Confidentiality the key to patients' choice of sexual health services
A recent study has investigated the views of patients attending a GUM clinic in Buckinghamshire. Patients were asked to complete a questionnaire, which included questions asking if they had been referred by their GP, where they would prefer to be seen for testing and treatment of STIs and what determined their choice.
Of 222 questionnaires distributed, 209 (94%) were returned. There was equal representation of men and women, and nearly half the respondents were less than 25 years old.
The survey found that just over a third had attended the same or other GUM clinic before. The same proportion also reported the first point of contact being their GP.
Almost 60% of patients preferred to be seen at a GUM clinic, and 30% by their GP. Those who reported initial contact with a GP reported an equal preference between the GUM clinic and general practice.
Determinants of patient preference included: confidentiality (81% of respondents rated this as ‘very important'); attitudes of staff (75%); the range of services available (65%); waiting times (51%) and location/ease of access (50%).
This study is consistent with findings from NATSAL 2000 and other studies, which suggest many people go to their GPs for STI testing and treatment.
These findings are also supported by another study investigating sexual health service provision.
A questionnaire was used to survey the views of 295 young people, 143 boys and 152 girls, aged 13 to 14, from four educational establishments in the Sheffield and Merseyside areas. The questions covered demographics, sexual health services and confidentiality.
Confidentiality was the most important quality for 56% of the respondents; this was rated higher then friendliness of staff, suitable (after school) opening hours or location. More than 90% of participants said that they were more likely to answer questions honestly if they knew the service was confidential.
Eighty per cent of respondents thought that a doctor should not tell child protection/social services if a young person was deemed to be at risk, and 63% stated that if they knew the doctor would inform child protection, they would not attend the clinic.
Only 47 of the respondents (15.9%) stated they would feel uncomfortable if they were asked sensitive questions. Half of the young people said they would prefer a clinic for patients under 20 years, and 35% would prefer a ‘one-stop shop'.
The issue of confidentiality cannot be overstated. For young people this is the most important criterion for judging a service. The assurance of confidentiality and having nonjudgmental and approachable staff might encourage more people to attend general practice, or indeed any setting, for STI care.
Confidentiality was clearly the most important factor and this probably explains why services such as Brook are so popular among young people.
Hambly S, Luzzi G. Sexual health services – a patient preference survey Int J STD AIDS 2006;17:372-374
Thomas N, Murray E, Rogstad KE. Confidentiality is essential if young people are to access sexual health services Int J STD AIDS 2006;17:525-529Reviewer
Dr Richard Ma
GP principal, North London and staff grade in sexual and reproductive health, Margaret Pyke Centre, London