Supporting general practices to provide sexual and reproductive health services: protocol for the 3Cs & HIV programme.
OBJECTIVE
Sexually transmitted infections, HIV and unplanned pregnancies continue to be a major public health problem in England, especially in young adults. Strengthening the provision of free condoms, HIV testing, chlamydia screening and contraception within primary care will contribute to reducing poor sexual and reproductive health outcomes. Recent research demonstrated the benefit for general practices of educational support visits based on behaviour change theory. Public Health England (PHE) has piloted an educational training programme to improve the delivery of sexual health services and HIV testing within general practice.


METHODS
The 3Cs & HIV programme used practice based workshops to improve staffs' awareness and skills in order to increase opportunistic offers of chlamydia testing, provision of contraceptive service information and free condoms (the '3Cs') to 15-24 year olds and HIV testing according to national guidelines. The programme was based on the theory of planned behaviour and has been implemented using a stepped wedge design. Process evaluation, testing and diagnosis data, plus qualitative interviews were all used in the evaluation. The primary outcome measures were chlamydia testing and diagnosis rates. Secondary outcome measures were HIV testing and diagnoses rates within each practice and rates of consultations where long acting reversible contraceptives had been discussed.


CONCLUSIONS
A key strength of the 3Cs & HIV programme has been the evidence base underpinning the development of the resources and the formal process evaluation of its implementation. The programme was designed to encourage sustainable relationships between general practice staff and local sexual health services as well as the knowledge, awareness and behaviours cultivated during the programme.
HIV/STI Department, Centre for Infectious Disease Control and Surveillance, Public Health England, London, UK. Electronic address: Katy.town@phe.gov.uk.
K
K
Town
Public Health England Primary Care Unit, Microbiology Department, Gloucestershire Royal Hospital, UK.
E J
EJ
Ricketts
HIV/STI Department, Centre for Infectious Disease Control and Surveillance, Public Health England, London, UK.
T
T
Hartney
HIV/STI Department, Centre for Infectious Disease Control and Surveillance, Public Health England, London, UK.
J K
JK
Dunbar
HIV/STI Department, Centre for Infectious Disease Control and Surveillance, Public Health England, London, UK.
A
A
Nardone
HIV/STI Department, Centre for Infectious Disease Control and Surveillance, Public Health England, London, UK.
K A
KA
Folkard
Statistics, Modelling and Economics Department, Public Health England, London, UK.
A
A
Charlett
Public Health England Primary Care Unit, Microbiology Department, Gloucestershire Royal Hospital, UK.
C A M
CA
McNulty
D000293:Adolescent; D002690:Chlamydia Infections / Q000517:prevention & control; D002985:Clinical Protocols; D017280:Condoms; D003267:Contraception; D004739:England; D058006:General Practice; D015658:HIV Infections / Q000517:prevention & control; D006801:Humans; D008403:Mass Screening; D034121:Reproductive Health Services; D012736:Sex Education; D055815:Young Adult
Chlamydia screening; Condoms; Contraception; Education; HIV testing; Primary care; Protocol