Cabecinha, Melissa;
Witney, Tom;
Saunders, John;
Gopalakrishnan, Gosala;
McDonagh, Lorraine K;
Rait, Greta;
(2025)
A qualitative exploration of barriers to, and interventions to improve, chlamydia retesting in England using the behaviour change wheel.
Sexually Transmitted Diseases
10.1097/OLQ.0000000000002264.
(In press).
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Abstract
Background: Chlamydia is the most diagnosed STI among young people in England. Repeat infections are common, and the risk of complications from chlamydia increase with the number of lifetime infections. National guidelines recommend re-testing three to six months following treatment; however, re-testing rates remain low at 10-14%. The objectives of this study were to explore barriers to, and identify potential interventions to improve, chlamydia re-testing among young people in England, using the behaviour change wheel (BCW). // Methods: Qualitative semi-structured interviews were conducted with twenty-two people aged 16-24 who had previously been diagnosed with chlamydia. Participants were recruited from sexual health services in London, the South West, and the North West of England. An inductive thematic analysis was conducted, followed by thematic categorisation to the BCW. // Results: Barriers to re-testing included low awareness and knowledge of the recommendation, and differences in how the term “re-test” was interpreted. Participants’ experience of the initial test influenced their willingness or intention to re-test. Possible interventions to overcome barriers include routine discussions of re-testing at diagnosis and the rationale behind the recommendation, re-testing reminders from service providers, and opt-in self-sampling kits. // Conclusions: Lack of awareness, and varied interpretations of “re-test” present challenges to retesting. Interventions such as routine discussions, text reminders, opt-in self-sampling kits, and clear guidance could improve awareness and understanding, and streamline the process. Future strategies should be developed with stakeholders and patients, and assessed for acceptability, practicability, effectiveness, affordability, side-effects, and equity, to maximise their real-world implementation and public health impact.
| Type: | Article |
|---|---|
| Title: | A qualitative exploration of barriers to, and interventions to improve, chlamydia retesting in England using the behaviour change wheel |
| Location: | United States |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1097/OLQ.0000000000002264 |
| Publisher version: | https://doi.org/10.1097/olq.0000000000002264 |
| Language: | English |
| Additional information: | Copyright © 2025 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Sexually Transmitted Diseases Association. This is an open access article distributed under the terms of the Creative Commons CC BY license, https://creativecommons.org/licenses/by/4.0/, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Primary Care and Population Health |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10217001 |
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