{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T11:05:02Z","timestamp":1787828702900,"version":"build-2784847793"},"reference-count":28,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2025,7,15]],"date-time":"2025-07-15T00:00:00Z","timestamp":1752537600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001921","name":"Public Health Research Programme","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001921","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Sex Transm Infect"],"accepted":{"date-parts":[[2025,6,20]]},"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>\n                      The study aimed to explore the acceptability of reducing the frequency of asymptomatic\n                      <jats:italic>Chlamydia trachomatis<\/jats:italic>\n                      (Ct) and\n                      <jats:italic>Neisseria gonorrhoeae<\/jats:italic>\n                      (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.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>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\u2009monthly 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/sextrans-2025-056556","type":"journal-article","created":{"date-parts":[[2025,7,15]],"date-time":"2025-07-15T21:40:37Z","timestamp":1752615637000},"page":"24-31","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["\u2018It does fill me with a bit of unease\u2019: 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"],"prefix":"10.1136","volume":"102","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-5519-193X","authenticated-orcid":false,"given":"William","family":"Berners-Lee","sequence":"first","affiliation":[{"name":"Blood Safety, Hepatitis, Sexually Transmitted Infections (STI) and HIV Division, UK Health Security Agency\u2014Colindale, London, UK"},{"name":"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"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa","family":"Cabecinha","sequence":"additional","affiliation":[{"name":"Research Department for Primary Care and Population Health, UCL, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2265-1205","authenticated-orcid":false,"given":"James","family":"Bell","sequence":"additional","affiliation":[{"name":"Blood Safety, Hepatitis, Sexually Transmitted Infections (STI) and HIV Division, UK Health Security Agency\u2014Colindale, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dawn","family":"Phillips","sequence":"additional","affiliation":[{"name":"Blood Safety, Hepatitis, Sexually Transmitted Infections (STI) and HIV Division, UK Health Security Agency\u2014Colindale, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2695-0605","authenticated-orcid":false,"given":"Tom","family":"Witney","sequence":"additional","affiliation":[{"name":"Department of Infection and Population Health, UCL, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caisey V","family":"Pulford","sequence":"additional","affiliation":[{"name":"Blood Safety, Hepatitis, Sexually Transmitted Infections (STI) and HIV Division, UK Health Security Agency\u2014Colindale, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabiana","family":"Lorencatto","sequence":"additional","affiliation":[{"name":"Centre for Behaviour Change, UCL, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helen","family":"Fifer","sequence":"additional","affiliation":[{"name":"Blood Safety, Hepatitis, Sexually Transmitted Infections (STI) and HIV Division, UK Health Security Agency\u2014Colindale, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirsty","family":"Foster","sequence":"additional","affiliation":[{"name":"Blood Safety, Hepatitis, Sexually Transmitted Infections (STI) and HIV Division, UK Health Security Agency\u2014Colindale, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2060-7286","authenticated-orcid":false,"given":"Hamish","family":"Mohammed","sequence":"additional","affiliation":[{"name":"Blood Safety, Hepatitis, Sexually Transmitted Infections (STI) and HIV Division, UK Health Security Agency\u2014Colindale, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katy","family":"Sinka","sequence":"additional","affiliation":[{"name":"Blood Safety, Hepatitis, Sexually Transmitted Infections (STI) and HIV Division, UK Health Security Agency\u2014Colindale, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah","family":"Williamson","sequence":"additional","affiliation":[{"name":"Blood Safety, Hepatitis, Sexually Transmitted Infections (STI) and HIV Division, UK Health Security Agency\u2014Colindale, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Greta","family":"Rait","sequence":"additional","affiliation":[{"name":"Institute of Epidemiology and Health, University College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kate","family":"Folkard","sequence":"additional","affiliation":[{"name":"Blood Safety, Hepatitis, Sexually Transmitted Infections (STI) and HIV Division, UK Health Security Agency\u2014Colindale, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3020-9916","authenticated-orcid":false,"given":"John","family":"Saunders","sequence":"additional","affiliation":[{"name":"Blood Safety, Hepatitis, Sexually Transmitted Infections (STI) and HIV Division, UK Health Security Agency\u2014Colindale, London, UK"},{"name":"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"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,7,15]]},"reference":[{"key":"2026081704400951000_102.1.24.1","unstructured":"UK Health Security Agency . Sexually transmitted infections and screening for chlamydia in england: 2023 report. GOV.UK; 2024. Available: https:\/\/www.gov.uk\/government\/statistics\/sexually-transmitted-infections-stis-annual-data-tables\/sexually-transmitted-infections-and-screening-for-chlamydia-in-england-2023-report"},{"key":"2026081704400951000_102.1.24.2","unstructured":"Coleman H , Samuel I , Soni S , et al . BASHH summary guidance on testing for sexually transmitted infections. BASHH, 2023."},{"key":"2026081704400951000_102.1.24.3","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(23)00356-0"},{"key":"2026081704400951000_102.1.24.4","doi-asserted-by":"publisher","DOI":"10.1097\/OLQ.0000000000000824"},{"key":"2026081704400951000_102.1.24.5","doi-asserted-by":"crossref","first-page":"1413","DOI":"10.1016\/S0140-6736(18)31816-6","article-title":"Population effectiveness of opportunistic chlamydia testing in primary care in Australia: a cluster-randomised controlled trial","volume":"392","author":"Hocking","year":"2018","journal-title":"The Lancet"},{"key":"2026081704400951000_102.1.24.6","doi-asserted-by":"publisher","DOI":"10.1258\/0956462021924712"},{"key":"2026081704400951000_102.1.24.7","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2019-054313"},{"key":"2026081704400951000_102.1.24.8","doi-asserted-by":"publisher","DOI":"10.3201\/eid2407.172104"},{"key":"2026081704400951000_102.1.24.9","doi-asserted-by":"publisher","DOI":"10.2807\/1560-7917.ES.2022.27.40.2200057"},{"key":"2026081704400951000_102.1.24.10","doi-asserted-by":"publisher","DOI":"10.1071\/SH19023"},{"key":"2026081704400951000_102.1.24.11","doi-asserted-by":"crossref","DOI":"10.1016\/j.ijnsa.2024.100174","article-title":"Saturation in qualitative research: An evolutionary concept analysis","volume":"6","author":"Rahimi","year":"2024","journal-title":"Int J Nurs Stud Adv"},{"key":"2026081704400951000_102.1.24.12","first-page":"1408","article-title":"Are We There Yet? Data Saturation in Qualitative Research","volume":"Available at","author":"Fusch","year":"2015","journal-title":"TQR"},{"key":"2026081704400951000_102.1.24.13","doi-asserted-by":"publisher","DOI":"10.1191\/1478088706qp063oa"},{"key":"2026081704400951000_102.1.24.14","doi-asserted-by":"publisher","DOI":"10.1186\/s13012-017-0605-9"},{"key":"2026081704400951000_102.1.24.15","doi-asserted-by":"publisher","DOI":"10.1186\/1748-5908-6-42"},{"key":"2026081704400951000_102.1.24.16","doi-asserted-by":"crossref","first-page":"1049","DOI":"10.1093\/tbm\/ibaa050","article-title":"Development of an online tool for linking behavior change techniques and mechanisms of action based on triangulation of findings from literature synthesis and expert consensus","volume":"11","author":"Johnston","year":"2021","journal-title":"Transl Behav Med"},{"key":"2026081704400951000_102.1.24.17","doi-asserted-by":"publisher","DOI":"10.1007\/s12160-013-9486-6"},{"key":"2026081704400951000_102.1.24.18","doi-asserted-by":"publisher","DOI":"10.1093\/abm\/kay082"},{"key":"2026081704400951000_102.1.24.19","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1071\/SH22139","article-title":"Would men who have sex with men support less frequent screening for asymptomatic chlamydia and gonorrhoea to improve antibiotic stewardship? A qualitative study","volume":"20","author":"Wardley","year":"2023","journal-title":"Sex Health"},{"key":"2026081704400951000_102.1.24.20","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1186\/s43058-021-00211-z","article-title":"De-implementation and substitution of clinical care processes: stakeholder perspectives on the transition to primary human papillomavirus (HPV) testing for cervical cancer screening","volume":"2","author":"Hahn","year":"2021","journal-title":"Implement Sci Commun"},{"key":"2026081704400951000_102.1.24.21","doi-asserted-by":"crossref","first-page":"1843","DOI":"10.1177\/1557988318797437","article-title":"Stigma and Shame Experiences by MSM Who Take PrEP for HIV Prevention: A Qualitative Study","volume":"12","author":"Dubov","year":"2018","journal-title":"Am J Mens Health"},{"key":"2026081704400951000_102.1.24.22","doi-asserted-by":"crossref","first-page":"1139","DOI":"10.1007\/s10461-017-1964-6","article-title":"Sex, PrEP, and Stigma: Experiences with HIV Pre-exposure Prophylaxis Among New York City MSM Participating in the HPTN 067\/ADAPT Study","volume":"22","author":"Franks","year":"2018","journal-title":"AIDS Behav"},{"key":"2026081704400951000_102.1.24.23","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2016-052983"},{"key":"2026081704400951000_102.1.24.24","doi-asserted-by":"crossref","DOI":"10.1186\/s13012-019-0960-9","article-title":"Unpacking the complexities of de-implementing inappropriate health interventions","volume":"15","author":"Norton","year":"2020","journal-title":"Implement Sci"},{"key":"2026081704400951000_102.1.24.25","doi-asserted-by":"crossref","DOI":"10.1186\/s13012-022-01191-x","article-title":"Translational framework for implementation evaluation and research: a normalisation process theory coding manual for qualitative research and instrument development","volume":"17","author":"May","year":"2022","journal-title":"Implement Sci"},{"key":"2026081704400951000_102.1.24.26","doi-asserted-by":"crossref","unstructured":"Smardon T , Vaisey A , Chow E , et al . P518\u2005Sexual practices and healthcare use of men who have sex with men only and men who have sex with men and women. Abstracts for the STI & HIV World Congress (Joint Meeting of the 23rd ISSTDR and 20th IUSTI), July 14\u201317, 2019, Vancouver, Canada; 2019 doi:10.1136\/sextrans-2019-sti.596","DOI":"10.1136\/sextrans-2019-sti.596"},{"key":"2026081704400951000_102.1.24.27","unstructured":"John Saunders MK , Medland N , Fifer H . Position statement on doxycycline as prophylaxis for sexually transmitted infections 2021 update. BASHH 2021."},{"key":"2026081704400951000_102.1.24.28","unstructured":"The Joint Committee on Vaccination and Immunisation (JCVI) . JCVI advice on the use of meningococcal b vaccination for the prevention of gonorrhoea. Department of Health and Social Care; 2023."}],"container-title":["Sexually Transmitted Infections"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/sextrans-2025-056556","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T11:40:46Z","timestamp":1786966846000},"score":1,"resource":{"primary":{"URL":"https:\/\/sti.bmj.com\/lookup\/doi\/10.1136\/sextrans-2025-056556"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,15]]},"references-count":28,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,1,16]]},"published-print":{"date-parts":[[2026,2]]}},"alternative-id":["10.1136\/sextrans-2025-056556"],"URL":"https:\/\/doi.org\/10.1136\/sextrans-2025-056556","relation":{},"ISSN":["1368-4973","1472-3263"],"issn-type":[{"value":"1368-4973","type":"print"},{"value":"1472-3263","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,15]]}}}