Provision Of Condoms Research Articles

Self-testing, communication and information technology to promote HIV diagnosis among young gay and other men who have sex with men (MSM) in Brazil.

Self-testing, communication and information technology to promote HIV diagnosis among young gay and other men who have sex with men (MSM) in Brazil.

Application of Bernoulli Process Model fitting the effect of intervention measures on sexual transmission among HIV sero-discordant couples

Objectives: To undersand the outcomes of major intervention measures on sexual transmission among HIV sero-discordant couples. Methods: Bernoulli Process Model was applied to model the major influencing factors of HIV transmission among HIV sero-discordant couples. The major influencing factors appeared as consistent condom use, antiretroviral therapy, frequency of sexual behavior. These parameters were from the HIV sero-discordant couples in 30 counties in 4 provinces (Guangxi Zhuang Autonomous Region, Yunnan Province, Xinjiang Uygur Autonomous Region and Henan provinces) from January 1, 2011 to December 31, 2012. According to the main factors, modeling-intervention strategies and measures on reduction HIV transmission among serodiscordant couples were formed. Results: Data from the present proportion of consistent condom use (85%) modeling and the coverage of antiretroviral treatment (60%) showed that, the proportion of cumulative seroconversion among the spouses was 1.76%. Results from the sensitivity analysis on modeling the consistent condom use and the antiretroviral treatment showed that, when the coverage of antiretroviral treatment was as 90% and the proportion of consistent condom use increased from 50% to 90%, with 80.7% of the risk of spouse seroconversion could be reduced. Or, when the proportion of consistent condom use was as 90% and the coverage of antiretroviral treatment increased from 50% to 90%, with 64.5% of the risk of spouse seroconversion could be reduced. Conclusions: With measures as consistent condom use plus provision of timely antiretroviral therapy to HIV positive index spouses, the risk of sexual transmission among sero-discordant couples could be greatly reduced.

Should condoms be available in secondary schools? Discourse and policy dilemma for safeguarding adolescent reproductive and sexual health in Rwanda.

IntroductionAs a response to challenges associated with adolescent reproductive and sexual health, policy makers in Rwanda have instituted preventive measures against risky sexual behaviours among adolescents. There is an ongoing debate on whether condoms should be made available in secondary schools to minimise risks related to unprotected sex in the context of a growing number of unintended pregnancies among school girls. This paper aims to examine the proposal of condom provision in Rwandan secondary schools through the analysis of policy narratives and the claims-making process.MethodsA narrative policy analysis was used to understand the claims and counter claims surrounding the debate on the provision of condoms in secondary schools. Documents that were consulted include: the national reproductive health policy, the girls' education policy, the national behaviour change and communication policy for the health sector, the Rwanda national policy on condoms, the adolescent sexual reproductive health and rights policy and the Rwanda family planning policy.ResultsSocial and cultural norms in the Rwandan context consider adolescent sexual practices as immoral and thus reject the idea of providing condoms in secondary schools. However, some stakeholders promoting reproductive health suggest that ignoring that some adolescents are sexually active will prevent them from accessing appropriate reproductive and sexual health protective programmes. Consequently, adolescents will be exposed to risky sexual behaviours, a situation which may be counter productive to the overarching goal of safeguarding adolescent sexual health which might impact their long-term education goals.ConclusionMaking condoms available in secondary schools evokes different meanings among the debaters, underscoring the complex nature of the condom provision debate in Rwanda. This paper calls for a revision of policies related to adolescent reproductive and sexual health in order to answer to the issues of risky sexual behaviours among secondary school students.

School practices important for students' sexual health: analysis of the school health research network survey in Wales.

This study investigates how the sexual health outcomes of a representative sample of students aged 15-16 in Wales vary according to the person delivering Sex and Relationships Education (SRE) in schools, students' access to on-site sexual health services and access to free condoms. Cross-sectional, self-report survey data were collected from students who participated in the 2015/16 School Health Research Network questionnaire in Wales. Data were analyzed from 59 schools, totalling 3781 students aged 15-16 (M = 15.7; SD = 0.3) who responded to questions about ever having had sex; age of sexual initiation and condom use at last intercourse. School level data were also collected, examining who delivers school SRE, provision of on-site, school 'drop-in' sexual health services and provision of free condoms for students. Binary and linear multi-level analyses explored the relationship between school level predictors and sexual health outcomes. Compared to teachers, other modes of SRE delivery were associated with better sexual health outcomes, including remaining sexually inactive, later age of first intercourse and condom use. Providing on-site sexual health services did not significantly reduce the odds of having ever had sex or delaying first intercourse; but was associated with increased condom use. On-site condom provision was associated with lower condom use. SRE delivery by educators other than teachers is optimum to young people's sexual health outcomes. Further funding and coordination of on-site sexual health advice services are required. Longitudinal research is needed to identify the temporal sequence of sexual health practices and outcomes.

Structural Intervention With School Nurses Increases Receipt of Sexual Health Care Among Male High School Students

PurposeAdolescent males are less likely to receive health care and have lower levels of sexual and reproductive health (SRH) knowledge than adolescent females. The purpose of this study was to determine if a school-based structural intervention focused on school nurses increases receipt of condoms and SRH information among male students. MethodsInterventions to improve student access to sexual and reproductive health care were implemented in six urban high schools with a matched set of comparison schools. Interventions included working with school nurses to improve access to sexual and reproductive health care, including the provision of condoms and information about pregnancy and sexually transmitted disease prevention and services. Intervention effects were assessed through five cross-sectional yearly surveys, and analyses include data from 13,740 male students. ResultsNurses in intervention schools changed their interactions with male students who visited them for services, such that, among those who reported they went to the school nurse for any reason in the previous year, those in intervention schools reported significant increases in receipt of sexual health services over the course of the study compared with students in comparison schools. Further, these results translated into population-level effects. Among all male students surveyed, those in intervention schools were more likely than those in comparison schools to report increases in receipt of sexual health services from school nurses. ConclusionsWith a minimal investment of resources, school nurses can become important sources of SRH information and condoms for male high school students.

Prevention Interventions for People Living with HIV in Military Settings.

Military HIV prevention programs and healthy living programs were developed in the mid-1980s to manage and support newly HIV-positive military personnel in the US military. Since then, a program developed by the Centers for Disease Control and Prevention with support from the Department of Defense HIV/AIDS Prevention Program (DHAPP), called Positive Health, Dignity and Prevention (PHDP), is currently being rolled out by DHAPP in partner militaries. The program, designed to reduce HIV transmission, is a package of interventions for people living with HIV (PLHIV), including risk reduction counseling, condom provision, disclosure counseling, testing of sexual partner(s) and children, adherence counseling, diagnosis and treatment of sexually transmitted infections, and provision of family planning services. DHAPP has trained military and civilian personnel caring for military personnel, their families, and the civilians seen at military installations in sub-Saharan Africa, such as Rwanda, Democratic Republic of the Congo, Malawi, and Zambia. These programs have varying degrees of implementing the program with innovative ways of engaging PLHIV. Many successes are being achieved through the training of military and civilian personnel working for or at military health care settings. In 2015, one of DHAPP's goals for the PHDP program is to enhance the monitoring, evaluation, and reporting of PHDP to demonstrate PHDP service provision to at least 90% of HIV-positive patients over the next 5 years.

Learners’ perspectives on the provision of condoms in South African public schools

ABSTRACTA stubborn health challenge for learners in South African public schools concerns sexual and reproductive health and rights (SRHR). In 2015, the Department of Basic Education (DBE) proposed the provision of condoms and SRHR-services to learners in schools. This study aimed to contribute to the finalisation and implementation of DBE’s policy by exploring learners’ perspectives on the provision of condoms and SRHR-services in schools. Sixteen focus group discussions were conducted with learners (n = 116) from 33 public schools, to assess their attitudes, social influences, and needs and desires regarding condom provision and SRHR-services in schools. The majority of learners did not support condom provision in schools as they feared that it may increase sexual activity. Contrarily, they supported the provision of other SRHR-services as clinics fail to offer youth-friendly services. Learners’ sexual behaviour and access to SRHR-services are strongly determined by their social environment, including traditional norms and values, and social-pressure from peers and adults. Learners’ most pressing needs and desires to access condoms and SRHR-services in school concerned respect, privacy and confidentiality of such service provision. Implementation of DBE’s policy must be preceded by an evidence-informed advocacy campaign to debunk myths about the risk of increased sexual activity, to advocate for why such services are needed, to shift societal norms towards open discussion of adolescent SRHR and to grapple with the juxtaposition of being legally empowered but socially inhibited to protect oneself from HIV, STIs and early pregnancy. Provision of condoms and other SRHR-services in schools must be sensitive to learners’ privacy and confidentiality to minimise stigma and discrimination.

\u201cWhen they know that you are a sex worker, you will be the last person to be treated\u201d: Perceptions and experiences of female sex workers in accessing HIV services in Uganda

BackgroundHIV prevalence among female sex workers (FSWs) in high burden countries in sub-Saharan Africa varies between 24 and 72%, however their access to HIV services remains limited. This study explored FSWs’ perspectives of the barriers and opportunities to HIV service access in Uganda.MethodsThe cross-sectional qualitative study was conducted between October and December 2013. Twenty-four focus group discussions were conducted with 190 FSWs in 12 districts. Data were analysed using manifest content analysis, using Atlas.ti software, based on the socio-ecological model.ResultsFSWs indicated that HIV services were available and these included condoms, HIV testing and treatment, and management of sexually transmitted infections. However, access to HIV services was affected by several individual, societal, structural, and policy related barriers. Individual level factors included limited awareness of some prevention services, fears, and misconceptions while societal stigma was prominent. Structural and policy level barriers included inconvenient hours of operation of the clinics, inflexible facility based distribution of condoms, interuptions in the supply of condoms and other commodities, and limited package of services with virtually no access to lubricants, HIV pre- and post-exposure prophylaxis, and support following client perpetrated violence. Policies such as partner testing and involvement at antenatal care, and using only one facility for antiretroviral drug refills hindered HIV service uptake and retention in care. FSWs had major concerns with the quality of services especially discrimination and rude remarks from providers, denial or delay of services, and potential for breach of confidentiality. However, some FSWs reported positive experiences including interface with friendly providers and participated in formal and informal FSW groups, which supported them to access health services.ConclusionDespite availability of services, FSWs faced major challenges in access to services. Comprehensive multilevel interventions targeting individual, societal, structural and policy level barriers are required to increase access to HIVservices among FSWs in Uganda. Policy and institutional adjustments should emphasize quality friendly services and expanding the package of services to meet the needs of FSWs.

A national evaluation using standardised patient actors to assess STI services in public sector clinical sentinel surveillance facilities in South Africa

ObjectivesQuality concerns in STI service delivery and missed opportunities for integration with HIV testing and prevention services in South Africa have been well documented. This national evaluation aimed to evaluate...

Social and structural factors related to HIV risk among truck drivers passing through the Iringa region of Tanzania

ABSTRACTTruck drivers and their assistants have been identified as groups at higher risk for HIV infection. We sought to identify and describe the social and structural factors that may contribute to HIV risk among truck drivers who visit rest stops in Iringa, Tanzania, a region characterized by high levels of migration and mobility. This analysis was part of a comprehensive strategic assessment to examine HIV risk factors in Iringa. This analysis focuses on 11 in-depth interviews with truck drivers and a transport owner. A semi-structured interview guide was developed to elicit open-ended responses and enable probing. Interviews were conducted in Swahili, transcribed, and translated into English. Data analysis followed thematic analysis procedures that included initial reading of transcripts, development of a codebook and identification of themes through in-depth reading of transcripts. Drivers described structural risk factors for HIV including work conditions, the power imbalance between male drivers and their sexual partners and minimal perceived HIV risk with certain partners (e.g., regular partners and women selling sex). Multiple and inter-related social norms associated with truck stop environments influenced HIV risk, including peer influence and expectations, presence of sex workers, ability to purchase sex throughout their travel and alcohol consumption. These distinct social norms in truck stops and other rest points facilitated behavior that many participants said they would not engage in elsewhere. HIV prevention strategies with truck drivers should address individual, social and structural barriers to HIV prevention through partnerships with the health and transportation sectors, local government and local communities. HIV prevention services should be adapted to drivers’ times and places of availability, for example, condom provision where/when drivers make decisions about or have sex. A focus on positive messaging and addressing specific challenges including the continual challenge of re-choosing and reinforcing decisions to engage in safer sexual behaviors is important.

Time taken to escort men who have sex with men (MSM) for HIV testing in the peer group interventions in Sri Lanka

Introduction: Sri Lanka has completed a phase of an HIV prevention project (from 2013 to 2015) for men who have sex with men (MSM) under the support of Global Fund. The intervention was to deliver an HIV prevention package (HPP) to MSM which included provision of six services (1. STI knowledge, 2. HIV knowledge, 3. MSM tailored leaflets, 4. Condom/dildo demonstration, 5. Provision of condoms, and 6. Clinic escort). MSM who received all 1, 2, 3, 4 and 5 services in the HPP are defined as “reached”. The final step is to escort the reached (who received initial 5 services) MSM to an STD clinic, and ones they are escorted they are defined as “escorted”. This HPP was delivered to MSM through peer educators (PE) scattered in four high populous districts in the country. Each PE has regular contact with another 6-15 peers forming a peer group (PG). However, in this model, a significant number of MSM does not take the escorting step (step 6). Therefore, the purpose of this paper is to analyze the time taken to escort and other associated factors for an MSM to be escorted to an STD clinic. Method: All the MSM peers (699 MSM) registered in 2013 and retained during the project till the end of December 2015 have been filtered out from the web-based monitoring and evaluation information management system (MEIMS) for analysis. Time-to escort analysis with Kaplan–Meier was performed to find out median escort time. Hypothesis testing for equality of survival distribution (Kaplan–Meier curve) was conducted to determine the differences in probabilities of first clinic escort for different socio-economic and demographic characteristics. Results: Estimated median time-to escort was 17 months (SD = 0.867). Escorting is less likely with non-youth MSM (≥25 years), educated MSM (> GCE O/L), rural MSM, Nachchi MSM (effeminate males), high frequent receptive MSM (≥7/week) and high duration MSM (≥10 years). Galle and Gampaha districts shows high performance in escorting compared to other districts Conclusions: More vulnerable and high risk segments of MSM population are less likely to be escorted for HIV testing in the current programme design. Current intervention need to strengthen with more focus strategies to address this programmatic gap. In addition, performance of PEs, field supervisors and coordinators has been observed to be a major factor in improving escort rate.

Adapting an HIV Risk Reduction Curriculum: Processes and Outcomes.

Becoming a Responsible Teen (BART) is a community-based, HIV risk reduction curriculum shown to increase safer sex behaviors among African American adolescents. However, BART does not address common barriers to sexual health care access, which may limit program efficacy. We used a community-engaged adaptation process to maximize program relevance and health outcomes by incorporating a broad ecological perspective. Adolescent and staff advisory boards at a community-based organization recommended modifications (e.g., delete references to Kwanzaa, update language, localize incentives) and supported inclusion of critical on-site health services, such as sexually transmitted infection testing and condom provision. We conducted a trial of adapted BART (one session/week for 8 weeks) with 36 adolescents at two community organizations (mean age = 15.5 years, 52% female; 61% reported previous sexual intercourse). Most received on-site sexually transmitted infection testing (61%) and condoms (70%). Adolescents demonstrated significant improvements in self-efficacy for safer sexual practices (p < .02), AIDS risk knowledge (p < .001), condom knowledge (p < .001), and condom attitudes (p < .04). Adolescents and staff were satisfied with the revised curriculum and found on-site services acceptable. Based on improvements in constructs influencing behavior and the successful delivery of services essential for optimal health, future studies to assess efficacy and sustainability of the adapted curriculum appear warranted.

Contraceptive uptake after a couples counseling intervention with community health workers: a cluster randomized trial

Objectives: We aimed to evaluate whether training health surveillance assistants (HSAs) in couples counseling would increase contraceptive uptake among young women. Methods: In this cluster randomized controlled trial, 30 HSAs based at Area 25 Health Center in Lilongwe, Malawi, received training in family planning, including provision of condoms, pills and the injectable. They were then randomized to receive or not receive additional training in couples counseling for family planning. All HSAs were asked to provide family planning counseling to sexually active young women who had never used family planning and record their contraceptive uptake. Generalized estimating equations with an exchangeable correlation matrix to account for clustering by HSA were used to estimate risk differences (RDs) and 95% confidence intervals (CIs). Results: Some 808 women received family planning counseling from the HSAs; 430 (53%) from the 15 HSAs who received couples counseling training and 378 (47%) from the 15 HSAs who did not. Some 115 (26%) women from the couples counseling group had male partners present during their first visit, compared with only 6 (2%) from the other group (RD: 0.21; 95% CI, 0.09–0.33; p<.01); 796 women (98%) received a short-term contraceptive method, with no significant difference between the two groups (p=.25). Women in the couples counseling group were 8% more likely to accept condoms (95% CI, −7 to 23%; p=.20) Conclusions: Training HSAs in family planning led to high contraceptive uptake among young women who had never used family planning. Couples counseling training increased male involvement with a trend toward higher condom uptake.

Support for Offering Sexual Health Services Through School-Based Health Clinics.

Numerous studies document support for sexuality education in the schools. However, there is a dearth of research assessing support for sexual health services offered through school-based health clinics (SBHCs). The purpose of this study was to assess voter support for offering 3 sexual health services (STI/HIV testing, STI/HIV treatment, condom distribution) through SBHCs. The survey was developed after review of existing surveys on support for sexuality education and sexual health services. The university's Public Opinion Research Laboratory used random-digit-dialing to administer the survey to participants (N = 311) including residential and cell phone numbers. Most participants were supportive of offering sexual health services at both middle schools (MS) and high schools (HS): testing for STIs/HIV (61% MS, 76% HS), treatment for STIs/HIV (60% MS, 75% HS), and provision of condoms (44% MS, 63% HS). Analyses showed significant differences in support for sexual health services by a few demographic variables, opinions about sexuality education, and the percentage of students perceived to have had sexual intercourse. Results document support for offering sexual health services through SBHCs. These findings may benefit other communities looking to implement similar clinics. Such services have great potential for positively impacting the sexual health of youth.

Change in attitudes and knowledge of problem drug use and harm reduction among a community cohort in Kabul, Afghanistan.

This pre-post evaluation aimed to measure changes in knowledge and attitudes towards drug users among community representatives in Kabul, Afghanistan, over a period of expansion of harm reduction and drug dependence programming. A convenience sample of 160 professionals aged 18+ years completed interview questionnaires in 2007 and 2009. Views endorsing programme quality and the provision of condoms, infection counselling/testing and needle/syringe distribution increased significantly over the 2-year period. In 13 of 38 statements, there was a substantial (> 10%) change in agreement level, most commonly among men and medical professionals. Attitudes concerning support of drug users remained largely positive, with substantial attitude changes in some subgroups of the population. Further community education through the media and a more cohesive government drug policy may be needed to strengthen community support for harm reduction/drug treatment in Afghanistan.

Compliance to Positive Health, Dignity and Prevention Services among HIV Infected Index Partners in HIV Sero-Discordant Relationships in Nairobi County, Kenya

Introduction: This study evaluated compliance to Positive Health, Dignity and Prevention [PHDP] practice among index partners in HIV sero-discordant relationships in Nairobi County, Kenya. PHDP involves a set of interventions that helps people living with HIV lead a complete and healthy life besides reducing risk of HIV transmission. These interventions were adopted in Kenya in 2013 by the National AIDS and STI Control Program [NASCOP], Ministry of Health and the United States Government [USG] funded affiliates. The evaluation focused on demographic factors, knowledge, perception and challenges encountered while adopting PHDP practices among index client. Methods: A cross sectional descriptive study design was used, 370 index partners in sero discordant relationship were recruited from three clinics within Nairobi County. The clinic’s patient registry was used to contact sequentially those who met the inclusion criteria. Standardized data collecting tools were administered. Data was cleaned and analyzed using SPSS VER 22.0. Results: Out of 370 respondents 19.7% were male. 40.1% had education level of primary school and below. The group exhibited high PHDP knowledge at 90.8% however, only 66.5% complied with PHDP practice. There was significant relationship between condom supply, condom demonstration and PHDP compliance at P values of 0.034 and 0.018 respectively. Odds ratio showed those index partners who had no challenge in accessing condom demonstration and supply complied more to PHDP practice. Consistence condom use was at 53.4%, while 28.2% had multiple sex partners. Conclusion: PHDP compliance is low which calls for improvement. There is significance relationship between condom supply/demonstration and PHDP compliance.

How to set up a remotely supported hub and spoke sexual health service for a military population

Military personnel are considered to be at high risk of sexually transmitted infections due to their being highly mobile, away from home for prolonged periods and often purchasers of commercial...

Determinants of demand for condoms to prevent HIV infections among barmaids and guesthouse workers in two districts, Tanzania.

BackgroundCondoms are scientifically recommended as potential products for preventing infections attributable to human immuno-deficiency viruses (HIV). However, evidence on factors leading to their inadequate use in developing countries is still scanty. This paper reports an exploratory study of factors constraining condoms use in Tanzania from the perspectives of barmaids, guest-house workers and retailers.MethodsData were collected in two districts—Mpwapwa in Dodoma Region and Mbeya Rural in Mbeya Region—between October and December 2011, using structured interviews with 238 individuals including barmaids, guesthouse workers and 145 retailers. Data analysis was performed using STATA 11 software.ResultsAwareness about condoms was high among all study groups. Male condoms were more popular and available than female ones. A considerable proportion of the barmaids and guesthouses were disappointed with condoms being promoted and distributed to young children and disliked condom use during sexual intercourse. Accessibility of condoms was reported as being lowered by condom prices, shortage of information concerning their availability; short supply of condoms; some people shying away to be watched by children or adult people while purchasing condoms; retailers’ using bad languages to condom customers; occasionally condom shops/kiosks found closed when they are urgently needed; and prevailing social perception of condoms to have low/no protective efficacy. Regression analysis of data from barmaids and guesthouse-workers indicated variations in the degree of condom acceptability and methods used to promote condoms among respondents with different demographic characteristics.ConclusionA combination of psychosocial and economic factors was found contributing to lower the demand for and actual use of condoms in study communities. Concerted measures for promoting condom use need to address the demand challenges and making operational research an integral element of monitoring and evaluation of the launched interventions, hence widening the evidence for informed policy decisions.Electronic supplementary materialThe online version of this article (doi:10.1186/s13104-015-1621-y) contains supplementary material, which is available to authorized users.

Risk factors of HIV infection among farm workers at Rattray Arnold Research Farm in Goromonzi district, Zimbabwe: a qualitative study

Notwithstanding the generally declining levels of HIV in Zimbabwe, HIV prevalence remains exceedingly high in commercial farms. Risky sexual practices underpinned by poverty, unreliable supply of condoms and lack of entertainment are the major underlying factors facilitating the spread of HIV. We carried out a qualitative study among farm workers at Rattray Arnold Research Farm in Goromonzi district in Zimbabwe to establish the prevalence of HIV, factors underlying HIV transmission among the farm workers and the impact of HIV and AIDS on the farm. Six focus group discussions and five key informant interviews were conducted to collect qualitative data. The study established that misconceptions about the modes of transmission are still pervasive among participants. Contrary to widespread knowledge about HIV and AIDS, high risk sexual behaviours and low condom use are still major concerns. Lack of health services at the farm — compounded by respondents’ negative attitudes towards use of condoms — also exacerbates exposure to HIV infections. Reports from the Home-based Care Officer revealed that HIV prevalence at the farm is estimated at about 42%. Further, morbidity and mortality due to HIV have profound effects on the daily activities at the farm. The study recommends that health services must be availed at the farm in addition to providing information, education and communication so as to foster positive behaviour change, while dispelling myths associated with HIV modes of transmission and preventive strategies.

P13.09 Evaluation of a pilot to improve primary care sexual health services in england: analysis of chlamydia testing and diagnosis rate changes

Introduction Provision of sexual health services in primary care is necessary to reduce STIs, such as chlamydia. We piloted an educational training programme, based on the theory of planned behaviour, for general practice staff with the aim of increasing chlamydia and HIV testing, and provision of condoms and contraceptive information (3Cs and HIV). Methods The pilot was delivered with a step wedge design over three phases. Chlamydia testing and diagnosis rates pre and post-training were compared separately for men and women using a multivariable negative binomial regression model with general practice fitted as a random effect. Month of test and practice population size were adjusted for and an interaction between the intervention and area of implementation fitted. Results 460 general practices agreed to participate in the pilot. These conducted 2448 tests across the pre and post intervention period. Intention to treat analysis showed decreased median test and diagnoses per month post-intervention (2.68 vs 2.67; 0.14 vs 0.13 respectively). The multivariable regression analysis did not find a significant change in testing or diagnoses of men. There was a significant increase in testing (IRR 1.15 CI 1.01–1.31) of women but no change in diagnoses (IRR 0.98 CI 0.84–1.18). Interaction between the intervention and area of implementation was found in both testing rate models for women. Conclusion This large national pilot found that educational support sessions slightly increased chlamydia testing in women within general practices after they received the 3Cs and HIV training but not diagnoses. The area of implementation had an impact on the programme’s effect, so further exploration of the factors that contribute to this increase is required. Disclosure of interest statement Public Health England is funded by the UK Department of Health.