Patient, staffing and health centre factors associated with annual testing for sexually transmissible infections in remote primary health centres
Belinda Hengel A B H , Handan Wand B , James Ward D , Alice Rumbold E F , Linda Garton C , Debbie Taylor-Thomson E , Bronwyn Silver E , Skye McGregor B , Amalie Dyda B , Jacqueline Mein A , Janet Knox G , Lisa Maher B , John Kaldor B , Rebecca Guy B and on behalf of the STRIVE Investigators
+ Author Affiliations
- Author Affiliations
A Apunipima Cape York Health Council, Cairns, PO Box 12045, Earlville, Qld 4870, Australia.
B Kirby Institute, UNSW Australia, Wallace Wurth Building, Kensington, NSW 2052, Australia.
C NT Department of Health, Sexual Health and Blood Borne Virus Unit, Casuarina, NT 0811, Australia.
D South Australian Health and Medical Research Institute, North Terrace Adelaide, SA 5000, Australia.
E Menzies School of Health Research, Darwin, NT 0810, Australia.
F Robinson Research Institute, The University of Adelaide, Adelaide, SA 5006, Australia.
G Lismore Sexual Health Service, NSW Health, Sydney, NSW, 2480, Australia.
H Corresponding author. Email: belinda.hengel@apunipima.org.au
Sexual Health 14(3) 274-281 https://doi.org/10.1071/SH16123
Submitted: 17 June 2016 Accepted: 31 January 2017 Published: 27 April 2017
Abstract
Background: In high-incidence Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) settings, annual re-testing is an important public health strategy. Using baseline laboratory data (2009–10) from a cluster randomised trial in 67 remote Aboriginal communities, the extent of re-testing was determined, along with the associated patient, staffing and health centre factors. Methods: Annual testing was defined as re-testing in 9–15 months (guideline recommendation) and a broader time period of 5–15 months following an initial negative CT/NG test. Random effects logistic regression was used to determine factors associated with re-testing. Results: Of 10 559 individuals aged ≥16 years with an initial negative CT/NG test (median age = 25 years), 20.3% had a re-test in 9–15 months (23.6% females vs 15.4% males, P < 0.001) and 35.2% in 5–15 months (40.9% females vs 26.5% males, P < 0.001). Factors independently associated with re-testing in 9–15 months in both males and females were: younger age (16–19, 20–24 years); and attending a centre that sees predominantly (>90%) Aboriginal people. Additional factors independently associated with re-testing for females were: being aged 25–29 years, attending a centre that used electronic medical records, and for males, attending a health centre that employed Aboriginal health workers and more male staff. Conclusions: Approximately 20% of people were re-tested within 9–15 months. Re-testing was more common in younger individuals. Findings highlight the importance of recall systems, Aboriginal health workers and male staff to facilitate annual re-testing. Further initiatives may be needed to increase re-testing.
Additional keywords: Aboriginal, annual screening, chlamydia, gonorrhoea, guidelines, re-testing, primary health care.
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