Access to online services for sexually transmitted infection self-sampling at home

Abstract

Recently, STI self-sampling services have become available online. However, there is limited information regarding who will access these services, the factors that influence access and the role that online services play within the wider sexual health service mix. This PhD investigates access to online services. 
This mixed methods PhD involves qualitative and quantitative enquiry. Demographic differences between users of online services and face-to-face services are identified by analysis of routinely collected data. Qualitative interviews explore the factors underlying the differences in access. A survey tool is then developed, and scales are psychometrically validated to measure these factors. The final survey tool is used to investigate the factors influencing use of online services. These findings are analysed using cross-sectional analysis and repeated measures analysis. Analysis of routinely collected data showed that demand for online services is high, although the access to online services was lower among young people aged 16 to 20 years and BME groups. Qualitative interviews revealed that the factors influencing use of online services relate to the individual and to their circumstances at the time of testing. 
Analysis of survey results found that among factors relating to the individual, a lack of institutional trust and a preference for professional support is a barrier of access to online services. Additionally, less normative beliefs around online testing, low self-efficacy and low trust in online services are a barrier to testing online now, however, among users this is likely to change over time as the service becomes more established. Among factors relating to users’ circumstances at the time of testing, not wanting to wait in a waiting room and finding it difficult to attend a clinic facilitated access to online services. However, higher perceived risk of infection and difficulty concealing a package received in the post are barriers to access.

Date of Award	1 Jan 2020
Original language	English
Awarding Institution	King's College London
Supervisor	Paula Baraitser (Supervisor) & Ioannis Bakolis (Supervisor)