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Health services research
Original research
Healthcare provider and service user perspectives on STI risk reduction interventions for young people and MSM in the UK
  1. Anupama Roy1,
  2. Carina King2,3,
  3. Richard Gilson2,
  4. Daniel Richardson4,5,
  5. Fiona Burns2,
  6. Alison Rodger2,6,
  7. Laura Clark4,
  8. Alec Miners7,
  9. Alex Pollard1,
  10. Sarika Desai8,
  11. Julia Bailey9,
  12. Maryam Shahmanesh2,
  13. Carrie Llewellyn1
  1. 1 Department of Primary Care & Public Health, Brighton & Sussex Medical School, Brighton, UK
  2. 2 Institute for Global Health, University College London, London, UK
  3. 3 Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
  4. 4 Sexual Health & HIV, Brighton & Sussex University NHS Trust, Brighton, UK
  5. 5 Sexual Health & HIV Medicine, Brighton & Sussex Medical School, Brighton, UK
  6. 6 Infection & Population Health, University College London, London, UK
  7. 7 Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
  8. 8 Blood Safety, Hepatitis, Sexually Transmitted Infections (STI) and HIV Service, National Infection Service, Public Health England, London, UK
  9. 9 Primary Care & Population Health, University College London, London, UK
  1. Correspondence to Dr Carina King, Institute for Global Health, University College London, London WC1E 6BT, UK; c.king{at}ucl.ac.uk

Abstract

Objective Behavioural interventions have been shown to reduce sexual behaviours associated with increased risk of sexually transmitted infections in young people (<25 years) and men who have sex with men (MSM) internationally, but evidence from England is limited. We aimed to explore service provider and user experiences and perspectives on behavioural interventions to reduce sexual behaviour risks, and the use of automated methods to triage individuals to these services.

Methods We conducted a sequential mixed methods study with sexual health service providers and users in 2015/2016. Qualitative interviews with providers and service users (heterosexual young people and MSM) in London and Brighton allowed us to explore a range of experiences and expectations. A subsequent national web-survey of service providers measured the feasibility of delivery within existing resources and preferences for intervention attributes.

Results We conducted 35 service user (15 heterosexual young people; 20 MSM) and 26 provider interviews and had 100 web-survey responses. We found considerable heterogeneity in prevention services offered. Service users and providers were broadly supportive of tailoring interventions offered, but service users raised concerns about automated, data-driven triage, particularly around equity and fairness of service delivery. Digital technologies, including social media or apps, were appealing to providers, being less resource intensive. However, one-to-one talking interventions remained popular with both service users and providers, being familiar, trustworthy and personal. Key tensions between desirability of interventions and availability of resources to deliver them were acknowledged/recognised by providers and users.

Conclusion Overall, behavioural interventions to reduce sexual behaviour risks were viewed favourably by service providers and users, with key considerations including: privacy, personalisation and convenience. However, introducing desirable targeted interventions within heterogeneous sexual health settings will require resources to adapt interventions and research to fully understand the barriers and facilitators to use within routine services.

  • STI
  • young people
  • MSM
  • risk reduction
  • intervention
https://creativecommons.org/licenses/by/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.

https://doi.org/10.1136/sextrans-2018-053903

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    Footnotes

    • Handling editor Claudia S Estcourt

    • Contributors The study was designed by RG, MS, CL, CK and AR, with input from all authors. Recruitment and interviews of service providers and users were conducted by AR, CK and SD and analysis of interviews was conducted by AR and CK. The web-survey was managed by CK and communications managed by RG and CK. The analysis of the web-survey was conducted by CK. The manuscript was written by AR and CK, with considerable input from MS and CL. All authors read and commented on the manuscript.

    • Funding This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme (12/191/05).

    • Competing interests None declared.

    • Patient consent for publication Not required.

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

    • Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information.