Introduction Women attending termination of pregnancy (TOP) clinics are a risk group for STIs, and those with STIs are at increased risk of developing postabortal complications. We explored what STI care is provided in Dutch TOP clinics, and we compared these results with the United Kingdom (UK).
Methods A qualitative study including 14 semi-structured interviews with health care professionals (HCPs) in TOP clinics (Netherlands: 9, UK: 5). Interviews were recorded, transcribed, and analysed by thematic content analysis.
Results In the Netherlands, azithromycin prophylaxis is routinely prescribed after a surgical TOP, but not routinely after a medical TOP. STI tests are only offered by Dutch clinics if clients are considered at high STI risk based on the intake questionnaire. High costs of STI testing form the main barrier for clients not accepting STI testing, as costs are not covered by all health insurances. Alternatively, some clinics refer women to the Public Health Service (PHS), where STI testing is free for high-risk groups. This also involves barriers as not all women go for testing. HCPs in TOP clinics that collaborate with PHSs in the Sense program (sexual and reproductive health care) experience less barriers, as free STI testing is then offered on location of the TOP clinic. Sexual health counselling in TOP clinics is often limited to birth control conversations, also in the UK. The major difference between Dutch and UK TOP clinics is that UK clinics (who are not privately owned) offer free STI testing to all clients.
Conclusion HCPs in Dutch TOP clinics consider STI testing an important part of their service, but financial barriers prevent STI testing on location. In the UK, free STI care is broadly implemented in TOP clinics. Collaboration with PHSs (in Sense program) could improve STI testing and sexual health counselling in Dutch TOP clinics.
Disclosure of interest statement The study is funded by the RIVM. No pharmaceutical grants were received in the development of this study.