PT  - JOURNAL ARTICLE
AU  - Natalie Edelman
AU  - Jennifer Whetham
AU  - Jackie Cassell
AU  - Richard de Visser
AU  - Catherine Mercer
AU  - Christopher Jones
AU  - Abbey Gersten
AU  - Stephen Bremner
TI  - Performance of a tool to identify different types of self-reported sexual risk among women attending a contraception and sexual health clinic: results of a cross-sectional survey
AID  - 10.1136/bmjsrh-2019-200482
DP  - 2021 Apr 01
TA  - BMJ Sexual & Reproductive Health
PG  - 117--128
VI  - 47
IP  - 2
4099  - http://jfprhc.bmj.com/content/47/2/117.short
4100  - http://jfprhc.bmj.com/content/47/2/117.full
SO  - BMJ Sex Reprod Health2021 Apr 01; 47
AB  - Introduction A clinical prediction rule (CPR) using psychosocial questions was previously derived to target sexual healthcare in general practice by identifying women at risk of unintended pregnancy (UIP) and sexually transmitted infections (STIs). This psychosocial CPR may help target resources within contraception and sexual health (CASH) services. This study investigated how well it predicted recent self-reported risk of UIP and STI acquisition among women attending a CASH clinic.Methods Female patients aged 16–44 years attending a CASH clinic in South-East England were offered a questionnaire on arrival. This comprised psychosocial questions, and others addressing three sexual risks: (1) two or more male sexual partners in the last year (2+P), (2) risk of STI acquisition through most recent partner and (3) risk of UIP in the last 6 months. A CPR score was calculated for each participant and cross-tabulated against self-report of each sexual risk to estimate CPR sensitivity and specificity.Results The psychosocial questions predicting 2+P had sensitivity 83.2% (95% CI 79.3% to 86.5%) and specificity 56.1% (95% CI 51.3%−60.6%). Those predicting combined 2+P and/or risk of STI acquisition through most recent partner had a sensitivity of 89.1% (95% CI 85.7%−91.8%) and specificity of 43.7% (95% CI 39.0%−48.5%). Questions predicting risk of UIP in the last 6 months had a sensitivity of 82.5% (95% CI 78.6%−86.0%) and specificity of 48.3% (95% CI 43.4%−53.1%).Conclusions The CPR demonstrated good sensitivity but low specificity, so may be suited to triaging or stratifying which interventions to offer CASH patients and by which mode (eg, online vs face-to-face). Further investigation of causal links between psychosocial factors and sexual risk is warranted to support development of psychosocial interventions for this patient group.Data are available upon request.