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What do young people in high-income countries want from STI testing services? A systematic review
  1. Joscelyn Gan1,
  2. Varsicka Kularadhan2,
  3. Eric P F Chow3,4,5,
  4. Christopher K Fairley3,4,
  5. Jane S Hocking5,
  6. Fabian Y S Kong6,
  7. Jason J Ong3,7
  1. 1 Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia
  2. 2 School of Rural Health, Monash University, Bendigo, Victoria, Australia
  3. 3 Central Clinical School, Monash University, Carlton, Victoria, Australia
  4. 4 Melbourne Sexual Health Centre, Alfred Health, Carlton, Victoria, Australia
  5. 5 Melbourne School of Population and Global Health, University of Melbourne, Carlton, Victoria, Australia
  6. 6 Centre for Epidemiology and Biostatistics, University of Melbourne, Melbourne, Victoria, Australia
  7. 7 Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
  1. Correspondence to Miss Joscelyn Gan, University of Melbourne Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia; joscelyn.gan{at}


Background There are upward trends of STI rates among young people in most high-income countries. We reviewed the literature to provide a summary of information to support health services with the aim of increasing testing of STIs among young people living in high-income countries.

Methods We conducted a systematic review (Prospero: CRD42020179720) using PubMed, Embase, PsychINFO and CINAHL. The search was performed on 10 January 2020 for studies between January 2000 and 10 January 2020. Two reviewers independently screened articles, and any discrepancies were resolved by a third reviewer. Studies were included if they were performed in high-income countries and contained data on both young people (<26 years) and STI testing preferences. Data regarding the characteristics of STI testing services that young people preferred was extracted. We categorised these characteristics using the framework of a social-ecological model.

Results We identified 1440 studies, and 63 studies were included in the final review. We found 32 studies that addressed individual factors, 62 studies that addressed service factors and 17 studies that addressed societal factors. At an individual level, we identified eight attributes including the need for improved sexual health education. At a service level, 14 attributes were identified including preferences from different subgroups of young people (such as sexual and ethnic minorities) for the types of services. At a societal level, we identified two attributes including the need to address stigma associated with STIs.

Conclusion We provide an overview of the growing body of literature capturing the preferences of young people for STI testing services. To optimise the uptake of STI testing among young people, factors from all socioecological levels should be considered. In addition, understanding and accounting for distinct preferences from subgroups of young people could increase demand for STI testing services for those at greatest need.

  • health services research
  • delivery of health care
  • qualitative research
  • sexual and gender minorities
  • sexual health

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  • JG and VK are joint first authors.

  • Handling editor Laith J Abu-Raddad

  • Twitter @EricPFChow, @kitfairley, @DrJasonJOng

  • Contributors All authors have contributed significantly to, seen and approved the final submitted version of the manuscript. JJO conceived the study idea and design. JG and VK are equal cofirst authors and led the study, including independently screening articles and performed the data extraction and analysis. JG supported the article screening, data extraction and analysis. All authors contributed to various drafts of the manuscript. All authors read, provided feedback and approved the final manuscript. The study was submitted by JG.

  • Funding JJO and EPFC are supported by the Australian National Health and Medical Research Council Emerging Leadership Investigator Grant (GNT1193955 and GNT1172873, respectively).

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.