Accessibility of sexual health services in teenage sexual health service users: local area geospatial analysis

Background: Australia has a widely dispersed network of public sexual health services that test large numbers of people from high prevalence populations for genital Chlamydia trachomatis infection. These populations include young sexually active heterosexuals, men who have sex with men, sex workers and Aboriginal and Torres Strait Islander people. The Australian Collaboration for Chlamydia Enhanced Sentinel Surveillance (ACCESS) Project was established to monitor chlamydia testing rates and positivity rates at a national level, which in turn will help interpret trends in chlamydia diagnoses reported through passive surveillance. The ACCESS Project is the first time that chlamydia-related data including priority population and testing denominators has been collated at a national level. The present paper reports on chlamydia testing and positivity rates in a sexual health service in the inner west of Sydney between 2004 and 2008 and compares these to published national data from the ACCESS Project in sexual health services. Methods: Chlamydia positivity and testing rates at an inner western Sydney sexual health service were compared with aggregate data from the ACCESS Project obtained from 14 sexual health services across Australia. Using a standardised extraction program, retrospective de-identified line-listed demographic and chlamydia testing data on all patients were extracted from patient management systems. Results: Over the 5-year period, 5145 new patients attended the inner-west sexual health service. Almost 66% had a chlamydia test at first visit and there was no significant difference in this testing rate when compared with the ACCESS Project national rate for sexual health services (67.0%; odds ratio [OR] 0.94, 95% confidence intervals 0.88–1.00). The testing rate increased over time from 61% in 2004 to 70% in 2008. There were 281 chlamydia diagnoses at this service, giving an overall chlamydia positivity rate of 9.3%, significantly higher than the ACCESS Project national rate of 8.2% (OR 1.16, 95% confidence intervals 1.02–1.32). Discussion: Testing rates were similar and positivity rates for Chlamydia trachomatis were higher in this sexual health service in Sydney than national trends.

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Involving service users in sexual health service development

Journal of Family Planning and Reproductive Health Care ◽

10.1783/147118905774480590 ◽

2005 ◽

Vol 31 (4) ◽

pp. 281-284 ◽

Cited By ~ 8

Author(s):

P. Baraitser ◽

V. Pearce ◽

G. Blake ◽

K. Collander-Brown ◽

A. Ridley

Keyword(s):

Health Service ◽

Sexual Health ◽

Service Development ◽

Service Users ◽

Sexual Health Service ◽

Health Service Development

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Beyond the binary: sexual health outcomes of transgender and non-binary service users of an online sexual health service

International Journal of STD & AIDS ◽

10.1177/0956462420982830 ◽

2021 ◽

pp. 095646242098283

Author(s):

Sara Day ◽

Joanna Smith ◽

Sean Perera ◽

Sophie Jones ◽

Ryan Kinsella

Keyword(s):

Health Service ◽

Sexual Health ◽

Health Outcomes ◽

Unmet Need ◽

P Value ◽

Service Users ◽

Healthcare Needs ◽

Sexual Health Service ◽

Hiv Test ◽

Group Sex

Sexual health data on transgender and non-binary (TNB) people in the United Kingdom are limited. TNB individuals experience significant socioeconomic and stigma-related disadvantages. Sexual health morbidity and unmet need is likely to be significant. We compared the sexual health outcomes of TNB and cisgender users of London’s online sexual health service. Of 119329 users that registered with the e-service between 30.4.19 and 31.12.19, 504 (0.42%) identified as TNB: 302 TNB users requested 463 kits. 78.4% (363/463) of kits were returned. 99.4% of dispatched kits included throat and rectal swabs for gonorrhoea and chlamydia testing. STI/HIV test positivity was: 5.5% syphilis, 4.8% chlamydia, 3.4% gonorrhoea and 0.7% HIV positive. HIV prevalence amongst TNB individuals was: 4.3%. 19.9% of TNB individuals engaged in chemsex, group sex, or fisting and were more likely to engage in sex work (95% CI 4.35-8.95, p-value <0.0001). 97.7% gave the service 4/5 or 5/5 star rating. We observed high positivity rates of HIV/STIs amongst TNB individuals and significant levels of high-risk sexual activity. Service users rated the service highly. Given TNB often have complex healthcare needs, some of which cannot be met entirely online, physical clinics must work collaboratively with e-services to support and protect this marginalised population.

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Do gay and bisexual men who conceal their same-sex behavior prefer different kinds of health services? Findings across four cities to inform client-centered HIV prevention in China

BMC Public Health ◽

10.1186/s12889-019-7990-8 ◽

2020 ◽

Vol 20 (1) ◽

Cited By ~ 2

Author(s):

Rong Fu ◽

Bryan A. Kutner ◽

Yumeng Wu ◽

Lu Xie ◽

Siyan Meng ◽

...

Keyword(s):

Health Service ◽

Health Services ◽

Sexual Health ◽

Health Clinic ◽

Sex Behavior ◽

Bisexual Men ◽

Same Sex ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Sexual Health Service

Abstract Background In China, addressing disparities in the HIV epidemic among men who have sex with men (MSM) requires targeted efforts to increase their engagement and retention in prevention. In an effort to advance MSM-friendly HIV services within China, and informed by community-based partnerships, we tested whether MSM who have ever versus never disclosed their same-sex behavior to healthcare providers (HCP) differ in sociodemographic and behavioral characteristics as well as the qualities of sexual health services each group would prefer to access. Methods We conducted a cross-sectional survey among HIV-negative MSM who went to MSM-focused voluntary counseling and testing clinics in four cities in China. The survey was anonymous and collected information on sociodemographic characteristics, testing behaviors, sexual-health related behavior, and sexual health service model preferences. Results Of 357 respondents, 68.1% participants had ever disclosed same-sex behavior to HCPs when seeking advice for sexual health. Younger age (aOR = 1.04; 95% CI: 1.01-1.08), and worry of HIV acquisition (aOR = 1.39; 95% CI: 1.05–1.84) were associated with higher odds of past disclosure. The availability of comprehensive sexual health services was one of the most valued characteristics of the ideal sexual health clinic. Those who ever disclosed and never disclosed differed significantly in their ranking of the importance of three out of ten dimensions: sexual health counseling services available (M = 3.99 vs. M = 3.65, p = .002), gay identity support available (M = 3.91 vs. M = 3.62, p = .016) and clinic collaborates with a gay CBO (M = 3.81 vs. M = 3.56, p = .036). Conclusions Our hypothesis that MSM who had disclosed versus never disclosed same-sex behavior would differ in the value they placed on different dimensions of sexual health service was partially borne out. As health authorities in China decide on implementation models for pre-exposure prophylaxis (PrEP) delivery and specifically within which institutions to integrate PrEP services, the preferences of target populations should be considered to develop comprehensive, patient-centric and LGBT-friendly services.

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Designing an intervention to improve sexual health service use among university undergraduate students: a mixed methods study guided by the behaviour change wheel

BMC Public Health ◽

10.1186/s12889-019-8059-4 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 1

Author(s):

Christine Cassidy ◽

Audrey Steenbeek ◽

Donald Langille ◽

Ruth Martin-Misener ◽

Janet Curran

Keyword(s):

Health Service ◽

Health Services ◽

Sexual Health ◽

Behaviour Change ◽

Undergraduate Students ◽

Service Use ◽

Intervention Strategies ◽

Behaviour Change Wheel ◽

Sexual Health Service ◽

University Undergraduate Students

Abstract Introduction University undergraduate students are within the population at highest risk for acquiring sexually transmitted infections, unplanned pregnancy, and other negative health outcomes. Despite the availability of sexual health services at university health centres, many students delay or avoid seeking care. In this study, we describe how the Behaviour Change Wheel was used as a systematic approach to design an intervention to improve sexual health service use among university undergraduate students. Methods This paper describes the intervention development phase of a three-phased, sequential explanatory mixed methods study. Phases one and two included a quantitative and qualitative study that aimed to better understand students’ use of sexual health services. In phase three, we followed the Behaviour Change Wheel to integrate the quantitative and qualitative findings and conduct stakeholder consultation meetings to select intervention strategies, including intervention functions and behaviour change techniques. Results Key linkages between opportunity and motivation were found to influence students’ access of sexual health services. Stakeholders identified six intervention functions (education, environmental restructuring, enablement, modelling, persuasion, and incentivization) and 15 behaviour change techniques (information about health consequences, information about social and environmental consequences, feedback on behaviour, feedback on outcomes of behaviour, prompts/cues, self-monitoring of behaviour, adding objects to the environment, goal setting, problem solving, action planning, restructuring the social environment, restructuring the physical environment, demonstration of the behaviour, social support, credible source) as relevant to include in a toolbox of intervention strategies to improve sexual health service use. Conclusions This study details the use of the Behaviour Change Wheel to develop an intervention aimed at improving university students’ use of sexual health services. The Behaviour Change Wheel provided a comprehensive framework for integrating multiple sources of data to inform the selection of intervention strategies. Stakeholders can use these strategies to design and implement sexual health service interventions that are feasible within the context of their health centre. Future research is needed to test the effectiveness of the strategies at changing university students’ sexual health behaviour.

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P203 HIV-testing African Service Users within a Newly Integrated Sexual Health Service - Our Experience

Sexually Transmitted Infections ◽

10.1136/sextrans-2016-052718.251 ◽

2016 ◽

Vol 92 (Suppl 1) ◽

pp. A87.2-A87 ◽

Cited By ~ 1

Author(s):

Joanna Bulman ◽

Deborah Goode ◽

Amy Evans

Keyword(s):

Health Service ◽

Sexual Health ◽

Hiv Testing ◽

Service Users ◽

Sexual Health Service

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Development of a Behavior Change Intervention to Improve Sexual Health Service Use Among University Undergraduate Students: Mixed Methods Study Protocol (Preprint)

10.2196/preprints.8326 ◽

2017 ◽

Author(s):

Christine Cassidy ◽

Audrey Steenbeek ◽

Donald Langille ◽

Ruth Martin-Misener ◽

Janet Curran

Keyword(s):

Health Service ◽

Health Services ◽

Sexual Health ◽

University Students ◽

Behavior Change ◽

Undergraduate Students ◽

Service Use ◽

Health Service Use ◽

Sexual Health Service ◽

University Undergraduate Students

BACKGROUND University students are at risk for acquiring sexually transmitted infections and suffering other negative health outcomes. Sexual health services offer preventive and treatment interventions that aim to reduce these infections and associated health consequences. However, university students often delay or avoid seeking sexual health services. An in-depth understanding of the factors that influence student use of sexual health services is needed to underpin effective sexual health interventions. OBJECTIVE In this study, we aim to design a behavior change intervention to address university undergraduate students’ use of sexual health services at two universities in Nova Scotia, Canada. METHODS This mixed methods study consists of three phases that follow a systematic approach to intervention design outlined in the Behaviour Change Wheel. In Phase 1, we examine patterns of sexual health service use among university students in Nova Scotia, Canada, using an existing dataset. In Phase 2, we identify the perceived barriers and enablers to students’ use of sexual health services. This will include focus groups with university undergraduate students, health care providers, and university administrators using a semistructured guide, informed by the Capability, Opportunity, Motivation-Behaviour Model and Theoretical Domains Framework. In Phase 3, we identify behavior change techniques and intervention components to develop a theory-based intervention to improve students’ use of sexual health services. RESULTS This study will be completed in March 2018. Results from each phase and the finalized intervention design will be reported in 2018. CONCLUSIONS Previous intervention research to improve university students’ use of sexual health services lacks a theoretical assessment of barriers. This study will employ a mixed methods research design to examine university students’ use of sexual health service and apply behavior change theory to design a theory- and evidence-based sexual health service intervention. Our approach will provide a comprehensive foundation to co-design a theory-based intervention with service users, health care providers, and administrators to improve sexual health service use among university students and ultimately improve their overall health and well-being.

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