway, which allowed asymptomatic service users to fill in a questionnaire and see a healthcare support worker, to include MSM, as it previously had not. The service has been implemented and rolled out successfully. We believe that this model for asymptomatic screening among MSM can reduce clinic visit duration. This should increase accessibility and also allow trained staff to manage more complex patients, while allowing for risk identification and health promotion among those MSM who may be at higher risk.

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‘Do it yourself’ sexual health care: the user experience

Abstract: Self-management is an acceptable option within sexual health services if informal support is available. Self-management options in clinical services could mean that 8% of clients at 6% of visits do not need to see a clinician, thus freeing up clinical capacity.

Cited by 13 publications

References 10 publications

Use of a risk quiz to predict infection for sexually transmitted infections: a retrospective analysis of acceptability and positivity

Use of a risk quiz to predict infection for sexually transmitted infections: a retrospective analysis of acceptability and positivity

A checklist approach to caring for women seeking pregnancy testing: Effects on contraceptive knowledge and use

How to do it: setting up an asymptomatic screening pathway for men who have sex with men

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