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Cassidy C, Bishop A, Steenbeek A, Langille D, Martin-Misener R, Curran J. Barriers and enablers to sexual health service use among university students: a qualitative descriptive study using the Theoretical Domains Framework and COM-B model. BMC Health Serv Res 2018; 18:581. [PMID: 30041649 PMCID: PMC6057095 DOI: 10.1186/s12913-018-3379-0] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Accepted: 07/11/2018] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND University students are within the age group at highest risk for acquiring sexually transmitted infections and other negative health outcomes. Despite the availability of sexual health services at university health centres to promote sexual health, many students delay or avoid seeking care. This study aimed to identify the perceived barriers and enablers to sexual health service use among university undergraduate students. METHODS We used a qualitative descriptive design to conduct semi-structured focus groups and key informant interviews with university students, health care providers, and university administrators at two university health centres in Nova Scotia, Canada. The semi-structured focus group and interview guides were developed using the Theoretical Domains Framework and COM-B Model. Data were analyzed using a directed content analysis approach, followed by inductive thematic analysis. RESULTS We conducted 6 focus groups with a total of 56 undergraduate students (aged 18-25) and 7 key informant interviews with clinicians and administrators. We identified 10 barriers and enablers to sexual health service use, under 7 TDF domains: knowledge; memory, attention and decision-making processes; social influences; environmental context and resources; beliefs about consequences; optimism; and emotion. Key linkages between students' social opportunity and motivation were found to influence students' access of sexual health services. CONCLUSIONS We identified barriers and enablers related to students' capability, opportunity and motivation that influence sexual health service use. We will use these findings to design an intervention that targets the identified barriers and enablers to improve students' use of sexual health services, and ultimately, their overall health and well-being.
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Affiliation(s)
- Christine Cassidy
- School of Nursing, Dalhousie University, 5869 University Avenue, PO BOX 15000, Halifax, NS B3H 4R2 Canada
| | | | - Audrey Steenbeek
- School of Nursing, Dalhousie University, 5869 University Avenue, PO BOX 15000, Halifax, NS B3H 4R2 Canada
| | - Donald Langille
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, NS Canada
| | - Ruth Martin-Misener
- School of Nursing, Dalhousie University, 5869 University Avenue, PO BOX 15000, Halifax, NS B3H 4R2 Canada
| | - Janet Curran
- School of Nursing, Dalhousie University, 5869 University Avenue, PO BOX 15000, Halifax, NS B3H 4R2 Canada
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Glasper EA. Promoting Optimum Sexual Health of Children and Young People. Compr Child Adolesc Nurs 2017; 40:137-141. [DOI: 10.1080/24694193.2017.1348754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Edward Alan Glasper
- Emeritus Professor of Children’s and Young People’s Nursing, The University of Southampton, Southampton, UK
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Friedman C, Owen AL. Sexual health in the community: Services for people with intellectual and developmental disabilities. Disabil Health J 2017; 10:387-393. [DOI: 10.1016/j.dhjo.2017.02.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Revised: 02/21/2017] [Accepted: 02/26/2017] [Indexed: 10/19/2022]
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Brookmeyer KA, Hogben M, Kinsey J. The Role of Behavioral Counseling in Sexually Transmitted Disease Prevention Program Settings. Sex Transm Dis 2016; 43:S102-12. [PMID: 26779681 DOI: 10.1097/OLQ.0000000000000327] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Behavioral counseling for sexually transmitted disease (STD) prevention is recommended for persons at risk, and the body of evidence yields numerous interventions that have STD preventive efficacy. What is needed is a review of the subset of these interventions that could be feasible in clinical settings, especially settings in STD prevention programs. METHODS We reviewed existing systematic reviews of the literature and abstracted from them studies that fit the following criteria in that the interventions: (1) used no more than 60 minutes of contact time in 1 to 2 sessions, (2) were individual level and face to face, (3) took place in a clinical setting, (4) had STD outcomes available, (5) were based in the United States, (6) were peer reviewed, and (7) had a control group. RESULTS From 6 reviews (published 2006-2014) covering 91 studies, we found 13 analyses representing 11 intervention studies that fit the selection criteria. Of these 13, 5 returned lower STD rates in the intervention group at follow-up; one study reported a higher rate of STD in one subset of the intervention group (men who have sex with men). Studies with effects on STD at follow-up were quite similar to studies across populations, settings, and follow-up periods, although successful interventions were more likely to demonstrate behavioral effects as well (5/5 vs. 2/5 among 10 interventions measuring behavior change). CONCLUSIONS Counseling is likely to benefit some STD clinic attendees, although unlikely to benefit men who have sex with men. The balance of costs and benefits of implementing behavioral counseling in STD programs is unclear, but feasibility would be improved if behavioral counseling were implemented in the context of other prevention efforts. Because populations outside typical STD clinic settings could also benefit, programs may exercise a valuable role through partnerships.
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Glasper A. Is the sexual health of children and young people adequately protected? ACTA ACUST UNITED AC 2016; 25:624-5. [PMID: 27281600 DOI: 10.12968/bjon.2016.25.11.624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Alan Glasper
- Emeritus Professor, from the University of Southampton
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Khalesi ZB, Simbar M, Azin SA, Zayeri F. Public sexual health promotion interventions and strategies: A qualitative study. Electron Physician 2016; 8:2489-96. [PMID: 27504163 PMCID: PMC4965198 DOI: 10.19082/2489] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Accepted: 04/23/2016] [Indexed: 11/20/2022] Open
Abstract
INTRODUCTION Sexual health promotion is the process of enabling people to increase control over their sexual health that should be based on people's needs and abilities. The aim of this study was to explore public sexual health promotion interventions and strategies. METHODS This study was a qualitative content analysis approach. This qualitative study was a qualitative part of an exploratory sequential qualitative-quantitative study that took place between November 2014 and May 2015 and was conducted in Rasht, Iran. Data were collected using semi-structured interviews with 38 engaged and married men and women as well as nine key informants. The data were analyzed by the content analysis method and by using qualitative data analysis software MAXqda 2011. RESULTS Analyzing participants' perspectives and experiences revealed two main categories, i.e., 1) General actions to promote sexual health (with three sub-categories: public policies promoting sexual health, development of sexual health supporting environments, and removal of barriers to receiving services) and 2) Specific actions in the current health system (with three sub-categories: economic policy, empowering individuals and the society, and reviewing the current health system). CONCLUSIONS General actions (public policies, supporting environments developed, and removal of barriers to receiving services) and integration of specific actions in the health system, such as empowering individuals' needs for promoting sexual health. Achieving these goals necessitates the review of the current health system in Iran.
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Affiliation(s)
- Zahra Bostani Khalesi
- Ph.D. Candidate of Reproductive Health, Student Research Office, School of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Masoumeh Simbar
- Ph.D. of Reproductive Health, Professor, Department of Midwifery & Reproductive Health, School of Nursing & Midwifery, Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Science, Tehran, Iran
| | - Seyed Ali Azin
- MD, Specialist in Social Medicine, Reproductive Biotechnology Research Center, Avicenna Research Institute (ACECR), Tehran, Iran
| | - Farid Zayeri
- Ph.D. of Statistics, Associate Professor, Department of Biostatistics, Shahid Beheshti University of Medical Sciences, Tehran Iran
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Woodhall SC, Sile B, Talebi A, Nardone A, Baraitser P. Internet testing for Chlamydia trachomatis in England, 2006 to 2010. BMC Public Health 2012; 12:1095. [PMID: 23253518 PMCID: PMC3554557 DOI: 10.1186/1471-2458-12-1095] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2012] [Accepted: 12/10/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In recent years there has been interest in websites as a means of increasing access to free chlamydia tests through the National Chlamydia Screening Programme (NCSP) in England. We aimed to describe and evaluate online access to chlamydia testing within the NCSP. METHODS We analysed NCSP chlamydia testing data (2006-2010) for 15-24 year olds from the 71/95 programme areas in England where site codes were available to identify tests ordered through the internet. The characteristics of people using online testing services in 2010 were compared with those testing in general practice (GP) or community sexual and reproductive health (SRH) services. We evaluated 58 websites offering free chlamydia tests through the NCSP, and 32 offering kits on a commercial basis for signposting to clinical service and health promotion advice offered. RESULTS Between 2006 and 2010, 5% of all tests in the included programme areas were accessed through the internet. The number of internet tests increased from 18 (<1% of all tests) in 2006 to 59,750 in 2010 (6% of all NCSP tests). In 2010 the proportion of NCSP tests accessed online by programme area ranged from <1% to 38%. The proportion of tests with a positive result on the internet was higher than tests from general practice and comparable to those from community SRH services (internet 7.6%; GP 5.6%; Community SRH 8.2%). A higher proportion of people accessing online testing were male, aged 20-24 and reported >1 sexual partner in the past year. Provision of sexual health information and appropriate signposting for those in need of clinical services varied between websites. Service provision within the NCSP was fragmented with multiple providers serving specific geographical catchment areas. CONCLUSION Internet testing reaches a population with a relatively high risk of chlamydia infection and appears acceptable to young men, a group that has been difficult to engage with chlamydia testing. In order to maximise the potential benefit of these services, websites should be consistent with national guidelines and adhere to minimum standards for signposting to clinical care and health promotion information. The current system with multiple providers servicing geographically specific catchment areas is contrary to the geographically unrestricted nature of the internet and potentially confusing for clients.
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Affiliation(s)
- Sarah C Woodhall
- Health Protection Agency, London, UK
- Department of Sexual Health and HIV, Kings College Hospital NHS Foundation Trust, London, UK
- Sarah Woodhall, Health Protection Agency, HIV & STI Department, 61 Colindale Avenue, London, NW9 5EQ, UK
| | | | | | | | - Paula Baraitser
- Health Protection Agency, London, UK
- Department of Sexual Health and HIV, Kings College Hospital NHS Foundation Trust, London, UK
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Abstract
This literature review focuses on what matters to young adults when they access primary care services in the United Kingdom. Patients' access to and experience of primary care services differs across age groups. Existing research has largely focused on the needs and experiences of children, adolescents, and adults. There is some evidence to suggest the views of young adults (aged 18-25 years) that may differ from the views of other age groups, and research has not previously reported specifically on the views of this group of the population. The literature was reviewed to identify the views and priorities of young UK adults regarding primary healthcare provision, and furthermore, to identify those related topics that would benefit from further research. Relevant academic publications and grey literature published from 2000 onwards was reviewed and synthesised. We identified and reported emerging themes that were of importance to young adults in respect of the UK primary care provision. A total of 19 papers met our inclusion criteria. Young adults access primary care services less frequently than other age groups; this may be because of their experience of primary care throughout childhood and adolescence. Five aspects of primary care provision emerged as being of importance to young adults--the accessibility and availability of services, the confidentiality of health-related information, issues relating to communication with healthcare professionals, continuity of care, and behaviours and attitudes expressed towards young adults by healthcare professionals. There is a lack of focus of current research on the expectations, needs, and primary healthcare experiences of young adults. Young adults may hold views that are distinct from other age groups. Further research is needed to better understand the needs of a young adult population as their needs may impact the future use of services.
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Sannisto T, Saaristo V, Ståhl T, Mattila K, Kosunen E. Quality of the contraceptive service structure: a pilot study in Finnish health centre organisations. EUR J CONTRACEP REPR 2012; 15:243-54. [PMID: 20809672 DOI: 10.3109/13625187.2010.500750] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES To evaluate the quality of the contraceptive service structure in health centre organisations (HCOs) in western Finland and to establish whether the characteristics of the HCOs are associated with the quality measured. METHODS Survey data were collected from all HCOs in a university hospital area in western Finland (N = 63). Quality was evaluated using a score of ten indicators. Associations between the score and the characteristics of the HCOs were studied using rank correlation analysis and a multivariate ordered logit model. RESULTS Among 51 HCOs yielding complete data for the evaluation, the quality score ranged from 3 to 10, the mean being 5.8. From 25 variables studied, 'a chief nursing officer or leading nurse engaged in the HCO' (p = 0.001) and 'an appointed person responsible for management of health promotion' (p = 0.006) were found to be associated with a good score in the rank correlation analysis, and they also remained significant in multivariate analysis (Odds Ratio [OR] = 11.5, 95% confidence interval [CI] 2.3-56.5 and OR = 5.9, 95% CI 1.6-21.5, respectively). CONCLUSIONS In the majority of the HCOs involved, the quality of service structure was rated average, but there was much variation between the HCOs. The results of the multivariate analysis emphasise the importance of good management of services.
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Affiliation(s)
- Tuire Sannisto
- Medical School, Department of General Practice, University of Tampere, Tampere, & Pirkanmaa Hospital District, Centre of General Practice, Tampere, Finland.
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Dave SS, French RS, Jungmann E, Brook G, Cassell JA, Mercer CH. The need for innovative sexually transmitted infection screening initiatives for young men: evidence from genitourinary medicine clinics across England. Int J STD AIDS 2011; 22:600-3. [DOI: 10.1258/ijsa.2009.009336] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The study objectives were to ascertain behavioural, access-related, health-seeking factors and sexually transmitted infection (STI) prevalence in young men (<25 years) attending genitourinary (GU) medicine clinics and compare them with older men (≥25 years) and young women (<25 years). Between October 2004 and March 2005, 4600 new attendees at seven sociodemographically and geographically contrasting GU medicine clinics across England completed questionnaires, which were linked to routine clinical data. Young men waited significantly less time to be seen in clinic compared with older men and young women. They were less likely to report symptoms than older men ( P = 0.021) yet more likely to be diagnosed with chlamydia ( P = 0.001) and gonorrhoea ( P = 0.007). They were also more likely to be diagnosed with an acute STI relative to young women ( P = 0.007). Our data confirm the need to make comprehensive STI screening readily available for young men and to develop effective and innovative screening strategies in different settings.
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Affiliation(s)
- S S Dave
- UCL/UCLH Institute for Women's Health
- Centre for Sexual Health and HIV Research, Research Department of Infection and Population Health, University College London, London
| | - R S French
- Centre for Sexual Health and HIV Research, Research Department of Infection and Population Health, University College London, London
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London
| | | | - G Brook
- Central Middlesex Hospital, North West London Hospitals NHS Trust, London
| | - J A Cassell
- Centre for Sexual Health and HIV Research, Research Department of Infection and Population Health, University College London, London
- Brighton and Sussex Medical School, University of Brighton, Brighton, UK
| | - C H Mercer
- Centre for Sexual Health and HIV Research, Research Department of Infection and Population Health, University College London, London
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French RS, Mercer CH, Robinson AJ, Gerressu M, Rogstad KE. Addressing sexual health needs: a comparison of a one-stop shop with separate genitourinary medicine and family planning services. ACTA ACUST UNITED AC 2010; 36:202-9. [PMID: 21067635 DOI: 10.1783/147118910793048502] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND AND METHODOLOGY Little evidence is available on the extent to which one-stop shops address users' sexual health needs and the extent to which they identify additional needs users may not have identified. As part of the One-Stop Shop Evaluation, a questionnaire was designed to compare the reasons for users' visits and the reported outcomes of visits at a one-stop shop with the experiences of users in separate genitourinary medicine (GUM) and contraceptive clinics. RESULTS The difference in the proportions of those attending the one-stop shop and those attending the control sites services for a sexually transmitted infection (STI)-related reason who were diagnosed with an STI was minimal, but those attending for an STI-related reason in the one-stop shop were more likely to receive an additional contraceptive outcome. Women attending for a contraceptive-related reason at the one-stop shop were more likely to have an STI screen than those attending the control sites for the same reason, but there was little difference in the proportions amongst this group receiving an STI diagnosis or receiving treatment. When focusing on women attending for a pregnancy-related reason, one-stop shop users were more likely to have received contraceptive advice or supplies. DISCUSSION AND CONCLUSIONS It was not possible in our evaluation to determine the relative effectiveness of the one-stop shop in comparison to the traditional GUM and contraceptive clinics in improving sexual health status, however the one-stop shop was more likely to address additional sexual health needs that service users may not have previously identified.
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Affiliation(s)
- Rebecca S French
- Department of Social & Environmental Health Research, London School of Hygiene & Tropical Medicine, London, UK.
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Hayter M. Commentary on Wang RH, Cheng CP and Chou FH (2008) A causal model of contraceptive intention and its gender comparison among Taiwanese sexually inexperienced adolescents. Journal of Clinical Nursing 17, 930-939. J Clin Nurs 2008; 17:3252-4; discussion 3254-5. [PMID: 19012795 DOI: 10.1111/j.1365-2702.2008.02403.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Mark Hayter
- Centre for Health and Social Care studies and Service Development, School of Nursing and Midwifery, University of Sheffield, Sheffield, UK.
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Hayter M, Harrison C. Gendered attitudes towards sexual relationships among adolescents attending nurse led sexual health clinics in England: a qualitative study. J Clin Nurs 2008; 17:2963-71. [DOI: 10.1111/j.1365-2702.2008.02515.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Mcandrew SE, Williams OE, Rogstad KE, Kell PD. Management of under-16-year olds in UK genitourinary medicine clinics: British Co-operative Clinical Group. Int J STD AIDS 2008; 19:625-8. [DOI: 10.1258/ijsa.2007.007307] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Summary: In 2004, the management of under-16-year olds in UK genitourinary (GU) medicine clinics was surveyed. Questionnaires were sent to 185 lead GU medicine consultants. A total of 111 questionnaires were returned (60%). Ninety-eight percent of respondents managed young people aged 13-16. Fifty percent managed under 13-year-olds. Twenty-nine percent of respondents ran dedicated young people's clinics. Ninety-eight percent were aware of the National Guidelines, and 74%had adopted them. Fifty-seven percent had a named departmental child protection lead. Thirty-seven percent of consultants had received training specific to child protection issues in GU medicine. Improvements had been made since a similar survey published in 2001, but the need for further training was still apparent.
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Affiliation(s)
- S E Mcandrew
- Sexual Health Clinic, Wrexham Maelor Hospital, Wrexham
| | - O E Williams
- Sexual Health Clinic, Wrexham Maelor Hospital, Wrexham
| | - K E Rogstad
- Department of Genitourinary Medicine, Royal Hallamshire Hospital, Sheffield
| | - P D Kell
- The Archway Sexual Health Clinic, London, UK
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Singh RH, Erbelding EJ, Zenilman JM, Ghanem KG. The role of speculum and bimanual examinations when evaluating attendees at a sexually transmitted diseases clinic. Sex Transm Infect 2006; 83:206-10. [PMID: 17108005 PMCID: PMC2659094 DOI: 10.1136/sti.2006.023309] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND With the advent of molecular techniques, self-collected specimens without a clinician's examination are often adequate to detect common genital infections. OBJECTIVE To evaluate the additional information that speculum and bimanual examinations provides clinicians in the routine evaluation of genital infections among attendees of a sexually transmitted disease (STD) clinic. METHODS Cross-sectional study from a database of all visit records to two STD clinics in Baltimore between 1996 and 2002. Women were stratified on the basis of reason for visit. Proportional and likelihood ratio estimates of the speculum examination in detecting clinically relevant cervicovaginal lesions (leading to a diagnosis of other infections or outside referral for further management) and bimanual examination in detecting abnormalities (leading to a diagnosis of pelvic inflammatory disease or referral) are presented. RESULTS 15 918 of 21 703 records were included: 12 073 were symptomatic (SYM; discharge, rash, abdominal pain, dysuria, genital irritation or odour), 1676 were asymptomatic contacts of an infected partner (CON) and 2169 were asymptomatic and presented for checkup (ASYM). The median age was 26 years; 94% were black. 11.8% of SYM, 4.6% of CON and 3.9% of ASYM patients had clinically meaningful lesions detected on speculum examination. The bimanual examination detected clinically relevant abnormalities in 6.5% of SYM, 0.8% of CON and 0.6% of ASYM patients. CONCLUSION Symptomatic women are most likely to benefit from speculum and bimanual examinations. However, their yield in evaluating asymptomatic women is low. Prospective studies are needed to determine whether eliminating speculum and bimanual examinations in a subset of women would offer an operational advantage without compromising patient safety.
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Affiliation(s)
- Rameet H Singh
- Divisions of Obstetrics and Gynecology, Johns Hopkins University School of Medicine, Baltimore, Maryland 21224,
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Jones KE, Beeching BA, Roberts P, Devine M, Davies J, Bates CM, Jones C. Success of a nurse led community based genitourinary medicine clinic for young people in Liverpool: review of the first year. Sex Transm Infect 2006; 82:318-20. [PMID: 16877583 PMCID: PMC2564719 DOI: 10.1136/sti.2005.017947] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES To assess the outcome and workload of a community based, nurse led comprehensive sexual health and contraceptive service for clients aged less than 25. METHODS Review of appointment diaries and clinic records of clients who attended the Brook genitourinary medicine (GUM) clinic. The workload, case mix, and achievement of national targets in the first year of the service were compared with those for the same age group of clients attending the nearby hospital based GUM clinic. A limited client satisfaction questionnaire was carried out 8 months after the clinic opened. RESULTS 1061/1700 (62.4%) clients (185, 17.4% male) attended booked appointments. Chlamydia trachomatis was detected in 16.1% of women and 20.5% of men at Brook (p<0.05), where 22.6% of women and 50% of men had at least one sexually transmitted infection (p<0.001). HIV testing was offered to 98.5% of clients. 60.7% of all identified contacts attended a clinic for testing and/or treatment. Client responses to a questionnaire about the service were very favourable. Only 2.3% of Brook GUM clients needed referral to a physician. CONCLUSIONS Nurse led community based GUM services, such as the one provided at the Merseyside Brook Centre, appeal to young people and our success should encourage others to consider similar ventures.
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Affiliation(s)
- K E Jones
- Merseyside Brook Centre, 81 London Road, Liverpool L3 8JA.
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French RS, Coope CM, Graham A, Gerressu M, Salisbury C, Stephenson JM. One stop shop versus collaborative integration: what is the best way of delivering sexual health services? Sex Transm Infect 2006; 82:202-6. [PMID: 16731668 PMCID: PMC2564738 DOI: 10.1136/sti.2005.018093] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES To examine various models of integrated and/or one stop shop (OSS) sexual health services (including general practice, mainstream specialist services, and designated young people's services) and explore their relative strengths and weaknesses. METHODS Literature review and interviews with key informants involved in developing the National Strategy for Sexual Health and HIV (n = 11). RESULTS The paper focuses on five broad perspectives (logistics, public health, users, staff, and cost). Contraceptive and genitourinary medicine issues are closely related. However, there is no agreement about what is meant by having "integrated" services, about which services should be integrated, or where integration should happen. There are concerns that OSSs will result in over-centralisation, to the disadvantage of stand alone and satellite services. OSS models are potentially more user focused, but the stigma that surrounds sexual health services may create an access barrier. From staff perspectives, the advantages are greater career opportunities and increased responsibility, while the disadvantages are concern that OSSs will result in loss of expertise and professional status. Cost effectiveness data are contradictory. CONCLUSION Although there is a policy commitment to look at how integrated services can be better developed, more evidence is required on the impact and appropriateness of this approach.
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Affiliation(s)
- R S French
- Centre for Sexual Health and HIV Research, Royal Free and University College Medical School, UCL, London, UK.
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Haley N, Roy É, Leclerc P. Interventions de prévention efficaces contre le VIH et l’hépatite C chez les jeunes utilisateurs de drogues par injection (UDI). ACTA ACUST UNITED AC 2003. [DOI: 10.7202/007184ar] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Résumé
La dernière décennie a été marquée par une augmentation importante du nombre de pays rapportant que l’injection de drogues est présente dans leur population. Et, dans plusieurs pays, particulièrement dans ceux en voie de développement, la plupart des nouveaux injecteurs ont entre 15 et 24 ans. De nombreuses conséquences sociales et sanitaires sont associées à l’injection de drogues, les principales conséquences de type infectieux étant l’hépatite C et l’infection par le virus de l’immunodéficience humaine (VIH). Nous présenterons dans cet article les comportements d’injection et les comportements sexuels des injecteurs adolescents et jeunes adultes qui en font des personnes à risque pour ces deux infections. Nous y décrirons également des caractéristiques de ces jeunes injecteurs, qui sont liées à leur âge, dont il faut tenir compte dans l’élaboration de programmes de prévention : besoins liés au développement cognitif, physique et psychologique et aux contraintes d’ordre légal. Finalement, nous exposerons les résultats d’une vaste recherche que nous avons menée dans la littérature en vue de trouver des projets de prévention de l’infection par le VIH et de l’hépatite C qui ont répondu aux besoins spécifiques des jeunes injecteurs et qui ont fait l’objet d’une évaluation. Cette recherche a démontré qu’il existe très peu d’interventions satisfaisantes dans ce domaine. Selon nous, il est urgent que de telles interventions soient développées, évaluées et diffusées afin de contrer les épidémies de VIH et d’hépatite C qui sévissent chez les jeunes injecteurs.
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Affiliation(s)
- Nancy Haley
- B. Sc., M.D., FRCP(C), FAAP, médecin, Unité Maladies infectieuses, DSP de Montréal
| | - Élise Roy
- M.D., M. Sc., médecin, Unité Maladies infectieuses, DSP de Montréal
| | - Pascale Leclerc
- M. Sc., professionnelle de recherche, Unité Maladies infectieuses, DSP de Montréal
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21
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Abstract
The Children Act 1989 defines a child as "a person who has not yet reached 18 years of age." In England, Wales, and Scotland the present age of consent for heterosexual and homosexual sex is 16 years and in Northern Ireland it is 17 years. The proportion of young people who report heterosexual intercourse before the age of 16 years increased in the 1990s compared with the previous decade.
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Affiliation(s)
- A Thomas
- Department of Community Paediatrics, St James's University Hospital, Leeds LS9 7TF, UK.
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22
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Thomas A, Forster G, Robinson A, Rogstad K. National guideline for the management of suspected sexually transmitted infections in children and young people. Sex Transm Infect 2002; 78:324-31. [PMID: 12407231 PMCID: PMC1744535 DOI: 10.1136/sti.78.5.324] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- A Thomas
- Department of Community Paediatrics, St James's University Hospital, Leeds LS9 7TF, UK.
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