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Young people’s experiences with clinical care and preferences for delivery of new point-of-care tests for STIs in England

BackgroundYoung people in the UK are at high risk for sexually transmitted infections (STIs), despite STI testing being freely and confidentially available. Given multiple barriers they may face for attending sexual health clinics (SHCs), young people should be consulted regarding changes to care. Studies have shown that point-of-care tests (POCTs) for STIs, which can accurately diagnose and treat patients in one clinical visit, have potential for individual and public health benefits, yet patient opinions of changes to clinical practice associated with POCT implementation are less understood.MethodsThe Precise study explored patient experiences of UK SHC services and their opinions of POCT implementation plans; here we focus on young participants within the Precise study. Male and female attendees of three SHCs in England were purposively sampled and then invited to participate in a qualitative in-depth interview. Interviews were conducted one-on-one, in person or via telephone, were audio-recorded and transcribed. NVivo (V10) was used to organise data for our content-based analysis.ResultsTen young people aged 17-22 years, including: three women-who-have-sex-with-men, four men-who-have-sex-with-women and three men-who-have-sex-with-men were interviewed between June 2015 and February 2016. Participants reported SHCs as the best place to receive results because treatment could be stared immediately, with advice and information available. Participants discussed the potential for POCTs to reduce anxiety currently felt waiting for laboratory results. POCTs were found broadly acceptable, and were generally regarded as an innovation to improve SHC experiences. Participants with less previous SHC experience raised concerns that implementation of POCTs could negatively affect the amount and quality of time patients spend in consultations with clinicians and that changes to pathways may cause confusion in clinic.ConclusionsWe advise POCT implementation be accompanied by SHC staff communicating changes in clinical pathways to patients, including method and timeline for receiving results. Our participants valued face-to-face counselling and advice currently experienced in SHCs; these findings emphasise that POCT implementation plans safe-guard these aspects of care. Our findings suggest that POCT implementation in SHCs has potential to improve young people’s clinical experiences, which may facilitate attendance.