Improving Access to Sexual Health Services in General Practice Using a Hub-and-Spoke Model: A Mixed-Methods Evaluation

Jason J. Ong, Christopher K. Fairley, Ria Fortune, Melanie Bissessor, Chantal Maloney, Henrietta Williams, Adrian Castro, Lea Castro, Jason Wu, Pei Sue Lee, Eric P. F. Chow and Marcus Y. Chen
Additional contact information
Jason J. Ong: Melbourne Sexual Health Centre, Alfred Health, Melbourne 3053, Australia
Christopher K. Fairley: Melbourne Sexual Health Centre, Alfred Health, Melbourne 3053, Australia
Ria Fortune: Melbourne Sexual Health Centre, Alfred Health, Melbourne 3053, Australia
Melanie Bissessor: Melbourne Sexual Health Centre, Alfred Health, Melbourne 3053, Australia
Chantal Maloney: Melbourne Sexual Health Centre, Alfred Health, Melbourne 3053, Australia
Henrietta Williams: Melbourne Sexual Health Centre, Alfred Health, Melbourne 3053, Australia
Adrian Castro: Kings Park Medical Centre Hillside, Hillside 3037, Australia
Lea Castro: Kings Park Medical Centre Hillside, Hillside 3037, Australia
Jason Wu: Kings Park Medical Centre Hillside, Hillside 3037, Australia
Pei Sue Lee: Tarneit Family Medical & Dental Centre, Tarneit 3029, Australia
Eric P. F. Chow: Melbourne Sexual Health Centre, Alfred Health, Melbourne 3053, Australia
Marcus Y. Chen: Melbourne Sexual Health Centre, Alfred Health, Melbourne 3053, Australia

IJERPH, 2022, vol. 19, issue 7, 1-9

Abstract: Improving access to sexual health services is critical in light of rising sexually transmitted infections (STIs). We evaluated a hub-and-spoke model for improving access to sexual health services in three general practices in Victoria, Australia. The primary outcome was the impact on HIV and STI (chlamydia, gonorrhoea, syphilis) testing. Segmented linear regression analysis was conducted to examine the trends in the total HIV/STI tests pre- (from January 2019 to June 2020) and post-implementation (from July 2020 to July 2021). We evaluated the feasibility and acceptability of integrating this model into the general practices using semi-structured individual interviews. There was a statistically significant rise in testing for HIV and STIs in all general practices: post-implementation, there was an increase of an average of 11.2 chlamydia tests per month ( p = 0.026), 10.5 gonorrhoea tests per month ( p = 0.001), 4.3 syphilis tests per month ( p = 0.010), and 5.6 HIV tests per month ( p = 0.010). Participants reported increases in knowledge level and confidence in offering STI testing and managing a greater variety of sexual health cases. This study demonstrates the feasibility of implementing a hub-and-spoke model to enable GPs to deliver sexual health care with support from a sexual health specialist service.

Keywords: HIV; sexually transmitted infection; general practice; hub and spoke; primary care; sexual health (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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