Reasons for delays in treatment of bacterial sexually transmissible XXXX in remote Aboriginal communities in Australia: a qualitative study of healthcentre staff.

@entity1 @entity281 @entity458
UNASSIGNED: Background: Remote Aboriginal communities in Australia experience high rates of bacterial sexually transmissible @entity281 (STIs). To control the transmission and decrease the risk of complications, frequent STI testing combined with timely treatment is required, yet significant delays in treatment have been reported. Perceived barriers to timely treatment for asymptomatic @entity1 in remote communities were explored. Methods: A qualitative study was undertaken as part of the STRIVE (STIs in Remote communities, ImproVed and Enhanced primary health care) project; a cluster randomised controlled trial of a @entity458 improvement program. During 2012, we conducted 36 in-depth interviews with staff in 22 clinics in remote Australia. Results: @entity1 included registered nurses (72%) and Aboriginal health practitioners (28%). A key barrier to timely treatment was infrequent transportation of specimens to laboratories often hundreds of kilometres away from clinics. Within clinics, there were delays checking and actioning test results, and under-utilisation of systems to recall @entity1 . @entity1 also described difficulties in physically locating @entity1 due to: (i) high mobility between communities; and (ii) low levels of community knowledge created by high staff turnover. @entity1 also suggested strategies to overcome some barriers such as dedicated clinical time to follow-up recalls and taking treatment out to @entity1 . Conclusions: @entity1 identified barriers to timely STI treatment in remote Aboriginal communities, and systems to address some of the barriers. Innovative strategies such as point-of-care testing or increased support for actioning results, coupled with incentives to individual @entity1 to attend for results, may also assist in decreasing the time to treatment.
