Response to article – R Dabis et al. Do attendees at sexual health and HIV clinics prefer to be called in by name or number? ( Int J STD AIDS 2014;25: 511–515 )

Sirs,

We read with interest the recent work by Dabis et al., ¹ which found that most people with HIV preferred to be called from the waiting room by first name whereas most others preferred a number. The conclusion was that all patients in these categories should be called in these ways. Persisting stigma surrounds attending sexual health and HIV services, ² and it is therefore important that attendees have the option to remain anonymous. However, calling people by a number risks dehumanising them and could thus contribute to stigma.

Since 2009, Grampian Sexual Health Service has offered patients a free choice of how they would like to be called from the waiting room. The registration sheet asks ‘While in the waiting area, how would you like staff to address you?’ With a blank space left for responses.

We conducted a service evaluation, the aim of which was to determine the proportion of patients who expressed a preference with regards to how they were called from the waiting room. And, for those who gave a preference, to determine whether there was any association with reason for attendance, age, gender or HIV status. Our assumption was that people who did not answer the ‘how would you like staff to address you’ question did not have a preference.

Whilst the study by Dabis et al. had 500 participants, our evaluation was of a smaller scale. We inspected the electronic records of the first 200 patients who attended the integrated sexual health drop-in clinic in Aberdeen from 1 October 2014. We also assessed the records of 50 people with HIV who had recently attended the clinic for HIV care. Thirty-three of the drop-in patients were excluded as no reason was recorded for their attendance. Data collected comprised age, gender, reason for attendance (HIV, other STI related, contraception related or other) and calling preference (no preference, real details, false or anonymised details). Pearson’s Chi square test was used to analyse the relationship between calling preference and gender, reason for attendance and age (based on the median age of 26).

The majority of people (132, 61%) expressed no preference as to how they would like to be called from the waiting area. First name was the most popular choice of those who expressed a preference with 36% of people choosing this. Only six people (2.8%) asked that false details be used when calling them.

There were no statistically significant differences between calling preference and reason for attendance, age or gender. This contradicts the findings by Dabis et al., where approximately 65% of patients expressed a preference as to how they wished to be called.

That no factor was found to influence calling preference suggests that applying one method to all patients based on reason for attendance will not cater to the individuality of patients. By offering every patient a free choice of how they wish to be called, stigma may be reduced and autonomy asserted before the consultation begins.

If a patient does not indicate a preference as to how they are called from the waiting room, then we call them by their first name, and confirm identity as we approach the consulting room.