{
  "abstract": "Objectives The study aimed to explore the acceptability of reducing the frequency of asymptomatic Chlamydia trachomatis (Ct) and Neisseria gonorrhoeae (Ng) screening among gay, bisexual, and other men who have sex with men (GBMSM)(Although the term GBMSM is used for convenience, the study also includes nonbinary people who were assigned male at birth who have sex with men.). Additionally, it sought to identify barriers and facilitators to implementing such changes and to develop potential interventions that could support a shift in current screening guidelines.Methods This qualitative study explored stakeholder perspectives on reducing screening frequency and identified potential interventions that could support future guideline changes of this kind. Semistructured interviews were conducted with 22 GBMSM and 8 professional stakeholders. Data were thematically analysed using the Capabilty, Opportunity, Motivation - Behaviour (COM-B) and Theoretical Domains Framework (TDF). TDF domains were mapped to behaviour change techniques to inform intervention development. Candidate interventions were refined based on acceptability, practicability, effectiveness, affordability, side effects, equity.Results Overall, GBMSM stakeholder responses to discontinuing asymptomatic Ng and Ct screening tended to be negative, while professional stakeholder opinions were mixed. Reducing the recommended screening frequency to 6 monthly was generally more acceptable to both groups. Barriers and facilitators to guideline changes included issues of knowledge and trust, social influence and identity, context and resources, concerns about consequences and emotional responses and habit. Ten candidate interventions were suggested. These involve providing information, social support, behavioural substitutions and feedback as well as facilitating discussions to resolve concerns.Conclusion Any reduction in the recommended frequency of asymptomatic screening will encounter a range of interrelated barriers, including knowledge gaps, social influences and emotional factors. We identified evidence-based interventions that could improve acceptance and minimise unintended consequences. Future research should incorporate stakeholder workshops to refine these strategies.",
  "authors": [
    {
      "affiliations": [
        "Blood Safety, Hepatitis, Sexually Transmitted Infections (STI) and HIV Division, UK Health Security Agency—Colindale, London, UK",
        "The National Institute for Health Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in Partnership with the UK Health Security Agency, London, UK"
      ],
      "name": "William Berners-Lee"
    },
    {
      "affiliations": [
        "Research Department for Primary Care and Population Health, UCL, London, UK"
      ],
      "name": "Melissa Cabecinha"
    },
    {
      "affiliations": [
        "Blood Safety, Hepatitis, Sexually Transmitted Infections (STI) and HIV Division, UK Health Security Agency—Colindale, London, UK"
      ],
      "name": "James Bell"
    },
    {
      "affiliations": [
        "Blood Safety, Hepatitis, Sexually Transmitted Infections (STI) and HIV Division, UK Health Security Agency—Colindale, London, UK"
      ],
      "name": "Dawn Phillips"
    },
    {
      "affiliations": [
        "Department of Infection and Population Health, UCL, London, UK"
      ],
      "name": "Tom Witney"
    },
    {
      "affiliations": [
        "Blood Safety, Hepatitis, Sexually Transmitted Infections (STI) and HIV Division, UK Health Security Agency—Colindale, London, UK"
      ],
      "name": "Caisey V Pulford"
    },
    {
      "affiliations": [
        "Centre for Behaviour Change, UCL, London, UK"
      ],
      "name": "Fabiana Lorencatto"
    },
    {
      "affiliations": [
        "Blood Safety, Hepatitis, Sexually Transmitted Infections (STI) and HIV Division, UK Health Security Agency—Colindale, London, UK"
      ],
      "name": "Helen Fifer"
    },
    {
      "affiliations": [
        "Blood Safety, Hepatitis, Sexually Transmitted Infections (STI) and HIV Division, UK Health Security Agency—Colindale, London, UK"
      ],
      "name": "Kirsty Foster"
    },
    {
      "affiliations": [
        "Blood Safety, Hepatitis, Sexually Transmitted Infections (STI) and HIV Division, UK Health Security Agency—Colindale, London, UK"
      ],
      "name": "Hamish Mohammed"
    },
    {
      "affiliations": [
        "Blood Safety, Hepatitis, Sexually Transmitted Infections (STI) and HIV Division, UK Health Security Agency—Colindale, London, UK"
      ],
      "name": "Katy Sinka"
    },
    {
      "affiliations": [
        "Blood Safety, Hepatitis, Sexually Transmitted Infections (STI) and HIV Division, UK Health Security Agency—Colindale, London, UK"
      ],
      "name": "Deborah Williamson"
    },
    {
      "affiliations": [
        "Institute of Epidemiology and Health, University College London, London, UK"
      ],
      "name": "Greta Rait"
    },
    {
      "affiliations": [
        "Blood Safety, Hepatitis, Sexually Transmitted Infections (STI) and HIV Division, UK Health Security Agency—Colindale, London, UK"
      ],
      "name": "Kate Folkard"
    },
    {
      "affiliations": [
        "Blood Safety, Hepatitis, Sexually Transmitted Infections (STI) and HIV Division, UK Health Security Agency—Colindale, London, UK",
        "The National Institute for Health Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in Partnership with the UK Health Security Agency, London, UK"
      ],
      "name": "John Saunders"
    }
  ],
  "title": "‘It does fill me with a bit of unease’: a qualitative study of the acceptability, facilitators and barriers to reducing the frequency of screening for asymptomatic sexually transmitted infections among gay, bisexual and other men who have sex with men",
  "uid": "da4741f5-8453-5e5d-9b29-09aeb90ff7d2"
}