Of 51 patients invited to participate, 17 declined due to practical reasons (16 for time related factors and just 1 due to sexual health nature of interview) and 36 people agreed. Nine were male and the sample had an age range 15-24 years (mean age 21 years). Of our participants 24 (65%) had never had a chlamydia screen. They were recruited from six GP surgeries with screening rates ranging from 3% to 15% (screening data from 2007 NCSP data). No difference was found in the attitudes and opinions between male and female participants or participants of different age. Neither between people who had had a chlamydia screen previously and those who had not nor between participants from high and low screening surgeries (data not shown), and therefore all results are presented together.
Personal attitudes to being offered a chlamydia screen
The majority of male and female participants had positive personal attitudes towards chlamydia screening in GP surgeries:
"I'd prefer it at the doctors.... I've been coming here basically since I was born.... so I like coming here"
Interview 2: London, Male 19 yrs
They reported that being offered a screen was easier than having to ask for one and being offered a screen gave patients the opportunity to ask questions:
"If someone offers [it to] me, it kind of makes it easier"
Interview 14: London, Female 23 yrs
Nearly all participants expressed positive views about being offered a screen during a family planning consultation. However, opinion regarding being offered a chlamydia screen in an unrelated consultation was more diverse. Most participants were either positive:
"It wouldn't bother me if I got offered it (in an unrelated consultation) because if I needed it I could just say yes"
Interview 4: London, Female 20 yrs
or stated that initially they would be shocked but would still take up the offer:
"I'd be slightly surprised but, um, I guess it would be sensible you know, I would say fair enough, ...they should be offering it."
Interview 6: London, Female, 24 yrs
Four participants expressed negative views about being offered a screen in a consultation unrelated to sexual health but only two participants expressed that they would feel offended if offered a screen.
With regard to receptionist involvement in chlamydia screening, 26 (72%) participants reported that they would accept if a receptionist gave them a leaflet about chlamydia screening, provided it was given in a discreet and non-judgemental way:
"That would be okay, yeah, if they said to you 'would you read that while you're waiting'"
Interview 15: London, Male, 20 yrs
"as long as they didn't shout it out in front of everyone"
Interview 36: Wirral, Female, 17 yrs
Participants' attitudes towards being offered a chlamydia screen by a receptionist were mixed. 11 of the above 26 participants would also accept a screening kit if offered by a receptionist. (2 were not asked due to change of subject) Those that were not happy to accept a kit felt that it was not the role of receptionists to offer screens as they were not health professionals and they were concerned that reception is too open and lacked the privacy to discuss personal matters:
"I would feel little bit, embarrassed if people are around, I'd rather, I don't know it's a bit too open I think"
Interview 35: Wirral, Female, 24 yrs
A large proportion, 26 (72%) of our participants said they would take a home testing screening kit, although some highlighted the importance of the location and discreetness of where the kits actually were situated:
"I think the whole idea of taking it home and doing it yourself it feels straightforward as well and it's convenience, sort of comfortable because you're doing it"
Interview 18: London, Female, 23 yrs
Despite most of the participants expressing positive views about the home testing kits, the majority of the sample actually reported a preference for taking the sample at the surgery rather than doing it at home. The main reason for this was so they would not have to worry about returning the sample:
"yeah, do it while you are here, why not, because it they're taking it home you're not going to bring it back"
Interview 14: London, Female, 24 yrs
Subjective Norms to being offered a screen at the GP surgery
About half of the participants believed that doctors and nurses did want them to be screened, mostly because it was good for their health:
"yeah I should imagine they'd want you to wouldn't they because they're doctors and they want to make sure you're healthy, you're on top of your health, yeah, I should imagine so yeah"
Interview 35: Wirral, Female, 24 yrs
However, the other participants either felt that doctors and nurses didn't want them to be screened or they were unsure as they had never discussed chlamydia screening with a health professional in their GP surgery:
"I don't know, I don't have any indication that they do"
Interview 13: London, Female, 20 yrs
Participants reported much more positive views regarding their family, partner and friends' beliefs about them getting screened. Twenty-five participants believed that they would either be positive about it or that it would not bother them:
"My friends and family wouldn't think any less of me; in fact I think they'd think more of me for going to the doctors and getting checked"
Interview 4: London, Female, 20 yrs
Only a minority of participants said that they would not tell their friends, partner and family and one person explained that their friends would laugh about it:
"They (my family) would be fine with it......my friends would probably laugh"
Interview 31: Wirral, Male, 20 yrs