Article Text


Improving clinical practice and service delivery
P154 Who is most affected by stigma of an integrated service?
  1. U Sauer1,
  2. A Singh2,
  3. R Pittrof3
  1. 1Barnet, Enfield and Haringey Mental Health Trust, London, UK
  2. 2University Health Services, KNUST Hospital, Kumasi, Ghana
  3. 3Guy's and St. Thomas' NHS Foundation Trust, London, UK


Background Stigma of sexual health services creates barriers to access to care but it is not known if it affects all groups service users equally. Targeted stigma reduction requires this information.

Objective To determine which user groups of a level 3 One Stop Shop (OSS) sexual health services perceives the service as stigmatised.

Method Application of a validated quantitative tool to assess stigma among 200 unselected patients attending a OSS in outer London. We defined that the service was perceived as stigmatised if at least one moderately positive response indicating stigma was given.

Results The service was perceived as stigmatised by 55% (111/200) of patients surveyed. Stigma of the service was more felt by men (25/39 64%) than by women (84/160; 53%) and or those who classified themselves UK black (29/46; 63%) rather than UK white (19/66; 57%). Young men (age <26 years) (12/20; 60%) perceived the service as less stigmatised than older men (13/19; 68%) while younger women (<26 years 57/111; 51%) found the service more stigmatising than older women (>25 years 27/49; 55%). Perception of the service as stigmatised was more prevalent among first time service users (48/84; 57%) than among those who have been there before (59/109; 54%) and among women attending for sexual health (SH) only (40/60; 66%) or for SH and contraception (FP) (11/20; 55%) than among women attending for FP only (29/56; 52%) than. None of these differences reached statistical significance.

Discussion Our survey shows that integrated services are perceived by as stigmatised by over 50% of service users. While this perception was even more prevalent in some subgroups it is more likely that the perceived stigma is a characteristic of the service than the subgroup. To address this we propose to change the image of the service to one that promotes a healthy life stile—including a healthy sexual life.

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