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.
Highlights
Chlamydia is the most common sexually transmitted infection in Europe and rates among young people are increasing.[1]
Participants displayed a clear preference for 3Cs and HIV to be offered at the GP practice over other sexual health service providers
General 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
Summary
Chlamydia is the most common sexually transmitted infection in Europe and rates among young people are increasing.[1] Testing those at higher risk of chlamydia infection and treating them effectively could reduce sequelae and onward transmission. General practice provides an ideal venue for opportunistic chlamydia testing when young people visit their GP practice.[2] GPs have performed a smaller proportion of all chlamydia tests undertaken compared with other sexual health providers (genitourinary medicine and sexual and reproductive health care [GUM and SRH])[3] despite research showing that primary care can provide an effective, popular alternative to GUM and SRH clinics.[4,5] National guidance in England produced by the National Institute for Health and Care Excellence (NICE) and the British HIV Association et al 6 considers that in areas of high HIV prevalence (two or more in 1000 population), an HIV test should be offered when a patient registers at a practice or a patient has an indicator illness.[6] optout HIV testing is regarded as appropriate and acceptable when offered to patients registering at a practice.[7]. 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
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