How to do it: setting up a PrEP service in an integrated sexual reproductive health service setting

2018 ◽  
Vol 94 (5) ◽  
pp. 327-330 ◽  
Author(s):  
Carys Knapper ◽  
Humphrey Birley ◽  
Zoe Couzens ◽  
Adam Thomas Jones ◽  
Irene Parker
Keyword(s):  
Reproductive Health ◽  
Health Service ◽  
Reproductive Health Service ◽  
Service Model ◽  
Fully Integrated ◽  
Sexual Reproductive Health ◽  
Service Setting ◽  
Sexual Health Service ◽  
Set Up ◽  
Exposure Prophylaxis

Pre-exposure prophylaxis for HIV (PrEP) has been shown to reduce transmission of HIV in a number of trials; however, there is limited evidence regarding the optimal way to deliver PrEP through pre-existing UK services, particularly through fully integrated drop-in sexual health service models. PrEP in the form of Truvada was launched in Wales in July 2017. We set up a PrEP service to be delivered via our drop-in integrated sexual reproductive health service. In the first 5 months of PrEP service provision, we found unforeseen levels of comorbidity, polypharmacy and renal impairment in our cohort of PrEP patients. As a result, we have altered our service model and all patients are now followed up in booked appointment PrEP clinics run by members of the HIV team. Those patients with estimated glomerular filtration rate (eGFR) of 60–70 mL/min or with eGFR of 60–80 mL/min and with comorbidities impacting on renal function are monitored every 4–6 weeks initially, and PrEP has been incorporated into our pre-existing virtual HIV renal clinic for discussion with a renal physician. The PrEP team clinicians report that monitoring and managing the PrEP cohort is now easier in its appointment-only format, although some patients have reported that they would prefer a drop-in system.

Audit of patient retention in pre-exposure prophylaxis (PrEP) services in an integrated sexual reproductive health service setting

2019 ◽  
Vol 30 (14) ◽  
pp. 1432-1435
Author(s):  
Eleanor Cochrane ◽  
Carys Knapper
Keyword(s):  
Reproductive Health ◽  
Health Service ◽  
Perceived Risk ◽  
Reproductive Health Service ◽  
Health Board ◽  
Sexual Reproductive Health ◽  
Sex With Men ◽  
Exposure Prophylaxis ◽  
Lost To Follow Up

Pre-exposure prophylaxis (PrEP) for HIV in Wales was launched in July 2017. We set up a PrEP service delivered via our integrated sexual reproductive health service in Aneurin Bevan University Health Board (ABUHB), south east Wales. Public Health Wales (PHW) data show a 22% ‘lost to follow-up’ rate amongst Welsh PrEP patients. Over 18 months, 278 patients booked into ABUHB PrEP clinics. Of these, 275 were men who have sex with men (MSM). One hundred and ninety-three patients commenced PrEP, 5 were diagnosed with HIV at baseline, 42 did not attend their first appointment. The remainder declined PrEP. Of those commenced on PrEP, 51.7% had reduced clinic attendances; all were MSM. Patients with reduced attendances were more likely to be younger (mean age 33 vs. 37 years), reside outside ABUHB catchment area (56.4% vs. 49.6%) and have mental health issues (28.6% vs. 18.8%), but were less likely to disclose substance misuse (24.2% vs. 27.1%) than those attending in line with operational guidance. Of the 63 patients who stopped attending the PrEP clinic, 32.3% (21) had documented reasons, the most common being reduced self-perceived risk. This is the first evaluation of reasons why patients stop attending as well as risk factors associated with those lost to follow-up in PrEP services in Wales.

Evaluation of a Peer Provider Reproductive Health Service Model for Adolescents

2005 ◽  
Vol 37 (2) ◽  
pp. 85-91 ◽  
Author(s):  
Claire D. Brindis ◽  
Sara Peterson Geierstanger ◽  
Nicole Wilcox ◽  
Virginia McCarter ◽  
Alan Hubbard
Keyword(s):  
Reproductive Health ◽  
Health Service ◽  
Reproductive Health Service ◽  
Service Model

Audit of a human papillomavirus vaccine programme for men who have sex with men delivered through an Integrated Sexual Reproductive Health service

2018 ◽  
Vol 29 (11) ◽  
pp. 1106-1109 ◽  
Author(s):  
Carys Knapper ◽  
Humphrey Birley ◽  
Irene Parker
Keyword(s):  
Human Papillomavirus ◽  
Reproductive Health ◽  
Health Service ◽  
Vaccination Programme ◽  
Hpv Vaccination ◽  
Health Service Delivery ◽  
Reproductive Health Service ◽  
Human Papillomavirus Vaccine ◽  
Sexual Reproductive Health ◽  
Sex With Men

Following the Joint Committee on Vaccination and Immunisation statement in November 2015 advising a human papillomavirus (HPV) vaccination programme targeting men who have sex with men (MSM) up to the age of 45 attending Genitourinary medicine and HIV services, we launched a HPV vaccination programme for MSM to be delivered through our Integrated Sexual Reproductive Health drop-in service across Newport and the South East Wales Valleys from 1 August 2016. Over the first 18 months of the vaccination programme 539 of the 693 (77%) eligible MSM who attended clinics where the vaccine was available commenced vaccination. The vaccination programme appears to have fitted in well with our pre-existing sexual health service delivery model and appears popular with MSM attending the service. We completed the full vaccination course in 40% of MSM who commenced the vaccine with adequate time to complete the schedule within the time frame of the audit. The audit demonstrates that HPV vaccination delivery for MSM is feasible in an Integrated Sexual Reproductive Health service setting.

scholarly journals Challenges Faced by Female Out-of-School Adolescents in Accessing and Utilizing Sexual and Reproductive Health Service: A Qualitative Exploratory Study in Southwest, Ethiopia

2021 ◽  
Vol 12 ◽  
pp. 215013272110189
Author(s):  
Shewangizaw Hailemariam ◽  
Lidiya Gutema ◽  
Wubetu Agegnehu ◽  
Msganaw Derese
Keyword(s):  
Reproductive Health ◽  
Health Service ◽  
Exploratory Study ◽  
Sexual And Reproductive Health ◽  
Reproductive Health Service ◽  
Cultural Barriers ◽  
Early Marriage ◽  
Community Based ◽  
Sexual Reproductive Health ◽  
Out Of School

Introduction Due to the limited access to sexual and reproductive health service, out-of-school-adolescents become at a higher risk for early marriage, early pregnancy early parenthood, and poor health outcomes over their life course. Hence, the aim of this study was to explore the challenges faced by female out-of-school adolescents in accessing sexual and reproductive health service in Bench-Sheko zone. Methods A community-based qualitative exploratory study was carried out from November 01/2020 to December 01/2020 among selected out-of-school adolescents residing in rural and urban districts of Bench-Sheko Zone, and healthcare professionals working in the local health centers. FGD participants and healthcare providers were purposely selected for this study. Eight focus group discussions and 8 in-depth interviews were conducted among female out-of-school adolescents, and health care professionals, respectively. Result The study revealed that out-of-school adolescents encounter several challenges in accessing sexual reproductive health service which includes socio-cultural barriers, health system barriers, perceived legal barrier, inadequate information regarding sexual reproductive health service, and low parent-adolescent communication. Conclusion The finding suggests the need to engage community influencers (religious leaders, community leaders, and elders) in overcoming the socio-cultural barriers. Program planners and policy makers have better make an effort to create adolescent friendly environments in SRH service areas. Furthermore, implementing community-based awareness raising programs, parental involvement in sexual reproductive health programs, and encouraging parent-adolescent communication on sexual reproductive health issues could improve sexual reproductive health service utilization by out-of-school adolescents in the study area.

scholarly journals Reproductive health service utilization and associated factors among adolescents at public school in Adama town east Shewa Ethiopia; 2018

2020 ◽  
Author(s):  
Abenet Menene Gurara ◽  
Admasu Belay Gizaw ◽  
Awoke Koyachew Ayalew ◽  
Aliye Kediro Adem
Keyword(s):  
Reproductive Health ◽  
Health Service ◽  
Health Services ◽  
Health Service Utilization ◽  
Associated Factors ◽  
Health Services Utilization ◽  
Reproductive Health Service ◽  
Reproductive Health Services ◽  
Services Utilization ◽  
Factors Associated

Background & Aim: Reproductive health services utilization is an important component of health services in preventing adolescents’ sexual and reproductive hedgies & take corrective measures. The main purpose of this study is to determine reproductive health services utilization status and associated factors among adolescents at public schools in Adama town Ethiopia. Methods & Materials: Institution based cross-sectional study design was used with a total sample size of 367 adolescents in the schools. The sample size was proportionally allocated to grade nine, ten, eleven, and twelfth. The study subjects were selected by simple random sampling. A Standard pre-tested self-administered questionnaire was used to collect data after getting informed consent from the study participants. Data were entered and analysed using SPSS version 20 software. Descriptive statistics and Logistic regression were done to describe and identify factors associated with reproductive health services utilization. A P-value of less than 0.05 was considered to declare a level of significance. Results: The magnitude of reproductive health service utilization in this was 122(34%). Discussion with a sexual partner and peer, student’s educational status, sex, knowledge about the availability of reproductive health service were among the factors associated with the use and non-use of RH service. Conclusion: Utilization of Reproductive Health services among adolescents in the study area was low. Therefore, interventions such as advancing adolescents’ knowledge, encouraging open discussion forum, strengthening of youth centers, and school reproductive health clubs are important.

scholarly journals Youth Reproductive Health Service Utilization and Associated Factors among Amhara Region Female Night Students, Ethiopia

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Tewachew Muche Liyeh ◽  
Yitayal Ayalew Goshu ◽  
Habtamu Gebrehana Belay ◽  
Habtamu Abie Tasew ◽  
Gedefaye Nibret Mihiretie ◽  
...  
Keyword(s):  
Reproductive Health ◽  
Health Service ◽  
Health Services ◽  
Service Utilization ◽  
Health Service Utilization ◽  
Sexual And Reproductive Health ◽  
Reproductive Health Service ◽  
Health Issues ◽  
Reproductive Health Services ◽  
Amhara Region

Introduction. Youth is a decisive age to shape the direction of their life and that of their family. However, due to the host of biological, social, and economic factors, adolescent females can be at high risk of adverse sexual and reproductive health outcomes. Therefore, assessing youth reproductive service utilization and associated factors among female night students is very crucial for timely intervention to their gaps. Method. An institutional-based cross-sectional study design was conducted in Amhara region among 2,050 female night students from September 15 to November 15, 2018. A self-administered pretested questionnaire was used to collect the data. Bivariate and multivariable logistic regression models were used. Odds ratio with 95% confidence interval was computed to determine the strength of association between predictor and outcome variables. P value less than or equal to 0.05 is considered as the level of significance. Results. Out of the total respondents, about 54.6%(CI: 52.5%-56.8%) of them utilized reproductive health services. Respondents who were attending secondary education ( AOR = 2.55 , 95 % CI = 1.97 ‐ 5.62 ), attitude towards youth reproductive health services ( AOR = 2.74 , 95 % CI = 2.07 ‐ 5.30 ), those who had a habit of communicating on sexual and reproductive health issues with their family ( AOR = 3.66 , 95 % CI = 3.59 ‐ 7.41 ), discussion on sexual and reproductive health issue with peers/friends ( AOR = 1.43 , 95 % CI = 1.01 ‐ 2.02 ), respondents with good knowledge on youth reproductive health services ( AOR = 2.03 , 95 % CI = 1.49 ‐ 2.75 ), and those who had faced reproductive health problems ( AOR = 2.03 , 95 % CI = 1.49 ‐ 2.75 ) were significantly associated with youth reproductive health service utilization. Conclusion. Youth reproductive health service utilization among female night students was not satisfactory. Therefore, special focus should be given to female night students by providing accessible, acceptable, confidential, flexible, and friendly reproductive health service utilization. Finally, community health promotion and education are mandatory to promote the practice of discussing youth reproductive health issues with their children.

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