title: Where do sexually active female London students go to access healthcare? Evidence from the POPI (Prevention of Pelvic Infection) chlamydia screening trial.
abstract: BACKGROUND
  Little is known about where sexually active female students access healthcare.
  
  
  OBJECTIVE
  Using data from the Prevention of Pelvic Infection (POPI) cohort, the authors aimed to: Describe where sexually active female students aged ≤ 27 years reported accessing healthcare. Investigate the association between numbers of sexual partners during 12 months of follow-up and healthcare usage, health-related quality of life (EQ-5D) and demographic and behavioural characteristics.
  
  
  METHODS
  Participants provided vaginal swabs and completed questionnaires on sexual health and quality of life at baseline and at a 12-month follow-up. The follow-up questionnaire also asked about healthcare attendances during the previous 12 months. Mann-Whitney tests were used to relate healthcare seeking behaviour and other characteristics to reported numbers of partners during follow-up.
  
  
  RESULTS
  Of 1865 women included in the analysis, 79% paid at least one visit to their general practice during follow-up, 23% attended an accident and emergency/walk-in clinic, 21% a family planning clinic and 14% a genitourinary medicine clinic. As the number of sexual partners increased (0-1, 2-3, 4+), women were more likely to have visited a genitourinary medicine clinic (10%, 16%, 30%, p<0.001) or accident and emergency/walk-in clinic (21%, 26%, 29%, p<0.002). Women with more sexual partners were also more likely to smoke, use condoms, be aged <16 years at sexual debut, have bacterial vaginosis, chlamydia or gonorrhoea at baseline and to have lower EQ5-D scores.
  
  
  CONCLUSIONS
  This is the first UK study of healthcare attendance in multiethnic female students recruited outside healthcare settings. The high attendance in general practice may represent a valuable opportunity for screening for sexually transmitted infections.
authors.affiliation: Division of Population Health Sciences and Education, St George's, University of London, London, UK.
authors.forename: Ruth
authors.initials: R
authors.lastname: Green
authors.forename: Sarah R
authors.initials: SR
authors.lastname: Kerry
authors.forename: Fiona
authors.initials: F
authors.lastname: Reid
authors.forename: Phillip E
authors.initials: PE
authors.lastname: Hay
authors.forename: Sally M
authors.initials: SM
authors.lastname: Kerry
authors.forename: Adamma
authors.initials: A
authors.lastname: Aghaizu
authors.forename: Pippa
authors.initials: P
authors.lastname: Oakeshott
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D008131:London; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D034161:Pelvic Infection / Q000517:prevention & control; D011788:Quality of Life / Q000523:psychology; D012725:Sexual Behavior / Q000706:statistics & numerical data; D012749:Sexually Transmitted Diseases / Q000175:diagnosis* / Q000188:drug therapy*; D013334:Students; D011795:Surveys and Questionnaires; D014621:Vagina / Q000382:microbiology; D055815:Young Adult