Features of the testing kit and process

Participants were asked about their opinions on various features of the testing kit and process for testing. A standard outreach model of Chlamydia testing was used as the foundation for the proposed testing process. Testing kits would contain urine specimen pots and have envelopes for free-post return to the laboratory. An alternative way to return the test kit would be to leave it at the club for collection and this option was also explored. Because of these two options for returning test kits, men could use the test at the club, at home or another setting. Their attitudes to these otpions was also explored. Results for the test, both negative and positive, would be sent to participants by text message as with many clinic based services.

Appearance of the testing kit

Although the testing kit is only comprised of a few pieces of equipment, the way in which this can be packaged is almost limitless and the appearance of the testing kit was important for some men. Most important was that the testing kit should be discreet and not immediately identifiable as a test for STIs by others. This is

because testing is stigmatised and men wanted to maintain a degree of

confidentiality around the whole process, especially if the testing kit was going to be used in a setting outside the football club. For those men who imagined using the test kit there and then, the appearance was less important as other team members would know what the package contained. Men who lived in shared accommodation or with family were especially keen that kits did not draw attention if accidentally found.

P “If someone has been in and given us a talk then everyone knows what’s in it. You can put a big red cross on it. You can put Chlamydia on it. You could put some kind of comedy cartoon on it. I don’t think it would make any difference personally because everyone knows what it’s there for.”

Participant 003

However, having test kits look discreet and anonymous had to be carefully balanced with having something that looked professional and of value. Men wanted test kits to look as if they were “sciencey” [Participant 005] and

something which they could put their trust in. Otherwise, the testing kits may be at risk of being thrown away unused. To make matters more complicated, very discreet packaging had the potential to reinforce stigma and shame related to STIs whilst packaging that mentioned Chlamydia, for example, was potentially

“intimidating” [Participant 014] for some men.

P “If it was a plastic bag it might give the impression that it’s not a good bit of kit. If it was like a – you know when you get a prescription for something it’s in like a paper bag or sealed paper bag with a fold, that looks like something more official, I guess because you associate plastic bags with supermarkets or whatever, that with a doctor’s prescription.

…So if it looks more valuable or looks like – I think you’d treat it with a bit more respect or just, intuitively, not throw it away, if it’s not a plastic bag.”

Participant 016

Using club specific logos and colours on the test kits was generally felt to be a waste of money by most men, unlikely to increase engagement and potentially gimmicky. However, the Premier League were a community partner in this research grant and the suggestion of using Premier League branding was viewed positively as it is strongly associated with aspirational values.

P “Because you’d relate it to the football stars and we all look up to them. Yeah, I think that would do good.”

Participant 017

Distribution of the testing kits

Several potential methods of distributing the test kits were discussed with participants; having a central collection point for test kits from which men could help themselves to test kits, having test kits handed directly to the men by

whoever was delivering the health promotion and having to ask for a kit from the team captain or visiting health care professional. The most popular methods were those which minimised any potential embarrassment, the feeling of being singled out and felt stigma. However, some of these issues were more important and could over-ride others. For example, handing kits out to everyone was not the most discreet method of kit distribution but ensured that no one was singled out and that those who may be too embarrassed to pick up a kit now had one in their possession. Therefore, for many men, this was seen as the best way to distribute test kits.

P “…if you have these kits that people have to go over and pick up, thinking, okay, I need one of these, whereas if they’re kind of literally handed out, ‘Here’s your thing, here’s your thing, here’s your thing,’ I feel like once you put that in someone’s hand, again that’s the kind of situation where there will probably be some people who will take it and think like, ‘I’m only taking this because you’re giving it to me,’ but who actually are probably thinking, ‘I’m quite happy this has been given to me because I would quite like to do this,’ and they may not have had the confidence to go over and pick one up. Because again it is just that whole thing that as soon as you actively step towards doing this that is, in some

people’s case, an admission that you have a reason to do it. So having something handed to you does get over that hurdle.”

Participant 014

However, not all men had negative feelings about being seen to pick up a testing kit. In fact, for some, it served as a way of affirming their masculinity and

maturity in front of others. By being seen to pick up a test kit, to actively seek one out, served as a way to show others that they were sexually active and would need to test in order to maintain sexual prowess. Whilst handing the test kits out to all men was the preferred method for most men, some men also valued the

opportunity to have test kits available to pick up from a central collection point as this maintained their options and perceived autonomy in the process. It also meant that men could take more than one testing kit to distribute to their friends.

P “…‘cos it’s in a lads’ environment, it’s all like, oh he’s got a testing kit, he must be getting some action. That kind of thing. So I think

‘cos it’s in that environment I don’t really think people would be

embarrassed about it. They’ll probably go, yeah, you know, I had this girl last week and a girl the week before and you just get a bit, a lot of egos flying about and it will create a lot of banter I think.”

Participant 007