Barriers and facilitators to service utilisation and management of sexually transmitted infections in India: a multicentric mixed-method approach study protocol

BMJ Open. 2026 Jun 12;16(6):e109882. doi: 10.1136/bmjopen-2025-109882.

Abstract

Introduction: Sexually transmitted infections (STIs) have emerged as significant public health concerns, imposing a substantial burden on both individuals and the healthcare system of the country. Additionally, STIs may also result in major extensive psychological consequences that profoundly affect individuals with STIs. Despite the government's implementation of different initiatives aimed at addressing STI-related challenges, these conditions are associated with shame and stigma which act as barriers to the effective utilisation of healthcare services. The purpose of the present study is to generate evidence on barriers and facilitators to service utilisation and management of STIs in India.

Methods and analysis: Indian Council of Medical Research, New Delhi, is conducting a multi-centre study employing a mixed-method approach. The study involves different levels of healthcare systems, including both government and private healthcare facilities across seven sites in several states of India, including Maharashtra, Rajasthan, Punjab, Bihar, Uttar Pradesh and New Delhi. For the quantitative data, individuals seeking healthcare services related to STIs will be enrolled and assessed using a semi-structured pilot-tested questionnaire. In-depth interviews and focus group discussions will also be conducted with different stakeholders as per the standard guidelines of the qualitative method by the designated trained project staff. Descriptive and inferential statistics will be applied to the quantitative data, while the qualitative data will be analysed using a deductive approach with thematic content analysis.

Ethics and dissemination: The study protocol has been approved by the ethics review committees of all the participating sites individually. The findings from this study will be published in peer-reviewed journals and disseminated through scientific conferences and meetings among policy-makers and government agencies. AIIMS/IEC/2024/609; AIIMS/Pat/IEC/2024/1205; F. 7/BIOETHICS/AIIMS-RBL/APPROEM/2021/1; KIMSDU/IEC/11/2022; LHMC/IEC/2024/11; IEC/02/EX/2024; PGI/IEC/2024EIC000373.

Keywords: Community gynaecology; Health Services; Sexually Transmitted Disease.

Publication types

  • Multicenter Study

MeSH terms

  • Female
  • Focus Groups
  • Health Services Accessibility*
  • Humans
  • India
  • Multicenter Studies as Topic
  • Patient Acceptance of Health Care* / statistics & numerical data
  • Qualitative Research
  • Research Design
  • Sexually Transmitted Diseases* / epidemiology
  • Sexually Transmitted Diseases* / psychology
  • Sexually Transmitted Diseases* / therapy
  • Surveys and Questionnaires