scholarly journals General Practitioners’ views and experiences on the barriers and facilitators that men who have sex with men have when accessing primary care for HIV testing and sexual health screening

2017 ◽  
Vol 19 (02) ◽  
pp. 205-209
Author(s):  
Steven Maxwell

Aim This study’s objectives were to collate General Practitioners’ (GPs) views and experiences on the barriers and facilitators for providing HIV and sexual health screening in primary care to men who have sex with men. Background Men who have sex with men (MSM) are disproportionately effected by sexually transmitted infections and HIV. Some MSM may not attend for testing and primary care may come in contact with this group. There may be varying barriers for MSM accessing services. Primary care can provide an opportunity to offer testing but with limited GPs views on this topic, it is important to understand the potential barriers and facilitators. Method A structured online survey was used to gather data and the survey link was emailed to all General Practices in the City of Edinburgh. The total available sample of GPs was 485. The survey used a combination of multiple choice questions and Likert scales rating from 1 to 5. Friedman’s two-way analysis of variation rank was used for data analysis. Findings In total, 62 GPs from the City of Edinburgh completed the survey with the majority of the sample having over 10 years’ experience in primary care. The most significant barrier was patient preference to access specialist services. The highest rated method to promote HIV and sexual health screening was the use of external promotion.

10.2196/15012 ◽  
2020 ◽  
Vol 9 (2) ◽  
pp. e15012
Author(s):  
Nigel Sherriff ◽  
Jorg Huber ◽  
Nick McGlynn ◽  
Carrie Llewellyn ◽  
Alex Pollard ◽  
...  

Background The term “community health worker” (CHW) can apply to a wide range of individuals providing health services and support for diverse populations. Very little is known about the role of CHWs in Europe working in nonclinical settings who promote sexual health and prevent HIV and other sexually transmitted infections (STIs) among gay, bisexual, and other men who have sex with men (MSM). Objective This paper describes the development and piloting of the first European Community Health Worker Online Survey (ECHOES) as part of the broader European Union-funded ESTICOM (European Surveys and Trainings to Improve MSM Community Health) project. The questionnaire aimed to assess the knowledge, attitudes, and practices of CHWs providing sexual health services to gay, bisexual, and other MSM in European settings. Methods ECHOES comprises three superordinate domains divided into 10 subsections with 175 items (routed) based on a scoping exercise and literature review, online prepiloting, and Europe-wide consultation. Additional piloting and cognitive debriefing interviews with stakeholders were conducted to identify comprehension issues and improve the clarity, intelligibility, accessibility, and acceptability of the survey. Psychometric properties, including internal consistency of the standardized scales used as part of the survey were examined. The final survey was available to 33 countries in 16 languages. Results Recruitment closed on January 31, 2018. Data from 1035 CHWs were available for analysis after application of the exclusion criteria. The findings of the ECHOES survey and the wider ESTICOM project, are now available from the ESTICOM website and/or by contacting the first author. Conclusions The findings of this survey will help characterize, for the first time, the diverse role of CHWs who provide sexual health services to gay, bisexual, and other MSM in Europe. Importantly, the data will be used to inform the content and design of a dedicated training program for CHWs as part of the larger ESTICOM project and provide recommendations for MSM-specific strategies to improve sexual health in general and to reduce the incidence and prevalence of HIV, viral hepatitis, and other STIs in particular. International Registered Report Identifier (IRRID) RR1-10.2196/15012


2018 ◽  
Vol 35 (4) ◽  
pp. 311-319
Author(s):  
Milan Bjekić ◽  
Sandra Šipetić-Grujičić ◽  
Hristina Vlajinac ◽  
Ivana Dunić

Abstract Penis size is a major body image concern for the majority of men in western nations, while in gay culture the penis has become a body part linked to sexual attractiveness and viability. The aim of this study was to reveal influence of the perceived penis size on sexual behaviour, condom use, sexually transmitted infections and men’s sexual positioning among men who have sex with men. In this cross-sectional study, the data were collected from consecutive men who have sex with men who attended Counselling for Sexually Transmitted Diseases at the City Institute for Skin and Venereal Diseases in Belgrade, Serbia. Out of 319 participants, 6.6% perceived their penis as "below average", 71.5% as "average", and 21.9% as "above average". In comparison with men with an average penis, men with below average penis were more frequently unsatisfied with their penis size (p < 0.05), more frequently lied to others about their penis size (p < 0.001) and took more frequently the passive sexual role (p < 0.05). Men with above average penis were more frequently satisfied with their penis size (p < 0.001), took more frequently the active sexual role (p < 0.01), they had more sexual partners (p < 0.05), more problems with a tight condom (p < 0.001) and more gonorrhoea/Chlamydia infections (p < 0.001) than men with an average penis. Perception of one’s penis size was associated with some aspects of sexual behaviour and the frequency of sexually transmitted diseases.


2018 ◽  
Vol 29 (14) ◽  
pp. 1407-1416 ◽  
Author(s):  
S Desai ◽  
F Burns ◽  
G Schembri ◽  
D Williams ◽  
A Sullivan ◽  
...  

Men who have sex with men (MSM) attending sexual health (SH) clinics are at high risk for HIV acquisition and are disproportionately affected by sexually transmitted infections (STIs). We collected standardised behavioural data from MSM attending clinics to characterise sexual behaviours and identify predictors for HIV and STIs. In 2012–2013, HIV-negative MSM attending five SH clinics in England reported sexual behaviours in the previous three months via a self-administered questionnaire. Behaviours were linked to the individual’s clinical records using national surveillance. The prevalence and incidence of bacterial STIs (gonorrhoea, Chlamydia, lymphogranuloma venereum and syphilis) and incidence of HIV were calculated. Adjusted odds ratios and hazard ratios with 95% confidence interval (CI) were reported for significant predictors. Of 1278 HIV-negative MSM, 54% were of white ethnicity and UK-born and 43% were 25–34 years old. Almost all men reported at least one partner in the last three months. Half reported condomless anal sex and 36% condomless receptive anal intercourse (CRAI). Incidence of bacterial STIs was 46/100 (95%CI 39–54) person years (py) and of HIV was 3.1/100 (95%CI 1.7–5.6) py. A STI at baseline and CRAI with increasing numbers of partners were associated with both incident infections. In this cohort of MSM high-risk behaviours and STIs were prevalent. Engagement in CRAI increased the likelihood of subsequent infection, while men diagnosed with a bacterial STI were at increased risk of a future STI. Clinical and behavioural risk assessments to determine an individual’s risk of infection could allow a more nuanced prevention approach that has greater success in reducing transmission.


Sexual Health ◽  
2018 ◽  
Vol 15 (5) ◽  
pp. 473 ◽  
Author(s):  
Kalysha Closson ◽  
Rachel Vickers Smith ◽  
Gbolahan Olarewaju ◽  
Richard Crosby

Background In the USA, young Black gay, bisexual or other men who have sex with men (YBMSM) bear the largest burden of HIV incidence. The aim of this study is to examine the independent associations between economic dependency on a sexual partner and several HIV risk behaviours and sexual health outcomes among YBMSM living in Jackson, Mississippi, USA. Methods: Baseline data from 589 YBMSM, with a median age of 22.0 years (IQR = 15–25) participating in a brief sex-positive HIV and STI prevention intervention, were used to measure the association between six sexual behaviours, sexually transmissible infections (STIs) status at baseline and economic dependence. Bivariate χ2 associations were tested and regression models adjusted for education level (≤ high school), employment and HIV-status. Results: In regressions, of the six sexual behaviours reported in the last 90 days and six STIs tested at baseline, economically dependent YBMSM were more likely to report condomless anal receptive sex (aOR = 2.19, 95%CI = 1.25–3.83), ≥3 partners as a top (aOR = 1.99, 95%CI = 1.17–340), ≥3 sex partners as a bottom (aOR = 2.07, 95%CI = 1.24–3.45), ≥3 sex acts as a bottom (aOR = 2.10, 95%CI = 1.16–3.82) and testing positive for oral gonorrhoea (aOR = 2.39, 95%CI = 1.18–4.83) after controlling for HIV status, employment and education. Conclusions: Interventions should consider how poverty, unemployment and economic dependence interact to influence relationship power imbalances, condom use and sexual positioning agency, and sexual health for key populations of MSM.


This chapter covers primary care and nursing of various conditions that adults may present with including frailty, skin infections (bacterial, fungal, and viral), skin cancer, eczema, psoriasis, pigmentation and hair problems, and allergies. It also covers deafness, mouth and throat problems, adrenal disorders, anal conditions, gastro-oesophageal reflux and disorders of the bowels, viral infection, and food-borne disease. It also covers bowel disease, coeliac disease, appendicitis, hernias, intestinal obstructions, problems of the liver, gallbladder, and pancreas, as well as common musculoskeletal problems, and bone and connective tissue disorders. Sexual health problems are extensively described, including how to conduct a consultation, sexually transmitted infections, sexual problems, and sexual health in the context of adults with learning difficulties. Breast and gynaecological cancers are covered, alongside problems with menstruation, the ovaries, uterus, and vagina. The final section covers issues relating to termination of pregnancy.


2014 ◽  
Vol 48 (spe) ◽  
pp. 145-151 ◽  
Author(s):  
Luciane Ferreira do Val ◽  
Lucia Yasuko Izumi Nichiata




This study aimed to identify programmatic vulnerability to STDs/HIV/AIDS in primary health centers (PHCs). This is a descrip - tive and quantitative study carried out in the city of São Paulo. An online survey was applied (FormSUS platform), involving administrators from 442 PHCs in the city, with responses received from 328 of them (74.2%), of which 53.6% were nurses. At - tention was raised in relation to program - matic vulnerability in the PHCs regarding certain items of infrastructure, prevention, treatment, prenatal care and integration among services on STDs/HIV/AIDS care. It was concluded that in order to reach comprehensiveness of actions for HIV/ AIDS in primary health care, it is necessary to consider programmatic vulnerability, in addition to more investment and reor - ganization of services in a dialogue with the stakeholders (users, multidisciplinary teams, and managers, among others).





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