31st August 2018, Volume 131 Number 1481

Hayley J Denison, Lisa Woods, Collette Bromhead, Jane Kennedy, Rebecca Grainger, Annemarie Jutel, Elaine M Dennison

Sexually transmitted infections (STIs) can lead to serious health complications including pelvic inflammatory disease, infertility and adverse pregnancy outcomes, as well as increased susceptibility to further STI acquisition including human…

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Summary

Untreated sexually transmitted infections (STIs) can lead to serious health complications and may be transmitted to uninfected individuals. Prior to this study, time to presentation for STI symptoms and risk of transmission in this period had not been assessed in New Zealand. This research surveyed people attending a sexual health clinic (SHC) in Wellington, New Zealand. In total, 243 people took part. The most common reason for seeking healthcare was experiencing symptoms. 41.7% of people with symptoms waited more than seven days to seek healthcare. Almost a third of people with symptoms had sex after they first thought they may need to seek healthcare. This work suggests more could be done to help people attend healthcare quicker when they experience symptoms suggestive of an STI. Some possible options could be a public health campaign explaining why taking swift action is important, or providing support and guidance to help people navigate the healthcare system.

Abstract

Aim

Untreated sexually transmitted infections (STIs) can lead to serious health complications and may be transmitted to uninfected individuals. Therefore, the early detection and subsequent management of STIs is crucial to control efforts. Time to presentation for STI symptoms and risk of transmission in this period has not been assessed in New Zealand to date.

Method

All new clients presenting to an urban sexual health clinic (SHC) were invited to complete a questionnaire, which included demographic information, sexual health history, and details about the clinic visit.

Results

Of 331 people approached, 243 (73.4%) agreed to complete the questionnaire. Four incomplete questionnaires were excluded, leaving 239 participants (47.3% female and 52.7% male, 43.8% under the age of 25). The most common reason for seeking healthcare was experiencing symptoms (39.4%) and 41.7% of people with symptoms waited more than seven days to seek healthcare. Around a third (30.6%) of people with symptoms had sex after they first thought they may need to seek healthcare. Infrequent condom use was reported more often by people who had sex with existing partners (84.6%) than by people who had sex with new partners (10.0%).

Conclusion

This is the first study to quantify healthcare-seeking behaviour for STI in New Zealand. Delayed healthcare-seeking (defined as waiting more than seven days) was common and almost a third of people reported engaging in sex while symptomatic. Enabling prompt healthcare-seeking is crucial to minimise transmission risk. Structural barriers such as the financial cost of STI tests must be removed and education around symptom recognition and healthcare system navigation should be provided.

Author Information

Hayley J Denison, Research Fellow, Centre for Public Health Research, Massey University, Wellington; Doctoral Candidate, School of Biological Sciences, Victoria University, Wellington;
Lisa Woods, Statistical Consultant, School of Mathematics and Statistics, Victoria University, Wellington; Collette Bromhead, Senior Lecturer, College of Health, Massey University, Wellington;
Jane Kennedy, Sexual Health Physician, Wellington Sexual Health Service, Wellington;
Rebecca Grainger, Senior Lecturer, Department of Medicine, University of Otago, Wellington;
Annemarie Jutel, Professor, Graduate School of Nursing, Midwifery and Health, Faculty of Health, Victoria University, Wellington; Elaine M Dennison, Professor, School of Biological Sciences, Victoria University, Wellington; Professor, MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom.

Acknowledgements

We thank the participants of this study for taking part in this research. We are grateful to the staff at the sexual health clinic in Wellington for their support of this work and their contribution to data collection. We also thank Hansa Patel for assisting with data entry for the study. 

Correspondence

Hayley J Denison, Centre for Public Health Research, Massey University - Wellington Campus, PO Box 756, Wellington 6140.

Correspondence Email

h.denison@massey.ac.nz

Competing Interests

Nil.

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