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Supervisors: Dr Greta Rait, Dr Lorraine McDonagh
We are an interdisciplinary team of researchers and clinicians from primary care, psychology, epidemiology,
and public health. We work across different disease areas, populations, and institutions. The majority of
our work focuses on adolescent health and sexually transmitted infections (STIs). We also collaborate on
research in other areas, such as malaria, e-health, respiratory and gastrointestinal infections. Our projects
include epidemiological research (including working with electronic health records), clinical trials,
qualitative research and online questionnaires. We have excellent collaborative links with Brighton and
Sussex Medical School and work closely with Public Health England (PHE).
We are part of the NIHR Health Protection Research Unit (HPRU) in Blood Borne Viruses and STIs led by
UCL, in partnership with PHE, in collaboration with London School of Hygiene & Tropical Medicine.
(http://bbsti.hpru.nihr.ac.uk/). PhD fellows would have the opportunity to join the HPRU Academy. This
offers a unique environment to those wishing to gain exposure to interdisciplinary research within an
organisation pursuing a highly acclaimed international research agenda.
We have numerous project individuals can become involved with.
Project 1: Approaches to young person's health in primary care
Supervisors: Dr Greta Rait, Dr Lorraine McDonagh
Good health care during adolescence is the foundation for good health and wellbeing in later life.
Particular issues sexual health (e.g., testing for STIs) as well as mental health and physical health
(e.g., alcohol, smoking, drugs, nutrition, exercise). For example, young people account for a
substantial proportion of new sexually transmitted infection diagnoses. Youth-friendly primary care
services, which can quickly and accurately assess (and address) their needs, are needed to improve
the health and wellbeing of young people. The aim of this project is to qualitatively explore how
primary health care professionals currently approach young people in practice and what has been
(or could be) done in general practice to promote young people's health. Semi-structured individual
interviews and focus groups will be conducted, guided by a theoretical model of behaviour.
Quesitons will focus on sexual health (e.g., testing for STIs) as well as mental health and physical
health (e.g., alcohol, smoking, drugs, nutrition, exercise).This will inform the development of an
intervention to improve young people's health via general practice.
Project 2: Chlamydia retesting and text messaging interventions
Supervisors: Dr Greta Rait, Dr Lorraine McDonagh
An examination of barriers and facilitators to chlamydia retesting and exploration of how these can
be incorporated into text messaging interventions
Young people (ages 16-24 years) who test positive for chlamydia are at high risk of repeat infection.
Chlamydia reinfection is common and increases the risk of reproductive complications. Possible
reasons for such repeat infections include non-compliance with treatment, incomplete or
unsuccessful partner notification, unsafe sexual behaviours and treatment failure. Guidelines
recommend retesting three months after a positive result, but often these individuals do not return
for repeat testing. This project seeks to identify the key barriers and facilitators associated with the
decision to re-test. Quantitative and qualitative methodologies will be employed. A psychological
theory of behaviour and behaviour change will be used to guide the methodologies and analyses.
Ultimately, this project will inform the development of a digital intervention to increase re-testing
rates among those who have been previously treated for chlamydia.
Project 3: Sexual health and well-being needs of sexual and gender minority youth
Supervisors: Dr Greta Rait, Dr Lorraine McDonagh
Lesbian, gay, bisexual, transgender (LGBT) and other sexual and gender minority have unique
health care needs. Social environments and structural factors (created through stigma, prejudice,
and discrimination) cause poor health outcomes for this population. They bear a disproportionate
burden of poor health and wellbeing in terms of sexual health and HIV, mental health, behavioural
health (substance use). The situation is exacerbated by a lack of orientation-appropriate health and
wellbeing support and services. The aim of this study is to qualitatively examine young sexual and
gender minority people's attitudes towards the provision of sexual health care via general practice,
and explore the best means through which to improve this. This will inform the development of
effective interventions to improve the provision of health care service via general practice for this
population.
Project 4: Factors associated with testing for sexually transmitted infections among young people
Supervisors: Dr Greta Rait, Dr Lorraine McDonagh
In 2016, there were approximately 420,000 diagnoses of sexually transmitted infections (STIs)
made in England. The burden of STIs is greatest among people aged 15-24 years where highest
prevalence rates are found. STIs are often asymptomatic, and if left undiagnosed and/or untreated,
can pose severe health consequences. Annual testing for sexually active young people is
recommended in the UK; however, many of those at risk do not receive testing. The aim of this
project is to quantitatively assess factors associated with STI testing. Specifically, an online
questionnaire will be developed which will be guided by theoretical models of behaviour change.
This will inform the development of an intervention to increase STI testing in young people.
Project 5: Interventions to increase chlamydia testing in general practice.
Supervisors: Dr Greta Rait, Dr Lorraine McDonagh
There were 200,288 chlamydia diagnoses made in England in 2015, with the highest prevalence
rates found amongst you people aged 15-24 years. General practice is one logical setting for
chlamydia testing for a variety of reasons: 1) Over 60% of young people attend general practice
annually; 2) Young people have reported a preference to receive testing and testing results from a
general practitioner; 3) Higher rates of positivity have been found, particularly for males, in general
practice compared to non-healthcare settings such as universities; and 4) Regular screening is
easier to maintain in this setting, due to patients attending for other reasons, which is necessary for
continued transmission reduction. However, in 2015, only 19% of chlamydia tests were performed
in the general practice setting. The aim of this systematic review, therefore, is to examine the
effectiveness and efficacy of interventions to increase chlamydia testing in general practice.
Contact: g.rait@ucl.ac.uk, l.mcdonagh@ucl.ac.uk
