title: Comparing expectations and experiences of care for sexually transmitted infections in general practice: a qualitative study.
abstract: BACKGROUND
  A key aim of England's National Strategy for Sexual Health is to extend high-quality sexual health services in primary care.
  
  
  OBJECTIVE
  To explore the expectations and experiences of men and women who initially presented at their general practice with a suspected sexually transmitted infection in order to identify areas where change could improve service delivery.
  
  
  METHODS
  Semi-structured interviews were carried out in six general practices and two genitourinary medicine (GUM) clinics in Brent primary care trust (London) and Bristol (southwest England). Patients within general practice, and GUM patients who had initially attended general practice were eligible to participate. Interview transcripts were analysed using thematic analysis.
  
  
  RESULTS
  49 patients (29 women, 20 men) were interviewed. Patients approaching their GP practice typically expected written referral or in-house care, but this expectation was often not met. Absence of formal referral, lack of information and perceived avoidance of sexual health matters by practitioners were commonly cited as reasons for disappointment. However, a dedicated service within general practice met expectations well.
  
  
  CONCLUSIONS
  Purchasers and providers of all general practice services should ensure that any patient consulting in primary care with a suspected sexually transmitted infection can either receive appropriate care there, or a formal and supported referral to a specialised GUM clinic or primary care service.
authors.affiliation: Research Department of Infection and Population Health, University College London, London, UK.
authors.forename: Lorna J
authors.initials: LJ
authors.lastname: Sutcliffe
authors.forename: Katharine E
authors.initials: KE
authors.lastname: Sadler
authors.forename: Nicola
authors.initials: N
authors.lastname: Low
authors.forename: Jackie A
authors.initials: JA
authors.lastname: Cassell
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000553:Ambulatory Care; D003695:Delivery of Health Care / Q000592:standards; D004739:England; D005260:Female; D058006:General Practice / Q000592:standards*; D006801:Humans; D008297:Male; D017060:Patient Satisfaction; D012749:Sexually Transmitted Diseases / Q000523:psychology / Q000628:therapy*; D055815:Young Adult