Register      Login
Sexual Health Sexual Health Society
Publishing on sexual health from the widest perspective
RESEARCH ARTICLE (Open Access)

Client and staff perceptions of acceptability of MyCheck: a direct-to-pathology telehealth and e-testing service for comprehensive bloodborne virus and sexually transmissible infection screening

Lise Lafferty https://orcid.org/0000-0002-8533-2957 A B * , Clinton Rautenbach A C , Anna McNulty https://orcid.org/0000-0003-3174-1242 D , Nathan Ryder https://orcid.org/0000-0002-2050-0155 E F , Carolyn Slattery E , Rebecca Houghton D , Aurelie Kenigsberg G , Carolyn Murray H , Nigel Carrington D H and Prital Patel A
+ Author Affiliations
- Author Affiliations

A The Kirby Institute, UNSW Sydney, Level 6, Wallace Wurth Building, Sydney, NSW 2052, Australia.

B Centre for Social Research in Health, UNSW Sydney, Level 1, Goodsell Building, Sydney, NSW 2052, Australia.

C University of Johannesburg, PO Box 524, Auckland Park 2006, South Africa.

D Sydney Sexual Health Centre, South Eastern Sydney Local Health District, Level 3, Nightingale Wing, Sydney Eye Hospital, 8 Macquarie Street, Sydney, NSW 2000, Australia.

E STI Programs Unit, NSW Ministry of Health, 150 Albion Street, Surry Hills, NSW 2010, Australia.

F The Pacific Clinic, Level 2/670 Hunter Street, Newcastle West, NSW 2302, Australia.

G NSW Sexual Health Infolink, NSW Ministry of Health, Locked Mail Bag 2030, St Leonards, NSW 1590, Australia.

H Centre for Population Health, NSW Ministry of Health, Locked Mail Bag 2030, St Leonards, NSW 1590, Australia.

* Correspondence to: l.lafferty@unsw.edu.au

Handling Editor: Dan Wu

Sexual Health 21, SH23194 https://doi.org/10.1071/SH23194
Submitted: 5 December 2023  Accepted: 12 April 2024  Published: 29 April 2024

© 2024 The Author(s) (or their employer(s)). Published by CSIRO Publishing. This is an open access article distributed under the Creative Commons Attribution 4.0 International License (CC BY)

Abstract

Background

Sydney Sexual Health Centre (SSHC) is the largest sexual health clinic in New South Wales (NSW), servicing clients at high risk of sexually transmissible infections and bloodborne viruses. SSHC piloted a direct-to-pathology pathway that facilitated bloodborne virus/sexually transmissible infection testing at one of the ~500 participating pathology collection centres located across NSW. This qualitative study sought to understand SSHC client and provider perspectives of acceptability of the MyCheck intervention.

Methods

Semi-structured in-depth interviews were conducted with 11 clients who underwent testing via the MyCheck pathway and eight staff members involved in implementing MyCheck. The seven components of Sekhon’s Theoretical Framework of Acceptability informed this analysis.

Results

Participants broadly conveyed ‘affective attitude’ toward the MyCheck pathway. The telehealth intervention reduced client ‘burden’ and ‘opportunity cost’ through enabling greater testing convenience at a location suitable to them and provided timely results. Issues of ‘ethicality’ were raised by clients and staff as pathology centre staff were, on a few occasions, regarded as being judgmental of SSHC clients. ‘Intervention coherence’ issues were largely attributed to pathology centre personnel being unfamiliar with the intervention, with billing issues being a recurrent concern. Participants perceived MyCheck as an ‘effective’ testing pathway. SSHC staff were able to offer the intervention with ease through seamless IT integration (‘self-efficacy’).

Conclusion

The MyCheck intervention was perceived by both SSHC clients and staff as an acceptable bloodborne virus/sexually transmissible infection testing pathway. However, further work is required to address stigma experienced by some clients when attending pathology collection centres.

Keywords: acceptability, bloodborne virus testing, digital health intervention, priority populations, qualitative research, sexual health, sexually transmissible infection testing, telehealth.

References

World Health Organization. Consolidated guidelines on HIV, viral hepatitis and STI prevention, diagnosis, treatment and care for key populations. Geneva: World Health Organization; 2022.

World Health Organization. Global health sector strategy on sexually transmitted infections 2016–2021. Geneva: World Health Organization; 2016.

ASHM. Australian STI management guidelines for use in primary care Sydney. Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine; 2022.

Commonwealth of Australia. Fifth national hepatitis C strategy 2018–2022. Canberra: Commonwealth of Australia; 2018.

Commonwealth of Australia. Eighth national HIV strategy 2018–2022. Canberra: Commonwealth of Australia; 2018.

Commonwealth of Australia. Fifth National Aboriginal and Torres Strait Islander blood borne viruses and sexually transmissible infections strategy 2018–2022. Canberra: Commonwealth of Australia; 2018.

Commonwealth of Australia. Third national hepatitis B strategy 2018–2022. Canberra: Commonwealth of Australia; 2018.

Commonwealth of Australia. Fourth national sexually transmissible infections 2018–2022. Canberra: Commonwealth of Australia; 2018.

Napoleon SC, Maynard MA, Almonte A, Cormier K, Bertrand T, Ard KL, et al. Considerations for STI clinics during the COVID-19 pandemic. Sex Transm Dis 2020; 47(7): 431-3.
| Crossref | Google Scholar | PubMed |

10  Contreras CM, Metzger GA, Beane JD, Dedhia PH, Ejaz A, Pawlik TM. Telemedicine: patient-provider clinical engagement during the COVID-19 pandemic and beyond. J Gastrointest Surg 2020; 24(7): 1692-7.
| Crossref | Google Scholar | PubMed |

11  Golinelli D, Boetto E, Carullo G, Nuzzolese AG, Landini MP, Fantini MP. Adoption of digital technologies in health care during the COVID-19 pandemic: systematic review of early scientific literature. J Med Internet Res 2020; 22(11): e22280.
| Crossref | Google Scholar | PubMed |

12  Gilbey D, Morgan H, Lin A, Perry Y. Effectiveness, acceptability, and feasibility of digital health interventions for LGBTIQ+ young people: systematic review. J Med Internet Res 2020; 22(12): e20158.
| Crossref | Google Scholar | PubMed |

13  Sekhon M, Cartwright M, Francis JJ. Acceptability of healthcare interventions: an overview of reviews and development of a theoretical framework. BMC Health Serv Res 2017; 17(1): 88.
| Crossref | Google Scholar | PubMed |

14  Gilbert M, Thomson K, Salway T, Haag D, Grennan T, Fairley CK, et al. Differences in experiences of barriers to STI testing between clients of the internet-based diagnostic testing service GetCheckedOnline.com and an STI clinic in Vancouver, Canada. Sex Transm Infect 2019; 95(2): 151-6.
| Crossref | Google Scholar |

15  Spence T, Kander I, Walsh J, Griffiths F, Ross J. Perceptions and experiences of internet-based testing for sexually transmitted infections: systematic review and synthesis of qualitative research. J Med Internet Res 2020; 22(8): e17667.
| Crossref | Google Scholar | PubMed |

16  Tucker JD, Hocking J, Oladele D, Estcourt C. Digital sexually transmitted infection and HIV services across prevention and care continuums: evidence and practical resources. Sex Health 2022; 19(4): 278-85.
| Crossref | Google Scholar | PubMed |

17  Llewellyn C, Pollard A, Miners A, Richardson D, Fisher M, Cairns J, et al. Understanding patient choices for attending sexually transmitted infection testing services: a qualitative study. Sex Transm Infect 2012; 88(7): 504-9.
| Crossref | Google Scholar | PubMed |

18  MacKinnon KR, Mykhalovskiy E, Worthington C, Gómez-Ramírez O, Gilbert M, Grace D. Pay to skip the line: the political economy of digital testing services for HIV and other sexually transmitted infections. Soc Sci Med 2021; 268: 113571.
| Crossref | Google Scholar | PubMed |

19  Ryan KE, Wilkinson AL, Asselin J, Leitinger DP, Locke P, Pedrana A, et al. Assessment of service refinement and its impact on repeat HIV testing by client’s access to Australia’s universal healthcare system: a retrospective cohort study. J Int AIDS Soc 2019; 22(8): e25353.
| Crossref | Google Scholar | PubMed |

20  World Health Organization. Patient engagement: technical series on safer primary care. Geneva: World Health Organization; 2016.

21  Singer RB, Johnson AK, Crooks N, Bruce D, Wesp L, Karczmar A, et al. “Feeling Safe, Feeling Seen, Feeling Free”: combating stigma and creating culturally safe care for sex workers in Chicago. PLoS ONE 2021; 16(6): e0253749.
| Crossref | Google Scholar | PubMed |

22  Haire BG, Brook E, Stoddart R, Simpson P. Trans and gender diverse people’s experiences of healthcare access in Australia: a qualitative study in people with complex needs. PLoS ONE 2021; 16(1): e0245889.
| Crossref | Google Scholar | PubMed |

23  Broady TR, Brener L, Cama E, Hopwood M, Treloar C. Stigmatising attitudes towards people who inject drugs, and people living with blood borne viruses or sexually transmissible infections in a representative sample of the Australian population. PLoS ONE 2020; 15(4): e0232218.
| Crossref | Google Scholar | PubMed |

24  Gan J, Kularadhan V, Chow EPF, Fairley CK, Hocking JS, Kong FYS, et al. What do young people in high-income countries want from STI testing services? A systematic review. Sex Transm Infect 2021; 97(8): 574-83.
| Crossref | Google Scholar | PubMed |