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How much do delayed healthcare seeking, delayed care provision, and diversion from primary care contribute to the transmission of STIs?

Mercer, CH; Sutcliffe, L; Johnson, AM; White, PJ; Brook, G; Ross, JDC; Dhar, J; ... Cassell, JA; + view all (2007) How much do delayed healthcare seeking, delayed care provision, and diversion from primary care contribute to the transmission of STIs? SEX TRANSM INFECT , 83 (5) 400 - 405. 10.1136/sti.2006.024554. Green open access

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Abstract

Objectives: To quantify the contribution of patient delay, provider delay, and diversion between services to delayed access to genitourinary medicine (GUM) clinics. To describe the factors associated with delay, and their contribution to STI transmission.Methods: Cross-sectional survey of 3184 consecutive new patients attending four GUM clinics purposively selected from across England to represent different types of population. Patients completed a short written questionnaire that collected data on sociodemographics, access, and health-seeking behaviour. Questionnaires were then linked to routinely collected individual-level demographic and diagnostic data.Results: Patient delay is a median of 7 days, and does not vary by demographic or social characteristics, or by clinic. However, attendance at a walk-in appointment was associated with a marked reduction in patient delay and provider delay. Among symptomatics, 44.8% of men and 58.0% of women continued to have sex while awaiting treatment, with 7.0% reporting sex with > 1 partner; 4.2% of symptomatic patients reported sex without using condoms with new partner(s) since their symptoms had begun. Approximately 25% of all patients had already sought or received care in general practice, and these patients experienced greater provider delay.Conclusions: Walk-in services are associated with a reduction in patient and provider delay, and should be available to all populations. Patients attending primary care require clear care pathways when referred on to GUM clinics. Health promotion should encourage symptomatic patients to seek care quickly, and to avoid sexual contact before treatment.

Type: Article
Title: How much do delayed healthcare seeking, delayed care provision, and diversion from primary care contribute to the transmission of STIs?
Open access status: An open access version is available from UCL Discovery
DOI: 10.1136/sti.2006.024554
Publisher version: http://www.ncbi.nlm.nih.gov/pmc/ articles/PMC26590...
Keywords: SEXUALLY-TRANSMITTED INFECTIONS, GENITOURINARY MEDICINE SERVICES, NATIONAL-STRATEGY, GENERAL-PRACTICE, PATIENT ACCESS, UNITED-KINGDOM, GUM CLINICS, HIV, CHLAMYDIA, ENGLAND
UCL classification: UCL
UCL > Provost and Vice Provost Offices
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
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health > Infection and Population Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL EGA Institute for Womens Health
URI: https://discovery.ucl.ac.uk/id/eprint/6742
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