Young women’s perspectives on a user-friendly self-sampling intervention to improve the diagnosis of sexually transmitted infections in underserved communities in KwaZulu-Natal South Africa

Abstract

Abstract Introduction Young women are disproportionately affected by sexually transmitted infections (STIs), especially in the KwaZulu-Natal province of South Africa. As such they should have easy access to STI healthcare services. The main objective of this study was to collaborate with young women, using a nominal group technique (NGT), to identify barriers to existing STI healthcare services to ultimately identify strategies to inform attributes for a discrete choice experiment (DCE) towards developing a user-friendly self-sampling intervention for STI diagnosis in young women. Methods Eight young women, aged 18–24 years, were purposively selected from primary healthcare clinics in underserved communities. A NGT was conducted comprising the following steps: silent generation where individuals considered and recorded their responses to a question; round-robin sharing, recording and discussion of individual responses; followed by ranking of contributions. Results The following barriers to accessing STI healthcare services were identified: the clinics were too far from home; young women feared judgement by clinic staff; young women feared being told to inform their partners; clinic hours clashed with school hours and other personal commitments; and young women did not know enough about the signs and symptoms of STIs. The following strategies to improve access to STI healthcare services were suggested: campaigns to promote self-sampling; self-sampling kits should be available free of charge; online system to assess symptoms and register to receive self-sampling kits via delivery or collection to accommodate people with disabilities. Conclusion The strategies identified informed the attributes for the DCE which is aimed towards the development of a user-friendly self-sampling interventions for STI diagnosis in young women in KwaZulu-Natal.