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Background: The Black Caribbean population have a disproportionately high burden of sexually transmitted infections (STIs) compared with other ethnic groups. The aim of this study was to explore barriers to engagement with STI testing within a UK-based young adult Black Caribbean community. Methods: Semi-structured interviews were carried out with 14 young adults from the Black Caribbean community and six sexual healthcare professionals. Data were analysed thematically. A focus group of five young adults was conducted to refine themes. Results: Data analysis generated three themes: (1) culturally embedded stigma; (2) historically embedded mistrust; and (3) lack of knowledge. Perceived as 'dirty', particularly for females, infection with STIs was stigmatised by religious conceptions of 'purity' and shame. This presented challenges in terms of cultural acceptability of talking about STI testing with partners, friends, and family. Legacies of colonialism, medical racism and malpractice compromised young people's trust in medical intervention and confidentiality of data management. A lack of knowledge related to STIs and their treatment, and in how to access and perform STI tests further served as a barrier. Culturally tailored interventions targeting these factors and delivered by radio, podcasts and social media were highlighted as having potential to improve engagement with STI testing. Discussion: Engagement with STI testing by young adults from the Black Caribbean community is impacted by historically and culturally embedded teachings, practices and beliefs inherited through generations. Targeting these factors within culturally tailored interventions may be effective for increasing STI-testing, and thus reducing rates of STI-infection in this population. The Black Caribbean population have a disproportionately high burden of sexually transmitted infections (STIs). This study explored barriers to engagement with STI testing within a UK-based young adult Black Caribbean community. Engagement with STI testing in young adults from the Black Caribbean community is impacted by historically and culturally embedded practices and beliefs inherited through generations. Targeting these factors within interventions may be effective for increasing STI-testing, and thus reducing rates of STI-infection in this population. [ABSTRACT FROM AUTHOR]

Background: Black ethnic groups are disproportionately affected by sexually transmitted infections (STIs). This review aimed to identify interventions designed to increase engagement with sexual healthcare among people of Black ethnicity as determined by rates of STI testing, adherence to sexual health treatment, and attendance at sexual healthcare consultations. The behaviour change techniques (BCTs) used within identified interventions were evaluated. Method: Four electronic databases (Web of science; ProQuest; Scopus; PubMed) were systematically searched to identify eligible articles published between 2000 and 2022. Studies were critically appraised using the Mixed Methods Appraisal Tool. Findings were narratively synthesised. Results: Twenty one studies across two countries were included. Studies included randomised controlled trials and non-randomised designs. Behavioural interventions had the potential to increase STI/HIV testing, sexual healthcare consultation attendance and adherence to sexual health treatment. Behavioural theory underpinned 16 interventions which addressed barriers to engaging with sexual healthcare. Intervention facilitators' demographics and lived experience were frequently matched to those of recipients. The most frequently identified novel BCTs in effective interventions included information about health consequences, instruction on how to perform behaviour, information about social and environmental consequences, framing/reframing, problem solving, and review behavioural goal(s). Discussion: Our findings highlight the importance of considering sociocultural, structural and socio-economic barriers to increasing engagement with sexual healthcare. Matching the intervention facilitators' demographics and lived experience to intervention recipients may further increase engagement. Examination of different BCT combinations would benefit future sexual health interventions in Black ethnic groups. People from Black ethnic backgrounds are disproportionately affected by sexually transmitted infections. In this paper, we reviewed existing literature to understand the effectiveness of interventions designed to increase engagement with sexual healthcare among people of Black ethnicity. Our findings highlight the importance of considering sociocultural, structural and socio-economic barriers to increasing engagement with sexual healthcare. Matching the intervention facilitators' demographics and lived experience to intervention recipients may further increase engagement and trust. [ABSTRACT FROM AUTHOR]

Background: Missed sexual healthcare appointments lead to inefficiencies and wasted resources, longer waiting times and poorer outcomes. The aim of this research was to identify factors influencing non-attendance at sexual healthcare appointments and to make recommendations for interventions. Methods: Semi-structured interviews were carried out with UK-based sexual health service-users with experience of booking and missing appointments and sexual health professionals (n = 28). Interviews were analysed using a thematic framework approach. Results: Perceptual, practical, and organisational factors were found to influence missed appointments. Perceptual factors included beliefs about the outcomes of attending; sense of responsibility to attend; and concerns about privacy and security. Practical factors included competing demands and disruption to daily life; ability to attend; and forgetting. Organisational factors included mode of appointment delivery and availability of appointments. Conclusions: Interventions should combine strategies shown to be effective for overcoming practical barriers to attendance (e.g. reminder systems) with novel strategies communicating the benefits of attending and risks of missed appointments (e.g. behaviourally informed messaging). Text reminders containing behaviourally informed messages may be an efficient intervention for targeting perceptual and practical factors associated with missed appointments. Offering appointment modalities to suit individual preference and enabling service-users to remotely cancel/reschedule appointments maight further support a reduction in missed appointments. Missed sexual healthcare appointments lead to wasted resources, long waiting times and poorer health for individuals who maight not receive the treatment they need. This research aimed to find out what makes it easy or difficult to attend a sexual healthcare appointment. Barriers to attendance included beliefs about what will happen, sense of responsibility, concerns about privacy, ability to attend, appointment availability and forgetting. Text message reminders with behaviour change messaging may be an efficient way to address these barriers. [ABSTRACT FROM AUTHOR]

Background: Attending a sexual health consultation is integral to the effective prevention and treatment of sexually transmitted infections (STIs). However, individuals who may be at risk of STIs do not always do so, leading to an increased risk of STI complications and transmission of infection to others. This systematic review aimed to identify interventions implemented to increase attendance at a pre-booked sexual health clinic appointment and to identify behavioural theory and behaviour change techniques (BCTs), which form the basis for such interventions.Methods: Articles were identified through a systematic search of four electronic databases (Web of Science; ProQuest; Scopus; PubMed) and included if they aimed to increase attendance at a pre-booked, synchronous sexual health consultation. The quality of included studies was assessed independently by two researchers. Findings were synthesised narratively.Results: Thirteen studies were included from three countries; eight non-randomised before-after study designs and five randomised controlled trials. Behavioural interventions increased attendance at pre-booked sexual health consultations. Text messages were the most frequently used mode for intervention delivery. A total of 19 BCTs were identified, but only three studies mentioned behavioural theory. The most frequently used BCTs in effective interventions were: using credible sources, employing prompts/cues and the provision of information about health consequences. However, these BCTs were also identified in interventions that were not effective, meaning that optimal content and theoretical underpinning of effective interventions remains unclear.Conclusions: Behavioural interventions can increase attendance at sexual health consultations. Further research is needed to examine the effectiveness of different BCT combinations. [ABSTRACT FROM AUTHOR]