Exploring sexual health among female sexually transmitted disease clinic patients, San Francisco 2010

Measuring Health and Quality of Life for Women Undergoing Testing and Screening for Chlamydia: A Systematic Review

BACKGROUND

Most economic evaluations of interventions to prevent or control curable sexually transmitted infections (STIs), such as chlamydia, have focused on the longer-term health impacts avoided. However, there is a range of qualitative evidence suggesting that those who think that they might have an STI and/or undergo testing can experience impacts on their quality of life (QoL) at the testing and diagnosis stage. A systematic review was undertaken to identify and evaluate studies that have measured QoL and sexual health for women undergoing testing and screening for chlamydia.

METHODS

A systematic review was conducted, with searches of 5 electronic databases up to the end of August 2013. Data on study characteristics, methods, and results were extracted using a standard template, and a narrative synthesis was undertaken.

RESULTS

Eight studies measuring QoL and sexual health were included. The included studies measured a variety of aspects of QoL and sexual health, with a focus on psychosocial well-being. A range of validated tools were used to measure health and QoL, and "bespoke" questions were also developed. Few significant differences were found with comparator groups using generic instruments, but some impacts were found using bespoke questions.

CONCLUSIONS

Although researchers have begun to examine the relationships between QoL and sexual health, there are limitations associated with the evidence available. There is, thus, a need for further research exploring sexual health and QoL for patients undergoing testing and screening for curable STIs, with a focus on analyzing the most appropriate methodological approaches in this context.

Conceptualising quality of life outcomes for women participating in testing for sexually transmitted infections: A systematic review and meta-synthesis of qualitative research

Many public health interventions have aims which are broader than health alone; this means that there are difficulties in using outcome measures that capture health effects only, such as Quality Adjusted Life Years (QALYs). Sexually Transmitted Infections (STIs) are a major public health concern both in the UK and globally, with Chlamydia trachomatis being the most common bacterial STI worldwide. There is scope for the wider use of qualitative syntheses in health-related research; in this study we highlight their potential value in informing outcome identification, particularly for public health interventions where a broad range of outcomes may need to be considered. This article presents a systematic review and meta-ethnography of qualitative studies that investigated women's experiences of thinking about and participating in testing for chlamydia. The meta-ethnography highlights issues relating to beliefs about STIs and testing, assessing risk and interpreting symptoms, emotional responses to testing, coping with diagnosis, relationship with sex partners(s), informal support, and interaction with health care services. The study findings suggest that women can experience a range of impacts on their health and quality of life. It is important that this range of effects is taken into account within evaluations, to ensure that decision makers are fully informed about the outcomes associated with screening interventions, and ultimately, to make sure that appropriate interventions are available to support women in maintaining good sexual health.