Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Improving Access to Sexual Health Services in General Practice Using a Hub-and-Spoke Model: A Mixed-Methods Evaluation

Version 1 : Received: 12 February 2022 / Approved: 16 February 2022 / Online: 16 February 2022 (09:17:05 CET)

A peer-reviewed article of this Preprint also exists.

Ong, J.J.; Fairley, C.K.; Fortune, R.; Bissessor, M.; Maloney, C.; Williams, H.; Castro, A.; Castro, L.; Wu, J.; Lee, P.S.; Chow, E.P.F.; Chen, M.Y. Improving Access to Sexual Health Services in General Practice Using a Hub-and-Spoke Model: A Mixed-Methods Evaluation. Int. J. Environ. Res. Public Health 2022, 19, 3935. Ong, J.J.; Fairley, C.K.; Fortune, R.; Bissessor, M.; Maloney, C.; Williams, H.; Castro, A.; Castro, L.; Wu, J.; Lee, P.S.; Chow, E.P.F.; Chen, M.Y. Improving Access to Sexual Health Services in General Practice Using a Hub-and-Spoke Model: A Mixed-Methods Evaluation. Int. J. Environ. Res. Public Health 2022, 19, 3935.

Abstract

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 before (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 (p=0.026), 10.5 gonorrhoea tests per month (p=0.001), 4.3 syphilis tests per month (p=0.010), and 5.6 HIV tests per month (p=0.010). Participants reported increases in knowledge level and confidence in offering STI testing and managing more variety of sexual health cases. This study demonstrated 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.

Keywords

HIV; sexually transmitted infection; general practice; Hub and spoke; primary care; sexual health

Subject

Medicine and Pharmacology, Epidemiology and Infectious Diseases

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