PhD defence D.E. (Denise) Twisk

Below is a brief summary of the dissertation:

In the Netherlands, individuals seeking testing for sexually transmitted infections (STIs), including HIV, mainly visit a general practitioner (GP) or a sexual health centre (SHC). SHCs, previously known as STI clinics, are coordinated by the Public Health Service. 

GPs conduct STI testing either upon patient request or guided by clinical indications. Moreover, GPs are recommended to proactively test individuals at higher risk of contracting an STI. Costs for tests and treatment at GPs might not fully covered by health insurance until a specific threshold of medical expenses is met. On the contrary, SHCs are government-funded and offer free-of-charge STI testing and care to specific key population group. These groups include those notified of an STI, people with STI-related symptoms, sex workers, men who have sex with men, individuals with non-western backgrounds and those under 25 years old.

The research described in this thesis aimed to enhance our understanding of STI testing provided by GPs and SHCs. The studies outlined in this thesis examined the extent to which the general population undergoes STI testing, the frequency of STI testing across various demographic groups and geographical areas, and factors influencing the utilisation of testing services. Additionally, the research assessed the relative contributions of GPs and SHCs to STI testing. The setup and outcomes of a community-based pilot-intervention to promote HIV testing are also detailed. The studies focused on the greater Rotterdam area. Insights generated from the research in this thesis may contribute to improved STI testing policies.