Center for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands.
Center for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands.
Prev Med. 2020 Oct;139:106200. doi: 10.1016/j.ypmed.2020.106200. Epub 2020 Jul 11.
Sexually transmitted infection (STI) testing without face-to-face counselling is increasingly offered at sexual health centers (SHC), and ordering self-sampling tests online is becoming more popular. However, the impact of testing without counselling on behavior is unknown. We examine the impact of STI testing with and without consultation and the combined effect of a positive test result and treatment consultation, on behavioral and psychological characteristics over time. Data from a longitudinal study among heterosexual SHC visitors aged 18-24 years was used. The impact of a test consultation (participants who tested chlamydia negative with vs. without consultation) and treatment consultation/positive test result (participants who tested chlamydia positive vs. negative), was assessed by comparing behavioral and psychological characteristics before testing (baseline), and at three-week and six-month follow-up, using generalized estimating equation models. Changes after testing were similar between participants who tested chlamydia negative with and without test consultation, namely decreased risk perception, shame, number of partners, and increased knowledge. However, participants who tested chlamydia positive reported stronger increases in health goals and intentions towards condom use, and stronger decreases in the number of partners and stigma, compared to participants who tested negative. Furthermore, condom use increased in chlamydia positive, and decreased in chlamydia negative participants. A treatment consultation/positive test result had a risk-reducing impact on behavioral and psychological characteristics, whereas the impact of a test consultation was limited. Since the majority of young heterosexuals test chlamydia negative, alternative interventions (e.g., online) achieving risk-reducing behavior change targeted to individuals who tested negative are needed.
性传播感染（STI）检测无需面对面咨询，在性健康中心（SHC）中越来越常见，而在线订购自我采样检测也越来越受欢迎。然而，这种检测方式对行为的影响尚不清楚。我们研究了有无咨询的 STI 检测以及检测结果阳性和接受治疗咨询的综合效应，对性行为和心理特征随时间的变化影响。本研究的数据来自一项对 18-24 岁异性 SHC 访客的纵向研究。通过比较检测前（基线）、检测后 3 周和 6 个月的行为和心理特征，评估了检测咨询（接受衣原体检测且有无咨询的参与者）和治疗咨询/阳性检测结果（检测出衣原体阳性和阴性的参与者）的影响，采用广义估计方程模型。无论是否进行检测咨询，检测出衣原体阴性的参与者在风险感知、羞耻感、性伴侣数量和知识水平等方面都有所下降，而检测出衣原体阳性的参与者在健康目标和使用安全套的意愿方面的增加更为显著，性伴侣数量和耻辱感的减少更为显著。此外，衣原体阳性参与者的安全套使用率有所增加，而衣原体阴性参与者的安全套使用率则有所下降。治疗咨询/阳性检测结果对行为和心理特征具有降低风险的影响，而检测咨询的影响则较为有限。鉴于大多数年轻异性恋者检测出衣原体阴性，需要开发其他干预措施（如在线干预），针对检测结果为阴性的个体，以实现降低风险的行为改变。
