Performance of a tool to identify different types of self-reported sexual risk among women attending a contraception and sexual health clinic: results of a cross-sectional survey
| Autor: | Abbey Gersten, Jennifer Whetham, Jackie Cassell, Stephen Bremner, Richard O. de Visser, Natalie Edelman, Catherine H Mercer, Christopher I. Jones |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Adult
Sexual health clinic Adolescent Cross-sectional study Sexual Behavior education Psychological intervention service delivery Clinical prediction rule Ambulatory Care Facilities Risk Assessment 03 medical and health sciences 0302 clinical medicine surveys needs assessment Pregnancy Surveys and Questionnaires Health care Medicine Humans 030212 general & internal medicine genitourinary medicine family planning service provision sexually transmitted infections Reproductive health Original Research 030505 public health business.industry Obstetrics and Gynecology medicine.disease Cross-Sectional Studies Reproductive Medicine England Female Reproductive Health Services Self Report 0305 other medical science business Psychosocial Unintended pregnancy Demography |
| Zdroj: | BMJ Sexual & Reproductive Health |
| ISSN: | 2515-1991 |
| Popis: | IntroductionA clinical prediction rule (CPR) using psychosocial questions was previously derived to target sexual healthcare in general practice by identifying women at risk of unintended pregnancy (UIP) and sexually transmitted infections (STIs). This psychosocial CPR may help target resources within contraception and sexual health (CASH) services. This study investigated how well it predicted recent self-reported risk of UIP and STI acquisition among women attending a CASH clinic.MethodsFemale patients aged 16–44 years attending a CASH clinic in South-East England were offered a questionnaire on arrival. This comprised psychosocial questions, and others addressing three sexual risks: (1) two or more male sexual partners in the last year (2+P), (2) risk of STI acquisition through most recent partner and (3) risk of UIP in the last 6 months. A CPR score was calculated for each participant and cross-tabulated against self-report of each sexual risk to estimate CPR sensitivity and specificity.ResultsThe psychosocial questions predicting 2+P had sensitivity 83.2% (95% CI 79.3% to 86.5%) and specificity 56.1% (95% CI 51.3%−60.6%). Those predicting combined 2+P and/or risk of STI acquisition through most recent partner had a sensitivity of 89.1% (95% CI 85.7%−91.8%) and specificity of 43.7% (95% CI 39.0%−48.5%). Questions predicting risk of UIP in the last 6 months had a sensitivity of 82.5% (95% CI 78.6%−86.0%) and specificity of 48.3% (95% CI 43.4%−53.1%).ConclusionsThe CPR demonstrated good sensitivity but low specificity, so may be suited to triaging or stratifying which interventions to offer CASH patients and by which mode (eg, online vs face-to-face). Further investigation of causal links between psychosocial factors and sexual risk is warranted to support development of psychosocial interventions for this patient group. |
| Databáze: | OpenAIRE |
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