在加拿大不列颠哥伦比亚省 COVID-19 大流行期间获取必要的性健康服务：对性健康服务客户的调查。
Accessing needed sexual health services during the COVID-19 pandemic in British Columbia, Canada: a survey of sexual health service clients.
机构信息
Clinical Prevention Services, BC Centre for Disease Control, Vancouver, British Columbia, Canada
School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada.
出版信息
Sex Transm Infect. 2022 Aug;98(5):360-365. doi: 10.1136/sextrans-2021-055013. Epub 2021 Nov 5.
OBJECTIVES
We assessed COVID-19 pandemic impacts on accessing needed sexual health services, and acceptability of alternative service delivery models, among sexual health service clients in British Columbia (BC), Canada.
METHODS
We administered an online survey on 21 July-4 August 2020 to clients using a provincial STI clinic or internet-based testing service, GetCheckedOnline, in the year prior to March 2020. We used logistic regression to identify factors associated with having unmet sexual health needs (ie, not accessing needed services) during March-July 2020 and the likelihood of using various alternative service models, if available.
RESULTS
Of 1198 survey respondents, 706 (59%) reported needing any sexual health service since March 2020; of these 706, 365 (52%) did not access needed services and 458 (66%) had avoided or delayed accessing services. GetCheckedOnline users (univariate OR (uOR)=0.62; 95% CI 0.43 to 0.88) or clients with more urgent needs (eg, treatment for new STI, uOR 0.40 (95% CI 0.21 to 0.7)) had lower odds of unmet sexual health needs. The most common factors reported for avoiding or delaying access were public messaging against seeking non-urgent healthcare (234/662, 35%), concern about getting COVID-19 while at (214/662, 32%) or travelling to (147/662, 22%) a clinic or lab and closure of usual place of accessing services (178/662, 27%). All factors were positively associated with having unmet sexual health needs, with public messaging showing the strongest effect (adjusted OR=4.27 (95% CI 2.88 to 6.42)). Likelihood of using alternative sexual health service models was high overall, with the most appealing options being home self-collection kits (634/706, 90%), receiving test kits or antibiotics at home (592/700, 85%) and express testing (565/706, 80%).
CONCLUSIONS
Of BC sexual health service clients needing services during March-July 2020, many had unmet needs. Offering alternative service delivery methods may help to improve access during and beyond the COVID-19 pandemic.
目的
我们评估了 COVID-19 大流行对不列颠哥伦比亚省（BC）加拿大性健康服务客户获得所需性健康服务的影响，以及对替代性服务提供模式的可接受性。
方法
我们于 2020 年 7 月 21 日至 8 月 4 日期间，向在 2020 年 3 月之前使用省级性传播感染（STI）诊所或基于互联网的检测服务 GetCheckedOnline 的客户，在线开展了一项调查。我们使用逻辑回归，确定了 2020 年 3 月至 7 月期间存在未满足的性健康需求（即未获得所需服务）的相关因素，以及在有替代服务模式的情况下使用各种替代服务模式的可能性。
结果
在 1198 名调查受访者中，有 706 名（59%）报告自 2020 年 3 月以来需要任何性健康服务；在这 706 名受访者中，有 365 名（52%）未获得所需服务，458 名（66%）避免或延迟获得服务。GetCheckedOnline 用户（单变量比值比（uOR）=0.62；95%置信区间 0.43 至 0.88）或有更紧急需求的客户（例如，治疗新的性传播感染，uOR 0.40（95%置信区间 0.21 至 0.7）），未满足性健康需求的可能性较低。避免或延迟获得服务的最常见原因包括公众对寻求非紧急医疗保健的信息（234/662，35%）、担心在（214/662，32%）或前往（147/662，22%）诊所或实验室时感染 COVID-19，以及通常的服务获取场所关闭（178/662，27%）。所有因素均与未满足的性健康需求呈正相关，公众信息传递的影响最强（调整比值比=4.27（95%置信区间 2.88 至 6.42））。总体而言，替代性性健康服务模式的使用可能性较高，最受欢迎的选择是家庭自我采集套件（634/706，90%）、在家中获得检测试剂盒或抗生素（592/700，85%）和快递检测（565/706，80%）。
结论
在 2020 年 3 月至 7 月期间需要服务的 BC 性健康服务客户中，许多人存在未满足的需求。提供替代服务提供方式可能有助于在 COVID-19 大流行期间及之后改善服务的获取。
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