scholarly journals Changes in the time of COVID-19: a quality improvement initiative to maintain services at a youth sexual health clinic

2021 ◽  
pp. sextrans-2021-055265
Author(s):  
Andrew C Lim ◽  
Meghana Venkatesh ◽  
Danielle L Lewald ◽  
Patricia J Emmanuel ◽  
Lisa Sanders
Keyword(s):  
Quality Improvement ◽  
Service Delivery ◽  
Sexual Health ◽  
Urban Youth ◽  
Community Outreach ◽  
Health Clinic ◽  
Quality Improvement Initiative ◽  
Reproductive Health Services ◽  
Health Clinics ◽  
Sexual Health Clinics

ObjectivesAdolescents and young adults (AYAs) face difficulties accessing sexual and reproductive health services. These difficulties were exacerbated for a variety of reasons by the COVID-19 pandemic. We document strategies and outcomes implemented at an urban youth sexual health clinic in Florida that allowed uninterrupted provision of services while protecting against spread of COVID-19.MethodsThe plan–do–study–act (PDSA) model was used to implement COVID-19 interventions designed to allow continued service delivery while protecting the health and safety of staff and patients. This method was applied to clinic operations, community referral systems and community outreach to assess and refine interventions within a quick-paced feedback loop.ResultsDuring the COVID-19 pandemic, changes made via PDSA cycles to clinical/navigation services, health communications and youth outreach/engagement effectively responded to AYA needs. Although overall numbers of youth served decreased, all youth contacting the clinic for services were able to be accommodated. Case finding rates for chlamydia, gonorrhoea, syphilis and HIV were similar to pre-pandemic levels.ConclusionsQuality improvement PDSA initiatives at AYA sexual health clinics, particularly those for underserved youth, can be used to adapt service delivery when normal operating models are disrupted. The ability for youth sexual health clinics to adapt to a changing healthcare landscape will be crucial in ensuring that under-resourced youth are able to receive needed services and ambitious Ending the HIV Epidemic goals are achieved.

Unlinked anonymous HIV prevalence among New Zealand sexual health clinic attenders: 2005–2006

2008 ◽  
Vol 19 (11) ◽  
pp. 752-757 ◽  
Author(s):  
S M McAllister ◽  
N P Dickson ◽  
K Sharples ◽  
M R Reid ◽  
J M Morgan ◽  
...  
Keyword(s):  
New Zealand ◽  
Sexual Health ◽  
Health Clinic ◽  
Bisexual Men ◽  
Sexually Transmitted ◽  
Health Clinics ◽  
Undiagnosed Hiv ◽  
And Bisexual ◽  
Sex With Men ◽  
Sexual Health Clinics

This unlinked anonymous study aimed at determining the prevalence of HIV among sexual health clinic attenders having blood samples taken for syphilis and/or hepatitis B serology in six major New Zealand cities over a 12-month period in 2005–2006. Overall, seroprevalence was five per 1000 (47/9439). Among men who have sex with men (MSM), the overall prevalence and that of previously undiagnosed HIV were 44.1 and 20.1 per 1000, respectively. In heterosexual men, the overall prevalence was 1.2 per 1000 and in women 1.4 per 1000. HIV remains to be concentrated among homosexual and bisexual men. Comparison with a previous survey in 1996–1997 suggests an increase in the prevalence of undiagnosed HIV among MSM and also an increase in the number of MSM attending sexual health clinics. The low prevalence of HIV among heterosexuals suggests no extensive spread into the groups identified at risk of other sexually transmitted infections.

Confidentiality and access to sexual health services

Sexual Health ◽  
2009 ◽  
Vol 6 (2) ◽  
pp. 153 ◽  
Author(s):  
Nathan Ryder ◽  
Anna M. McNulty
Keyword(s):  
Health Care ◽  
Health Services ◽  
Sexual Health ◽  
Risk Groups ◽  
Health Clinic ◽  
Sexual Health Care ◽  
Health Clinics ◽  
Care Workers ◽  
English Speaking ◽  
Sexual Health Clinics

Background: Confidentiality concerns are often described as barriers to seeking sexual health care. There has been little research describing the relative importance of confidentiality to clients of sexual health clinics, and whether members of high-risk groups have greater concerns. This study aimed to determine the importance of confidentiality and anonymity to clients of a public sexual health clinic, and determine associations with gender and sexuality. Methods: A self-administered questionnaire was offered to consecutive new English-speaking clients in October and November 2007. Participants were asked to describe the reasons for presenting, likelihood of disclosing identifying information, and concern should specific people and agencies become aware of their attendance. Results: Of 350 eligible clients, 270 (77%) participated in the survey. Expert care was included in the top three reasons for choosing a sexual health clinic rather than a general practitioner by over half of participants, while confidentiality and cost were each included in the top three reasons by one-third of respondents respectively. Over 90% of clients reported they were likely to give accurate identifying information to the clinic. Participants were comfortable with disclosure of information to other health-care workers but became increasingly unwilling for information to be shared with services not directly involved in their care. Overall there were few associations with gender or sexuality. Conclusion: Clients choose to attend our clinic for a variety of reasons, with confidentiality and anonymity being of lesser importance than competence and cost. Confidentiality is important to the majority of clients, whereas few desire anonymity. Most clients would accept information being shared with other health services, suggesting that confidentiality may not be a barrier to the use of electronic health records in sexual health clinics.

scholarly journals The Acceptability and Feasibility of Implementing a Bio-Behavioral Enhanced Surveillance Tool for Sexually Transmitted Infections in England: Mixed-Methods Study (Preprint)

2017 ◽  
Author(s):  
Sonali Wayal ◽  
David Reid ◽  
Paula B Blomquist ◽  
Peter Weatherburn ◽  
Catherine H Mercer ◽  
...  
Keyword(s):  
Sexual Health ◽  
Health Clinic ◽  
Bisexual Men ◽  
Transmitted Infection ◽  
Web Based ◽  
Sexually Transmitted ◽  
Clinic Staff ◽  
Research And Innovation ◽  
Health Clinics ◽  
Sexual Health Clinics

BACKGROUND Sexually transmitted infection (STI) surveillance is vital for tracking the scale and pattern of epidemics; however, it often lacks data on the underlying drivers of STIs. OBJECTIVE This study aimed to assess the acceptability and feasibility of implementing a bio-behavioral enhanced surveillance tool, comprising a self-administered Web-based survey among sexual health clinic attendees, as well as linking this to their electronic health records (EHR) held in England’s national STI surveillance system. METHODS Staff from 19 purposively selected sexual health clinics across England and men who have sex with men and black Caribbeans, because of high STI burden among these groups, were interviewed to assess the acceptability of the proposed bio-behavioral enhanced surveillance tool. Subsequently, sexual health clinic staff invited all attendees to complete a Web-based survey on drivers of STI risk using a study tablet or participants’ own digital device. They recorded the number of attendees invited and participants’ clinic numbers, which were used to link survey data to the EHR. Participants’ online consent was obtained, separately for survey participation and linkage. In postimplementation phase, sexual health clinic staff were reinterviewed to assess the feasibility of implementing the bio-behavioral enhanced surveillance tool. Acceptability and feasibility of implementing the bio-behavioral enhanced surveillance tool were assessed by analyzing these qualitative and quantitative data. RESULTS Prior to implementation of the bio-behavioral enhanced surveillance tool, sexual health clinic staff and attendees emphasized the importance of free internet/Wi-Fi access, confidentiality, and anonymity for increasing the acceptability of the bio-behavioral enhanced surveillance tool among attendees. Implementation of the bio-behavioral enhanced surveillance tool across sexual health clinics varied considerably and was influenced by sexual health clinics’ culture of prioritization of research and innovation and availability of resources for implementing the surveys. Of the 7367 attendees invited, 85.28% (6283) agreed to participate. Of these, 72.97% (4585/6283) consented to participate in the survey, and 70.62% (4437/6283) were eligible and completed it. Of these, 91.19% (4046/4437) consented to EHR linkage, which did not differ by age or gender but was higher among gay/bisexual men than heterosexual men (95.50%, 722/756 vs 88.31%, 1073/1215; P<.003) and lower among black Caribbeans than white participants (87.25%, 568/651 vs 93.89%, 2181/2323; P<.002). Linkage was achieved for 88.88% (3596/4046) of consenting participants. CONCLUSIONS Implementing a bio-behavioral enhanced surveillance tool in sexual health clinics was feasible and acceptable to staff and groups at STI risk; however, ensuring participants’ confidentiality and anonymity and availability of resources is vital. Bio-behavioral enhanced surveillance tools could enable timely collection of detailed behavioral data for effective commissioning of sexual health services.

51. PATTERNS OF TREATMENT AND RESOURCE UTILISATION IN THE TREATMENT OF GENITAL WARTS IN AUSTRALIAN SEXUAL HEALTH CLINICS

Sexual Health ◽  
2007 ◽  
Vol 4 (4) ◽  
pp. 304
Author(s):  
A. Morrow ◽  
J. Chuah ◽  
E. L. Conway ◽  
C. K. Fairley ◽  
J. McCloskey ◽  
...  
Keyword(s):  
Sexual Health ◽  
Genital Warts ◽  
Quadrivalent Vaccine ◽  
Health Clinic ◽  
Resource Utilisation ◽  
Common Disease ◽  
Treatment Practices ◽  
Health Clinics ◽  
Topical Treatments ◽  
Sexual Health Clinics

The introduction of the quadrivalent vaccine (HPV types 6, 11, 16, 18), GARDASIL, in the National HPV Vaccination program has the potential to eliminate a substantial proportion of the health burden of genital warts, currently the most common sexually transmitted viral disease in Australia. Although there are an estimated 10�000 cases per year managed through sexual health clinics in Australia, there is very limited data on treatment practices and resource use in this setting. A clinical audit was undertaken in five sexual health clinics in different states of Australia. A total of 500 cases (100 consecutive cases per clinic) were identified of patients aged 18 to 45 years with a first ever diagnosis of genital warts between 1 January 2004 and 31 December 2004. The average age of cases was 27 years for females and 31 years for males with 43% cases female. There was an average of 2.7 visits per case (range 1-22). Ablative measures (cryotherapy, laser or diathermy) were the most common form of treatment applied in 58% cases (mean per case�=�2.4; range 1-16); topical treatments were prescribed in 44% cases (mean per case�=�1.5; range 1-8) and topical treatments were applied by the health care provider in 22% cases (mean per case�=�1.5; range 1-8). Additional analyses including type of treatment, variation in treatment practices by sexual health clinic and duration of cases will be presented. This study confirms the considerable individual and clinical burden of this common disease.

Epididymitis and its aetiologies in a central London sexual health clinic

2020 ◽  
pp. 095646242096387
Author(s):  
Venkateshwaran Sivaraj ◽  
Azraan Ahamed ◽  
Ruslan Artykov ◽  
Anatole Menon-Johansson
Keyword(s):  
Sexual Health ◽  
Trichomonas Vaginalis ◽  
Health Clinic ◽  
Study Cohort ◽  
Scrotal Pain ◽  
Sexually Transmitted ◽  
Health Clinics ◽  
Results Management ◽  
Sexual Health Clinics

Epididymitis is a common cause of scrotal pain presentation in sexual health clinics; however, it is unclear what fraction is attributable to transmissible infections. We, therefore, reviewed the aetiologies causing epididymitis. A retrospective data analysis of all cases of epididymitis diagnosed from January 2018 to December 2018 in three sexual health clinics was conducted, collecting demographics, results, management and symptom resolution at two weeks follow up. A total of 127 cases of epididymitis (mean age 32 years, heterosexual 97, MSM 30) were included. Among them 14 cases (11%) were caused by sexual transmitted infections (<35 years n = 9; >35 years n = 5): seven cases of chlamydia, six gonorrhoea, one syphilis and one trichomonas vaginalis. There were three cases of urinary tract infection diagnosed. All cases were treated with antibiotics recommended by the British Association for Sexual Health and HIV (BASHH). At two weeks follow up post-treatment 10 (7%) were symptomatic; 91% did not attend for follow up. Sexually transmitted infections were associated with acute epididymitis in 11% of this study cohort.

scholarly journals Early impact of COVID-19 social distancing measures on reported sexual behaviour of HIV pre-exposure prophylaxis users in Wales

2020 ◽  
pp. sextrans-2020-054598
Author(s):  
David Gillespie ◽  
Carys Knapper ◽  
Dyfrig Hughes ◽  
Zoe Couzens ◽  
Fiona Wood ◽  
...  
Keyword(s):  
Sexual Health ◽  
Sexual Behaviour ◽  
Control Measures ◽  
Relationship Status ◽  
Health Clinic ◽  
Social Distancing ◽  
Condomless Sex ◽  
Health Clinics ◽  
Sexual Health Clinics ◽  
Exposure Prophylaxis

ObjectivesTo describe the early impact of COVID-19 and associated control measures on the sexual behaviour of pre-exposure prophylaxis (PrEP) users in Wales.MethodsData were obtained from an ecological momentary assessment study of PrEP use and sexual behaviour. Participants were individuals accessing PrEP through the National Health Service (NHS) sexual health clinics across four health boards in Wales. Weekly data documenting condomless sex in the preceding week were analysed between 03/02/2020 and 10/05/2020. The introduction of social distancing measures and changes to sexual health clinics in Wales occurred on the week starting 16/03/2020. Two-level logistic regression models were fitted to condomless sex (yes/no) over time, included an indicator for the week starting 16/03/2020, and were extended to explore differential associations by relationship status and sexual health clinic.ResultsData were available from 56 participants and included 697 person-weeks (89% of the maximum number that could have been obtained). On average, 42% of participants reported condomless sex in the period prior to the introduction of social distancing measures and 20% reported condomless sex after (OR=0.16, 95% CI 0.07 to 0.37, p<0.001). There was some evidence to suggest that this association was moderated by relationship status (OR for single participants=0.09, 95% CI 0.06 to 0.23; OR for not single participants=0.46, 95% CI 0.16 to 1.25).ConclusionsThe introduction of social distancing measures and changes to PrEP services across Wales was associated with a marked reduction in reported instances of condomless sexual intercourse among respondents, with a larger reduction in those who were single compared with those who were not. The long-term impact of COVID-19 and associated control measures on this population’s physical and mental health and well-being requires close examination.

scholarly journals Help-seeking for genitourinary symptoms: a mixed methods study from Britain’s Third National Survey of Sexual Attitudes and Lifestyles (Natsal-3)

BMJ Open ◽  
2019 ◽  
Vol 9 (10) ◽  
pp. e030612
Author(s):  
Fiona Mapp ◽  
Kaye Wellings ◽  
Catherine H Mercer ◽  
Kirstin Mitchell ◽  
Clare Tanton ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Sexual Health ◽  
Survey Data ◽  
National Survey ◽  
Help Seeking ◽  
Sexual Attitudes ◽  
Health Clinic ◽  
Health Clinics ◽  
Semistructured Interviews ◽  
Sexual Health Clinics

ObjectivesQuantify non-attendance at sexual health clinics and explore help-seeking strategies for genitourinary symptoms.DesignSequential mixed methods using survey data and semistructured interviews.SettingGeneral population in Britain.Participants1403 participants (1182 women) from Britain’s Third National Survey of Sexual Attitudes and Lifestyles (Natsal-3; undertaken 2010–2012), aged 16–44 years who experienced specific genitourinary symptoms (past 4 weeks), of whom 27 (16 women) who reported they had never attended a sexual health clinic also participated in semistructured interviews, conducted May 2014–March 2015.Primary and secondary outcome measuresFrom survey data, non-attendance at sexual health clinic (past year) and preferred service for STI care; semistructured interview domains were STI social representations, symptom experiences, help-seeking responses and STI stigma.ResultsMost women (85.9% (95% CI 83.7 to 87.9)) and men (87.6% (95% CI 82.3 to 91.5)) who reported genitourinary symptoms in Natsal-3 had not attended a sexual health clinic in the past year. Around half of these participants cited general practice (GP) as their preferred hypothetical service for STI care (women: 58.5% (95% CI 55.2% to 61.6%); men: 54.3% (95% CI 47.1% to 61.3%)). Semistructured interviews elucidated four main responses to symptoms: not seeking healthcare, seeking information to self-diagnose and self-treat, seeking care at non-specialist services and seeking care at sexual health clinics. Collectively, responses suggested individuals sought to gain control over their symptoms, and they prioritised emotional reassurance over accessing medical expertise. Integrating survey and interview data strengthened the evidence that participants preferred their general practitioner for STI care and extended understanding of help-seeking strategies.ConclusionsHelp-seeking is important to access appropriate healthcare for genitourinary symptoms. Most participants did not attend a sexual health clinic but sought help from other sources. This study supports current service provision options in Britain, facilitating individual autonomy about where to seek help.

scholarly journals HIV testing amongst older sexual health clinic attendees in England: an epidemiological study

2018 ◽  
Vol 30 (2) ◽  
pp. 113-119 ◽  
Author(s):  
Sadie Bell ◽  
Joy Adamson ◽  
Fabiola Martin ◽  
Tim Doran
Keyword(s):  
Public Health ◽  
Older Adults ◽  
Sexual Health ◽  
Hiv Testing ◽  
Health Clinic ◽  
Health Clinics ◽  
Hiv Test ◽  
Increased Risk ◽  
Sex With Men ◽  
Sexual Health Clinics

Older adults with HIV are at increased risk of late diagnosis. We aimed to explore the association between age and HIV testing rates in sexual health clinics in England using Public Health England data for 2009–2014. We investigated associations between attendee age and likelihood of HIV test offer, acceptance, and coverage. For each year, increasing age was associated with reduced likelihood of test offer (Rs −0.797 to −0.958, p < 0·01). Offer rates were highest for men who have sex with men (MSM), and lowest for heterosexual females (HSFs). HSFs had the greatest decline in offer rates with age (from 86.2% for age 25–29 to 52.1% for age 70+ in 2014). Odds ratios for test offer in 2014 for attendees aged 15–49 compared with attendees aged 50+ were 1.94 (95%CI: 1.88, 2.00) for heterosexual males (HSMs), 1.86 (95%CI: 1.81, 1.91) for HSFs, and 1.54 (95%CI: 1.45, 1.64) for MSM. Overall, there was no significant association between age and test acceptance in any year (Rs −0.070 to −0.547; p > 0·05). The strongest determinant of acceptance was sexual orientation; for attendees aged 50+, compared with HSMs, acceptance was higher for MSM (OR: 1.10; 95%CI: 1.06, 1.13) and lower for HSFs (OR: 0.30; 95%CI: 0.30, 0.31).

scholarly journals Improving our understanding of the disproportionate incidence of STIs in heterosexual-identifying people of black Caribbean heritage: findings from a longitudinal study of sexual health clinic attendees in England

2021 ◽  
pp. sextrans-2020-054784
Author(s):  
Megan Bardsley ◽  
Sonali Wayal ◽  
Paula Blomquist ◽  
Hamish Mohammed ◽  
Catherine H Mercer ◽  
...  
Keyword(s):  
Sexual Health ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Health Clinic ◽  
Prevention Measures ◽  
Sti Prevention ◽  
Health Clinics ◽  
Cox Proportional Hazards Models ◽  
Black Caribbean ◽  
Sexual Health Clinics

ObjectiveIn England, people of black minority ethnicities are at elevated risk of STI diagnosis, especially those of black Caribbean (BC) heritage. Understanding the factors that predict STI acquisition in this population is key to inform prevention measures. We examined the differences in predictors of incident STI diagnoses across ethnic groups in people attending sexual health clinics (SHCs).MethodsResponses from an attitudinal and behavioural survey run in 16 English SHCs (May–September 2016) were linked to routinely collected national surveillance data on bacterial STI or trichomoniasis diagnoses. Cox proportional hazards models investigated the relationship between participant characteristics and rate of incident STI in the 18 months after survey completion for all heterosexual participants (N=2940) and separately for heterosexual BC (N=484) and white British/Irish (WBI, N=1052) participants.ResultsWe observed an overall STI incidence of 5.7 per 100 person-years (95% CI 5.1 to 6.5). STI incidence was higher in participants of BC ethnicity (BC, 12.1 per 100 person-years, 95% CI 9.7 to 15.1; WBI, 3.2 per 100 person-years, 95% CI 2.4 to 4.2), even in adjusted analysis (BC adjusted HR (aHR), 2.60, p<0.001, compared with WBI). In models stratified by ethnicity, having had two or more previous STI episodes in the past year was the strongest predictor of incident STI for both BC (aHR 5.81, p<0.001, compared with no previous episodes) and WBI (aHR 29.9, p<0.001) participants. Aside from younger age (aHR 0.96 for increasing age in years, p=0.04), we found no unique predictors of incident STI for BC participants.ConclusionsIncident STI diagnoses among SHC attendees in England were considerably higher in study participants of BC ethnicity, but we found no unique clinical, attitudinal or behavioural predictors explaining the disproportionate risk. STI prevention efforts for people of BC ethnicity should be intensified and should include tailored public health messaging to address sexual health inequalities in this underserved population.

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