Melbourne Sexual Health Centre, Alfred Health, Melbourne 3053, Australia.
Central Clinical School, Monash University, Melbourne 3004, Australia.
Int J Environ Res Public Health. 2022 Mar 25;19(7):3935. doi: 10.3390/ijerph19073935.
Improving access to sexual health services is critical in light of rising sexually transmitted infections (STIs). We evaluated a hub-and-spoke model for improving access to sexual health services in three general practices in Victoria, Australia. The primary outcome was the impact on HIV and STI (chlamydia, gonorrhoea, syphilis) testing. Segmented linear regression analysis was conducted to examine the trends in the total HIV/STI tests pre- (from January 2019 to June 2020) and post-implementation (from July 2020 to July 2021). We evaluated the feasibility and acceptability of integrating this model into the general practices using semi-structured individual interviews. There was a statistically significant rise in testing for HIV and STIs in all general practices: post-implementation, there was an increase of an average of 11.2 chlamydia tests per month ( = 0.026), 10.5 gonorrhoea tests per month ( = 0.001), 4.3 syphilis tests per month ( = 0.010), and 5.6 HIV tests per month ( = 0.010). Participants reported increases in knowledge level and confidence in offering STI testing and managing a greater variety of sexual health cases. This study demonstrates the feasibility of implementing a hub-and-spoke model to enable GPs to deliver sexual health care with support from a sexual health specialist service.
鉴于性传播感染（STIs）不断上升，改善获得性健康服务的机会至关重要。我们评估了澳大利亚维多利亚州三个普通实践中，通过一个中心辐射式模型来改善性健康服务的机会。主要结果是对 HIV 和性健康（衣原体，淋病，梅毒）检测的影响。采用分段线性回归分析来检查实施前（2019 年 1 月至 2020 年 6 月）和实施后（2020 年 7 月至 2021 年 7 月）HIV/STI 检测的总趋势。我们使用半结构化个人访谈评估了将这种模式整合到普通实践中的可行性和可接受性。所有普通实践中的 HIV 和 STI 检测都有统计学上的显著增加：实施后，每月平均增加 11.2 例衣原体检测（=0.026），10.5 例淋病检测（=0.001），4.3 例梅毒检测（=0.010）和 5.6 例 HIV 检测（=0.010）。参与者报告说，他们的知识水平提高了，对提供 STI 检测和管理更多种类的性健康病例的信心也增强了。这项研究表明，实施中心辐射式模型以支持普通医生提供性健康护理是可行的，而这种模型是通过性健康专家服务来支持的。
