(P323) Service user perspectives on online postal self-sampling (OPSS) for sexually transmitted infection (STI) testing: a qualitative study

Wednesday, July 26, 2023

16:00 – 18:00 CST

Primary Presenter(s)

Fiona Burns

Professor of Epidemiology and HIV
University College London, United Kingdom

Co-Author(s)

TS

Tommer Spence

Research Fellow
University College London
London, United Kingdom

Co-author(s)

JS

Jessica Sheringham

Senior Research Fellow
University College London, United Kingdom
AH

Alison Howarth

Senior Research Associate & Project Manager
University College London, United Kingdom
DR

David Reid

University College London, United Kingdom
DC

David J. Crundwell

Consultant
Lay Representative
London, England, United Kingdom
JR

Jonathan Ross, MB ChB MD FRCP

Professor of Sexual Health and HIV
University Hospital Birmingham NHS Trust
Birmingham, United Kingdom
GW

Geoff Wong

Associate Professor of Primary Care
University of Oxford, United Kingdom
VA

Vanessa Apea

Barts Health NHS Trust, United Kingdom
SD

Sara L. Day, MBChB

Consultant in Sexual Health & HIV and Clinical Lead for Sexual Health London
Sexual Health London, Chelsea and Westminster NHS Trust
London, England, United Kingdom
CD

Claire Dewsnap

Sheffield Teaching Hospitals NHS Foundation Trust
Sheffield, United Kingdom
JG

Jo Gibbs

Senior Clinical Research Associate and Honorary Consultant in Sexual Health & HIV
University College London, United Kingdom

Background

Online postal self-sampling (OPSS) is increasingly used to test for STIs, a trend accelerated by the COVID-19 pandemic. Whilst prior research has found OPSS to be acceptable, there remains limited understanding of how users experience OPSS compared to clinic-based services, the changes to user journeys following the introduction of OPSS, and facilitators and barriers to access. This research seeks to address these gaps, by undertaking a large qualitative study which sits within the ASSIST study, a mixed-methods, realist evaluation of OPSS.

Methods

Participants were recruited via OPSS and clinic-based sexual health services in three UK cities: Birmingham; London; and Sheffield. People were eligible if they were aged 16 or over, spoke English and had accessed one of the participating services within the past year. Purposive sampling was used to ensure populations of interest – including young adults, people of colour, men who have sex with men and gender minorities – were over-represented. Semi-structured interviews were initially analysed thematically and then using a realist logic of analysis.

Results

94 service users have been interviewed to date, with 21 having experience of OPSS, 14 experience of clinics and 59 experience of both. We found that users expected OPSS to be easy to access and convenient, with participants expressing high satisfaction with OPSS in services where this was the case, but higher levels of anxiety and dissatisfaction where expectations were not met. Although users appreciate the privacy offered by OPSS, and the opportunity to avoid long waits for appointments, they valued the support that in-person staff interaction offers, along with a wider range of tests available and expedited access to treatment in face-to-face services; particularly when they perceived themselves at higher risk of having an STI. Participants found OPSS easy to use overall, aside from finger-prick blood sampling.

Conclusion

Our findings constitute one of the largest qualitative studies to have explored OPSS and offer valuable insights to providers. They suggest that users find OPSS acceptable, provided it operates in line with their expectations. Users also want to retain access to clinic-based services for specific circumstances, such as when they believe they have acquired an STI.