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Where do sexually active female London students go to access healthcare? Evidence from the POPI (Prevention of Pelvic Infection) chlamydia screening trial
  1. Ruth Green1,
  2. Sarah R Kerry1,
  3. Fiona Reid1,
  4. Phillip E Hay2,
  5. Sally M Kerry3,
  6. Adamma Aghaizu1,
  7. Pippa Oakeshott1
  1. 1Division of Population Health Sciences and Education, St George's, University of London, London, UK
  2. 2Department of Genitourinary Medicine, St George's Hospital, London, UK
  3. 3Centre for Public Health and Primary Care, Queen Mary, University of London, London, UK
  1. Correspondence to Dr Pippa Oakeshott, Reader in General Practice, Population Health Sciences and Education, St George's, University of London, London SW17 0RE, UK; oakeshot{at}


Background Little is known about where sexually active female students access healthcare.

Objectives Using data from the Prevention of Pelvic Infection (POPI) cohort, the authors aimed to:

  1. Describe where sexually active female students aged ≤27 years reported accessing healthcare.

  2. Investigate the association between numbers of sexual partners during 12 months of follow-up and healthcare usage, health-related quality of life (EQ-5D) and demographic and behavioural characteristics.

Methods Participants provided vaginal swabs and completed questionnaires on sexual health and quality of life at baseline and at a 12-month follow-up. The follow-up questionnaire also asked about healthcare attendances during the previous 12 months. Mann–Whitney tests were used to relate healthcare seeking behaviour and other characteristics to reported numbers of partners during follow-up.

Results Of 1865 women included in the analysis, 79% paid at least one visit to the general practice during follow-up, 23% attended an accident and emergency/walk-in clinic, 21% a family planning clinic and 14% a genitourinary medicine clinic. As the number of sexual partners increased (0–1, 2–3, 4+), women were more likely to have visited a genitourinary medicine clinic (10%, 16%, 30%, p<0.001) or accident and emergency/walk-in clinic (21%, 26%, 29%, p<0.002). Women with more sexual partners were also more likely to smoke, use condoms, be aged <16 years at sexual debut, have bacterial vaginosis, chlamydia or gonorrhoea at baseline and to have lower EQ5-D scores.

Conclusion This is the first UK study of healthcare attendance in multiethnic female students recruited outside healthcare settings. The high attendance in general practice may represent a valuable opportunity for screening for sexually transmitted infections.

  • Antiretroviral therapy
  • vaginosis
  • AIDS
  • chlamydia infection
  • general practice
  • HPV

Statistics from


  • Funding BUPA Foundation Grant 684/GB14B and Medical Research Council Grant 80280. Gen-Probe provided the Aptima test kits.

  • Competing interests PO and PEH are members of the eSTI2 consortium funded by the UK Clinical Research Collaboration

  • Patient consent Obtained.

  • Ethics approval The study was reviewed by Wandsworth Research Ethics Committee (reference 03.0012) and Bromley Research Ethics Committee (reference: 07/Q0705/16).

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

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