Notification of STI test results by text messaging: Why do patients refuse? Cross-sectional study in a Parisian sexual health centre

Text messaging has been used to notify patients of results after sexually transmitted infection (STI) testing. This study aimed to characterise the population who refused notification of results by short message services (SMS) and to explore their reasons for refusing. From January to August 2018, 1180 patients coming for STI testing in a Parisian sexual health centre were offered SMS notification of their results, completed a self-administered questionnaire and were included in the study. Factors associated with refusal of SMS notification were explored using logistic regression models. Reasons for refusal were analysed following a qualitative content analysis methodology. In the study population, 7.3% [95% CI 5.8–8.8] of patients refused SMS notification. In the multivariate logistic regression model, male gender and older age were associated with refusal, as were non-French nationality, having forgone health care for economic reasons and being unemployed. Qualitative analysis showed that preferring face-to-face medical contact (32%) and anxiety about the test result (29%) were the main reasons given by patients for refusal. Socially disadvantaged patients may have more limited access to technology and be less at ease using it in a health context. Preference for face-to-face medical contact may reflect the need for human support in vulnerable populations.

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Integrated community-based sexual health services for young people in urban areas: are we meeting the needs of the local community?

International Journal of STD & AIDS ◽

10.1258/ijsa.2008.008055 ◽

2008 ◽

Vol 19 (10) ◽

pp. 713-714 ◽

Cited By ~ 6

Author(s):

K M Forbes ◽

N Rahman ◽

S Mccrae ◽

I Reeves

Keyword(s):

Health Services ◽

Sexual Health ◽

Urban Areas ◽

Local Community ◽

Local Population ◽

Nucleic Acid Amplification ◽

Community Based ◽

Transmitted Infection ◽

Sti Testing ◽

Hiv Test

Community-based sexual health services (SHS) are intended to improve access for people who may have difficulty attending traditional genitourinary medicine clinics. The objective of this study was to review uptake of sexually transmitted infection (STI) testing in an outreach clinic for those under 25 in an area where Black and minority ethnic groups comprise the majority of the local population. A retrospective case-notes review was undertaken of those attending. Standards were that Fraser guidelines should be completed in all under 16-year-old and all clients should be offered STI testing, HIV testing and contraception (if applicable) in accordance with local standards. One hundred and seventeen clients attended. Ten percent self-reported ethnicity was Asian. Thirty-six (31%) clients tested for chlamydia. Thirty (26%) had an HIV test. Five (14% of those tested) had a positive nucleic acid amplification test for chlamydia. Five (13%) of those requesting long term contraception had STI testing. This service has successfully improved access to STI screening. However, there may have been missed opportunities to offer tests in those requesting contraception. Under-representation of those of non-white ethnicity suggests access to SHS may be a particular problem and further work is required to improve the sexual health of the local community.

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College students’ preferences for information on self-initiated sexually transmitted infection testing

Health Education Journal ◽

10.1177/0017896920959690 ◽

2020 ◽

pp. 001789692095969

Author(s):

Oluwamuyiwa Winifred Adebayo ◽

Jocelyn C Anderson ◽

Britney M Wardecker

Keyword(s):

College Students ◽

Sexually Transmitted Infection ◽

Qualitative Content Analysis ◽

Low Cost ◽

Transmitted Disease ◽

Structured Interview ◽

Sexual History ◽

Transmitted Infection ◽

Sexually Transmitted ◽

Sti Testing

Objective: The purpose of this study was to identify preferences for content, method of delivery and frequency of information to encourage self-initiated sexually transmitted infection (STI) testing. Design: Qualitative study involving individual in-depth interviews with 35 college students aged 18–24 years. Setting: A university in Central Pennsylvania, USA. Method: Data were collected using a demographic and sexual history questionnaire, Sexually Transmitted Disease Knowledge Questionnaire and a semi-structured interview guide. Transcribed interviews were analysed using qualitative content analysis. Results: Findings from the study document STI testing information preferences as they relate to self-initiated testing. The majority of participants preferred receiving STI testing information through email. Themes within their accounts included Actionable Information Content, Frequently Accessed Delivery Method, and Routine STI Testing Information. Conclusion: The high incidence of STIs among US college students is an indication of the need to increase diagnosis and treatment to reduce transmission. Study findings have implications for the development and evaluation of low-cost interventions to improve the uptake of STI testing and reduce STI burden among college students.

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Safeguarding outcomes of 16 and 17-year-old service users of Sexual Health London (SHL.uk), a pan-London online sexual health service

International Journal of STD & AIDS ◽

10.1177/0956462420933462 ◽

2020 ◽

Vol 31 (14) ◽

pp. 1373-1379

Author(s):

Sara Day ◽

Ryan Kinsella ◽

Sophie Jones ◽

Victoria Tittle ◽

Tara Suchak ◽

...

Keyword(s):

Risk Assessment ◽

Sexual Health ◽

Social Services ◽

Child Protection ◽

Transmitted Infection ◽

Sexually Transmitted ◽

Health Clinics ◽

Sti Testing ◽

Sexual Health Service ◽

Sexual Health Clinics

Guidance around how to safeguard young people using online sexual health services (e-SHSs) is limited. Sexual Health London (SHL.uk) is an e-SHS, integrated with London’s sexual health clinics (SHCs), offering users aged 16 years and above sexually transmitted infection (STI) testing. For a safeguarding risk assessment, under 18s must complete a safeguarding e-triage, and any concern raised results in a ‘call back’ (CB) by the SHL.uk team. The safeguarding outcomes of CBs between 8 January 2018 and 18 September 2018 were reviewed; 261/454 (57.5%) users never triggered a CB on their e-triage (non-CB group) and 193/454 (42.5%) users triggered one or more CB(s) (CB group). Safeguarding concerns disclosed predominantly related to drug/alcohol use and partner's age imbalance. Successful telephonic risk assessment took place in 84.5% CB cases. Safeguarding outcomes comprised referrals to: SHC in 35.5%; child protection team in 8.5%; social services in 7%. STI positivity was 16.4% and 15.2% in the CB and non-CB groups, respectively. Although a high number of safeguarding triggers were disclosed, only a small proportion warranted referral for further support/intervention. Using e-triage with telephony support to screen and safeguard adolescents accessing an e-SHS was acceptable to users and enabled their clinical and safeguarding needs to be safely met. e-SHS integration within a network of SHCs further supported this model.

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Fuckbuddy partnerships among men who have sex with men – a marker of sexually transmitted infection risk

International Journal of STD & AIDS ◽

10.1177/0956462417717647 ◽

2017 ◽

Vol 29 (1) ◽

pp. 44-50 ◽

Cited By ~ 2

Author(s):

Vincent J Cornelisse ◽

Christopher K Fairley ◽

Tiffany Phillips ◽

Sandra Walker ◽

Eric PF Chow

Keyword(s):

Sexual Health ◽

Health Centre ◽

Romantic Attachment ◽

Sexual Partners ◽

Health Clinic ◽

Transmitted Infection ◽

Sexually Transmitted ◽

Hiv Prevention Strategies ◽

Sex With Men ◽

Exposure Prophylaxis

‘Fuckbuddies’ are a type of regular sexual partner with whom men have ongoing sexual contact, generally in the absence of romantic attachment. We surveyed 989 men who have sex with men (MSM) at the Melbourne Sexual Health Centre, Australia, with the aim of determining the frequency of ‘fuckbuddy’ partnerships among sexual health clinic attendees and assessing their sexual risk. The majority (60%) of 1139 regular partnerships were described as ‘fuckbuddies’. Most MSM (63%) with a ‘fuckbuddy’ had multiple ‘fuckbuddies’. MSM with ‘fuckbuddies’ were more likely to also have casual sexual partners (odds ratio [OR] 5.7; 95% confidence interval 3.6–8.9) and had more casual sexual partners (median of 4 versus 1, p < 0.001) and more rectal chlamydia (12.4% versus 5.7%; adjusted OR 2.3; p < 0.05) than MSM without ‘fuckbuddies’, and this risk persisted after adjusting for total numbers of sexual partners. Our findings suggest that patients with ‘fuckbuddies’ are at particular risk of sexually transmitted infections. We argue that clinicians should specifically ask about ‘fuckbuddy’ partnerships as part of their risk assessment during patient interviews, as these patients may benefit from HIV prevention strategies such as pre-exposure prophylaxis (PrEP).

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Demand for sexual health services during the Olympic Games: both sides of the Sherman effect

International Journal of STD & AIDS ◽

10.1258/095646203321605495 ◽

2003 ◽

Vol 14 (5) ◽

pp. 307-308 ◽

Cited By ~ 6

Author(s):

Anna M McNulty ◽

Richard Rohrsheim ◽

Basil Donovan

Keyword(s):

Sexual Health ◽

Olympic Games ◽

Health Centre ◽

Care Utilization ◽

Chi Square ◽

Transmitted Infection ◽

Sexually Transmitted ◽

Centre Database ◽

The Impact ◽

The Olympic Games

To determine the impact of the Olympic Games the Sydney Sexual Health Centre database was accessed for demographic, health care utilization, and morbidity variables for two periods of interest: 15-29 September 2000 (the 'Olympic period'), and 1-30 September 1999 ('1999 comparison period'). Differences were tested by chi-square statistics and by calculation of odds ratios (ORs) using SPSS. During the Olympic period twice as many of the new patients had arrived in Australia that year (35% c.f. 18%: OR 2.46, 95% CI 1.49-4.05, P=0.0002). Per attendance the proportion with symptoms or a known sexually transmitted infection (STI) contact was higher during the Games (29% c.f. 16% OR 1.67, 95% CI 1.1.27-2.21, P=0.0002) and there was a marginally higher yield of bacterial STIs (6% c.f. 3%: OR 1.83, 95% CI 1.06-3.13 P=0.03). The normal clinic population was replaced by an increased proportion of symptomatic patients who were recent arrivals in Australia.

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Clients’ preferred methods of obtaining sexually transmissable infection or HIV results from Sydney Sexual Health Centre

Sexual Health ◽

10.1071/sh12062 ◽

2013 ◽

Vol 10 (1) ◽

pp. 91 ◽

Cited By ~ 10

Author(s):

Lynne Martin ◽

Vickie Knight ◽

Phillip J. Read ◽

Anna McNulty

Keyword(s):

Sexual Health ◽

Text Messaging ◽

Health Centre ◽

Text Messages ◽

Phone Call ◽

Short Message ◽

Test Results ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Message Service

Given the documented benefits of using text messaging (short message service; SMS), the internet and email to deliver sexually transmissible infection (STI) test results, including high acceptability among clients, Sydney Sexual Health Centre (SSHC) aimed to identify which methods our clients preferred for receiving their results, using a cross-sectional survey. There was a preference for SMS (32%) for negative STI results, and for SMS (27%), phone call (27%) and in-person (26%) for negative HIV results. An in-person preference was shown for receiving positive STI results (40%) and positive HIV results (56%, P < 0.001). While many clients would prefer to receive STI test results via text messages or phone call, many also still prefer a return visit, with this preference is dependent on the type and nature of the results. Our study suggests that, ideally, several options for obtaining results should be available.

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Sexually transmitted infection diagnoses and access to a sexual health service before and after the national lockdown for COVID-19 in Melbourne, Australia

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa536 ◽

2020 ◽

Author(s):

Eric P F Chow ◽

Jane S Hocking ◽

Jason J Ong ◽

Tiffany R Phillips ◽

Christopher K Fairey

Keyword(s):

Health Service ◽

Sexual Health ◽

Sexually Transmitted Infection ◽

Health Centre ◽

Transmitted Infection ◽

Sexually Transmitted ◽

Sexual Health Service ◽

Before And After ◽

Clinical Conditions ◽

The Impact

Abstract Background We aimed to examine the impact of lockdown on sexually transmitted infection (STI) diagnoses and access to a public sexual health service in the COVID-19 pandemic in Melbourne, Australia. Methods The operating hours of Melbourne Sexual Health Centre (MSHC) remained the same during the lockdown. We examined the number of consultations and STI at MSHC between January and June 2020 and stratified the data into pre-lockdown (3-February to 22-March), lockdown (23-March to 10-May) and post-lockdown (11-May to 28-June) with seven weeks in each period. Incidence rate ratio (IRR) and its 95% confidence intervals (CI) were estimated using Poisson regression models. Results The total number of consultations dropped from 7,818 in pre-lockdown to 4,652 during lockdown (IRR=0.60;95%CI:0.57-0.62) but increased to 5,347 in the post-lockdown period (IRR=1.15;95%CI:1.11-1.20). There was a 68% reduction in asymptomatic screening during lockdown (IRR=0.32; 95%CI:0.30-0.35) but it gradually increased in the post-lockdown period (IRR=1.59;95%CI:1.46-1.74). STI with milder symptoms showed a marked reduction, including non-gonococcal urethritis (IRR=0.60;95%CI:0.51-0.72), and candidiasis (IRR=0.61;95%CI:0.49-0.76) during lockdown compared with pre-lockdown. STI with more marked symptoms did not change significantly, including pelvic inflammatory disease (IRR=0.95;95%CI:0.61-1.47) and infectious syphilis (IRR=1.14;95%CI:0.73-1.77). There was no significant change in STI diagnoses in post-lockdown compared to lockdown. Conclusions The public appeared to be prioritising their attendance for sexual health services based on the urgency of their clinical conditions. This suggests that the effectiveness of clinical services in detecting, treating and preventing onward transmission of important symptomatic conditions is being mainly preserved despite large falls in absolute numbers of attendees.

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Distance as Explanatory Factor for Sexual Health Centre Utilisation in an Infrastructure-Rich Urban Area in the Netherlands: A Population-Based Multilevel Study

10.21203/rs.3.rs-106320/v1 ◽

2020 ◽

Author(s):

Denise E. Twisk ◽

Bram Meima ◽

Daan Nieboer ◽

Jan Hendrik Richardus ◽

Hannelore M. Götz

Keyword(s):

The Netherlands ◽

Sexual Health ◽

Health Centre ◽

Multilevel Modelling ◽

Population Based ◽

Travel Distance ◽

Postal Code ◽

Large Area ◽

Sti Testing ◽

Area Variation

Abstract BackgroundThe sole sexual health centre (SHC) in the greater Rotterdam area, the Netherlands, is instrumental in finding people unaware of their STI/HIV status. We hypothesized that travel distance to the SHC is inversely associated with SHC utilisation. Insight in area-specific utilisation is needed for potential new outreach policies to enhance STI testing. MethodsThe study population consists of all residents aged 15 to 45 years in the greater Rotterdam area (2015-2017). We linked SHC consultation data from STI tested heterosexual clients to the population registry. The association between SHC utilisation and distance was investigated by multilevel modelling, adjusting for sociodemographic and area-specific determinants. The data was also stratified by age (aged below 25) and migratory background (non-Western), since SHC triage may affect their utilisation. We used straight-line distance between the centroid of the postal code area and SHC address as a proxy for travel distance. ResultsWe found large area variation in SHC utilisation (ranged from 1.13 to 48.76 per 1,000 residents). Both individual and area level determinants determine utilisation. Travel distance explained most area variation and was inversely associated with SHC utilisation when adjusted for other sociodemographic and area-specific determinants (odds ratio [OR] per kilometre: 0.95; 95% CI: 0.93-0.96). Similar results were obtained for residents aged below 25 (OR: 0.95; 95% CI: 0.94-0.96), but not for non-Western residents (OR: 0.99; 95% CI: 0.99-1.00). ConclusionLiving further away from the sole SHC in the greater Rotterdam area decreases utilisation. This provides evidence for local policy to enhance STI testing, for example by offering STI testing services closer to the population.

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Associations between oral sex practices and frequent mouthwash use in men who have sex with men: implications for gonorrhoea prevention

Sexual Health ◽

10.1071/sh18131 ◽

2019 ◽

Vol 16 (5) ◽

pp. 473 ◽

Cited By ~ 1

Author(s):

Tiffany Phillips ◽

Christopher K. Fairley ◽

Sandra Walker ◽

Eric P. F. Chow

Keyword(s):

Logistic Regression ◽

Sexual Health ◽

Prevention And Control ◽

Health Centre ◽

Final Analysis ◽

Oral Sex ◽

Male Partners ◽

Sex With Men ◽

And Control ◽

Sex Practices

Background Rates of gonorrhoea continue to rise among men who have sex with men (MSM) in Australia and worldwide. Recently, it has been proposed that oropharyngeal gonorrhoea may play a role in its onward transmission and that mouthwash use may be an effective intervention for gonorrhoea prevention and control. The objective of this study was to determine the association between specific oral sex practices and frequency of mouthwash use. Methods: A questionnaire-based study was conducted among MSM attending the Melbourne Sexual Health Centre in Australia from March to September 2015. Logistic regression was performed to examine the association between frequent mouthwash use (i.e. daily or weekly mouthwash use) and four oral sex practices (tongue kissing, receptive fellatio with or without ejaculation, and insertive rimming) among MSM. Results: Of the 918 MSM included in the final analysis, 490 men (53.4%) were frequent mouthwash users. Participants aged 24–34 years were 2.13-fold (95% CI 1.52–2.98) and those ≥35 years were 2.64-fold (95% CI 1.83–3.83) more likely to use mouthwash frequently than those aged ≤24 years. The most common oral sex practice was tongue kissing (n=874; 95.2%), followed by receptive fellatio without ejaculation (n=839; 91.4%), receptive fellatio with ejaculation (n=610; 66.5%), then insertive rimming (n=356; 38.8%). No significant association was found between frequent mouthwash use and tongue kissing, receptive fellatio with or without ejaculation, or insertive rimming with regular or casual male partners in the previous 3 months. Conclusions: Younger MSM are less likely to use mouthwash. There is no association between engaging in oral sex practices and frequent mouthwash use among MSM.

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Sexual assault reporting amongst users of online sexual health services

International Journal of STD & AIDS ◽

10.1177/0956462420963940 ◽

2020 ◽

pp. 095646242096394

Author(s):

Sara Day ◽

Gurmit Jagjit Singh ◽

Sophie Jones ◽

Ryan Kinsella

Keyword(s):

Sexual Assault ◽

Health Services ◽

Sexual Health ◽

Reporting Rate ◽

High Response Rate ◽

Transmitted Infection ◽

Health Clinics ◽

Sti Testing ◽

Sexual Health Clinics ◽

Sexual Assault Reporting

Sexual assault (SA) survivors often attend sexual health clinics (SHC) for care relating to their assault. Reported rates of SA amongst SHC attendees can be high. Online sexual health services are becoming increasingly popular. Sexual Health London (SHL) is a large online sexual transmitted infection (STI) screening service. Between 1.1.20– 8.2.20, 0.5% (242/45841) (54% female, 45.6% male) of adults disclosed a recent SA when ordering an online STI testing kit. 79% (192/242) users engaged in a call back discussion initiated by the SHL team: 45% (87/192) users confirmed a SA had occurred and 53% (101/242) users denied an assault (particularly men) stating they had reported this in error. 18% (16/87) users had already reported their SA to the police/sexual assault centre, and one user accepted an onward referral. This study found a low reporting rate of SA amongst SHL users, but despite a high response rate to call backs, >50% cited they reported in error, 25% (22/87) didn’t want to discuss their SA and few accepted onward referrals. Using e-triage to screen for SA followed by service-initiated telephonic support to everyone who discloses, may not be acceptable or offer utility to all. Further evaluation of ways to engage these individuals is required.

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