Do women requesting only contraception find attendance at an integrated sexual health clinic more stigmatizing than attendance at a family planning–only clinic?

Ulrike Sauer,¹ Arti Singh,² Punam Rubenstein,¹ Rudiger Pittrof<sup>3

1</sup>Department of Reproductive and Sexual Health Services, Enfield Community Services, London, UK; ²University Health Services, KNUST Hospital, Kumasi, Ghana, ³Guy’s and St Thomas’ NHS Trust, London, UK

Purpose: Both sexually transmitted infections and the genitourinary medicine clinics that patients attend for management of sexually transmitted infections are stigmatized by patients’ perceptions. The aim of this study was to assess whether women requesting contraception only find attendance at an integrated sexual health clinic (ISHC) more stigmatizing than attendance at a family planning (FP)–only clinic.
Patients and methods: Women requesting contraception only were asked to complete a stigma assessment questionnaire in the waiting room of the clinic they attended. Ease of understanding was assessed for each item of the questionnaire prior to commencement of the survey. The questionnaire was given to women attending either an ISHC or a FP-only clinic.
Results: One hundred questionnaires that fulfilled the inclusion criteria were returned. The users of FP-only services were generally older than the users of ISHCs and were more likely than the users of ISHCs to classify themselves as UK white. Stigma perception was significantly higher for the ISHC than the FP-only clinic.
Conclusion: The results of this research indicate that among women who request contraception only, perceived stigma is higher when they attend an ISHC than when they attend a FP-only clinic. As this survey only enrolled clinic users, the authors were unable to assess whether integration generates sufficient stigma to deter some women from accessing contraception from integrated services. Of all stigma-related issues, disclosure concerns are likely to be the most important to the service user. Stigma is not an issue of overriding concern for most service users.

Keywords: stigma, one-stop shop, sexually transmitted diseases, contraception