title: Examining the potential public health benefit of offering STI testing to men in amateur football clubs: evidence from cross-sectional surveys.
abstract: BACKGROUND
  In Britain, young people continue to bear the burden of sexually transmitted infections (STIs) so efforts are required, especially among men, to encourage STI testing. The SPORTSMART study trialled an intervention that sought to achieve this by offering chlamydia and gonorrhoea test-kits to men attending amateur football clubs between October and December 2012. With football the highest participation team sport among men in England, this paper examines the potential public health benefit of offering STI testing to men in this setting by assessing their sociodemographic characteristics, sexual behaviours, and healthcare behaviour and comparing them to men in the general population.
  
  
  METHODS
  Data were collected from 192 (male) members of 6 football clubs in London, United Kingdom, aged 18-44 years via a 20-item pen-and-paper self-completion questionnaire administered 2 weeks after the intervention. These were compared to data collected from 409 men of a similar age who were resident in London when interviewed during 2010-2012 for the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3), a national probability survey that used computer-assisted-personal-interviewing with computer-assisted-self-interview. Age standardisation and multivariable regression were used to account for sociodemographic differences between the surveys.
  
  
  RESULTS
  Relative to men in the general population, SPORTSMART men were younger (32.8 % vs. 21.7 % aged under 25 y), and more likely to report (all past year) at least 2 sexual partners (adjusted odds ratio, AOR: 3.25, 95 % CI: 2.15-4.92), concurrent partners (AOR: 2.05, 95 % CI: 1.39-3.02), and non-use of condoms (AOR: 2.17, 95 % CI: 1.39-3.41). No difference was observed in STI/HIV risk perception (AOR for reporting "not at all at risk" of STIs: 1.25, 95 % CI: 0.76-2.04; of HIV: AOR: 1.54, 95 % CI: 0.93-2.55), nor in reporting STI testing in the past year (AOR: 0.83, 95 % CI: 0.44-1.54), which was reported by only one in six men.
  
  
  CONCLUSIONS
  Relative to young men in the general population, football club members who completed the SPORTSMART survey reported greater sexual risk behaviour but similar STI/HIV risk perception and STI testing history. Offering STI testing in amateur football clubs may therefore widen access to STI testing and health promotion messages for men at higher STI risk, which, given the minority currently testing and the popularity of football in England, should yield both individual and public health benefit.
authors.affiliation: Research Department of Infection and Population Health, University College London, London, UK. c.mercer@ucl.ac.uk.
authors.forename: Catherine H
authors.initials: CH
authors.lastname: Mercer
authors.affiliation: Centre for Immunology and Infectious Disease, Blizard Institute of Cell & Molecular Science, Barts and The London School of Medicine and Dentistry, London, UK. s.fuller@qmul.ac.uk.
authors.forename: Sebastian S
authors.initials: SS
authors.lastname: Fuller
authors.affiliation: Centre for Immunology and Infectious Disease, Blizard Institute of Cell & Molecular Science, Barts and The London School of Medicine and Dentistry, London, UK. j.saunders@qmul.ac.uk.
authors.forename: John M
authors.initials: JM
authors.lastname: Saunders
authors.affiliation: Research Department of Infection and Population Health, University College London, London, UK. p.muniina@ucl.ac.uk.
authors.forename: Pamela
authors.initials: P
authors.lastname: Muniina
authors.affiliation: Research Department of Infection and Population Health, University College London, London, UK. a.copas@ucl.ac.uk.
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Copas
authors.affiliation: Research Department of Infection and Population Health, University College London, London, UK. g.hart@ucl.ac.uk.
authors.forename: Graham J
authors.initials: GJ
authors.lastname: Hart
authors.affiliation: Centre for Immunology and Infectious Disease, Blizard Institute of Cell & Molecular Science, Barts and The London School of Medicine and Dentistry, London, UK. l.j.sutcliffe@qmul.ac.uk.
authors.forename: Lorna J
authors.initials: LJ
authors.lastname: Sutcliffe
authors.affiliation: Research Department of Infection and Population Health, University College London, London, UK. anne.johnson@ucl.ac.uk.
authors.forename: Anne M
authors.initials: AM
authors.lastname: Johnson
authors.affiliation: Division of Primary Care and Public Health, Brighton and Sussex Medical School, University of Sussex, Brighton, UK. j.cassell@bsms.ac.uk.
authors.forename: Jackie A
authors.initials: JA
authors.lastname: Cassell
authors.affiliation: Research Department of Infection and Population Health, University College London, London, UK. c.s.estcourt@qmul.ac.uk.
authors.forename: Claudia S
authors.initials: CS
authors.lastname: Estcourt
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D006801:Humans; D008131:London; D008297:Male; D008403:Mass Screening / Q000379:methods*; D015980:Public Health Practice; D012309:Risk-Taking; D012725:Sexual Behavior; D012749:Sexually Transmitted Diseases / Q000175:diagnosis* / Q000453:epidemiology; D012916:Soccer; D006113:United Kingdom / Q000453:epidemiology; D055815:Young Adult