What are young people’s attitudes towards internet-based chlamydia testing via general practice websites?
Chlamydia remains the most prevalent sexually transmitted infection in the UK, with high social and economic costs. Young people aged 15-24 experience the highest rates of chlamydia, with 62% of diagnoses in 2016 belonging to this demographic. Chlamydia, which is often asymptomatic, can cause major health consequences if left undiagnosed/untreated (e.g., pelvic inflammatory disease). Hence, testing and early treatment are essential to prevent transmission and negative outcomes. The National Chlamydia Screening Programme advocates a wide range of testing for young people across a range of settings, including general practice. However, only 19% of tests were performed in the UK in 2016 were conducted in general practice, indicating testing has not been widely implemented in this setting.An increasingly prevalent method of chlamydia testing is internet-based. Several websites offer free testing whereby a test is sent to an individual’s home for completion, and the sample is then free-posted for analysis. Young people have reportedly been highly receptive to internet-based chlamydia testing. Nevertheless, emerging issues with internet-based testing include concerns about test accuracy and credibility, privacy and confidentiality, and being diagnosed without professional contact. To address such concerns, we proposed the development of internet-based testing service delivered via general practice websites. The aim of this study, therefore, was to explore young people’s attitudes towards the provision of a general practice internet-based testing service, and identify barriers and facilitators to such a service.
Semi-structured, individual interviews (face-to-face and telephone) were conducted with 27 young people aged 16-24 years (17 women, 10 men). Participants were recruited from across the UK via youth organisations, charities, youth groups, online platforms (e.g., social networking sites), and through chain-referral sampling. Interviews were audio recorded and transcribed verbatim. Data were analysed using an inductive thematic analysis.
Young people perceived general practice internet-based testing positively and felt that this service would encourage more people to get tested for chlamydia. Moreover, participants reported that they would have greater trust in a general practice-led service, due to existing familiarity with the practice. Participants also mentioned that individuals would need to be made aware that the service exists as many were unaware of current internet-based chlamydia testing services. Alternative kit collection locations, clear instructions with demonstration video, disclaimer for ensuring confidentiality, a tracking service, and reminders were identified as ways to overcome barriers to internet-based testing.
These findings are the first step in the development of an intervention to facilitate effective and efficient chlamydia testing via general practice. Further work is needed regarding the attitudes of key stakeholders (general practice staff, sexual health commissioners) towards such a service. Clinical and policy implications, and study limitations will be explored.