P216 Umbrella combined sexual health services, chlamydia screening and deprivation: are we achieving continued screening of high-risk populations?

Since October 2015 up to September 2016, HIV diagnoses fell by 32% compared with October 2014–September 2015 among men who have sex with men (MSM) attending selected London sexual health clinics. This coincided with high HIV testing volumes and rapid initiation of treatment on diagnosis. The fall was most apparent in new HIV testers. Intensified testing of high-risk populations, combined with immediately received anti-retroviral therapy and a pre-exposure prophylaxis (PrEP) programme, may make elimination of HIV achievable.

Download Full-text

What proportion of sexually transmissible infections and HIV are diagnosed in New South Wales’ public sexual health services compared with other services?

Sexual Health ◽

10.1071/sh12020 ◽

2013 ◽

Vol 10 (2) ◽

pp. 119 ◽

Cited By ~ 6

Author(s):

Chris Bourne ◽

Debbie Allen ◽

Katherine Brown ◽

Stephen C. Davies ◽

Anna McNulty ◽

...

Keyword(s):

Health Services ◽

Sexual Health ◽

New South ◽

New South Wales ◽

Large Contribution ◽

Geographical Variations ◽

South Wales ◽

Sexually Transmissible Infections ◽

Geographical Regions ◽

High Risk Populations

Background: In New South Wales (NSW), publicly funded sexual health services (PFSHSs) target the populations at greatest risk for important sexually transmissible infections (STIs) and so may make a large contribution to the diagnosis of notifiable STIs. We aimed to determine the proportions of STIs diagnosed in PFSHSs and notified to the NSW Ministry of Health in 2009, and describe geographical variations. Methods: The number of notifiable STIs (infectious syphilis, gonorrhoea, HIV and chlamydia) diagnosed in 2009 was obtained for each Area Health Service (AHS) and each PFSHS. The proportion of diagnoses made by PFSHSs was calculated at the state and AHS level according to five geographical regions: inner and outer metropolitan, regional, rural and remote. Results: The overall proportions of diagnoses made by NSW PFSHSs were syphilis, 25%; gonorrhoea, 25%; HIV, 21%; and chlamydia, 14%. Within each zone, the proportions of these STIs were (respectively): (i) inner metropolitan: 32%, 26%, 21% and 13%; (ii) outer metropolitan: 41%, 24%, 43% and 9%; (iii) regional: 62%, 15%, 23% and 10%; (iv) rural: 8%, 29%, <5% and 20%; and (v) remote: <5%, 43%, <5% and 29%. There was considerable variation in proportions of STIs between and within AHSs (<5–100%). Conclusions: NSW PFSHSs contribute a large proportion of diagnoses for syphilis, gonorrhoea and HIV, but less so for chlamydia. Across AHSs and zones, there was considerable variation in the proportions. These data support the role of PFSHS in identifying and managing important STIs in high-risk populations.

Download Full-text

Corrigendum to: What proportion of sexually transmissible infections and HIV are diagnosed in New South Wales’ public sexual health services compared with other services?

Sexual Health ◽

10.1071/sh12020_co ◽

2013 ◽

Vol 10 (3) ◽

pp. 290

Author(s):

Chris Bourne ◽

Debbie Allen ◽

Katherine Brown ◽

Stephen C. Davies ◽

Anna McNulty ◽

...

Keyword(s):

Health Services ◽

Sexual Health ◽

New South ◽

New South Wales ◽

Large Contribution ◽

Geographical Variations ◽

South Wales ◽

Sexually Transmissible Infections ◽

Geographical Regions ◽

High Risk Populations

Background: In New South Wales (NSW), publicly funded sexual health services (PFSHSs) target the populations at greatest risk for important sexually transmissible infections (STIs) and so may make a large contribution to the diagnosis of notifiable STIs. We aimed to determine the proportions of STIs diagnosed in PFSHSs and notified to the NSW Ministry of Health in 2009, and describe geographical variations. Methods: The number of notifiable STIs (infectious syphilis, gonorrhoea, HIV and chlamydia) diagnosed in 2009 was obtained for each Area Health Service (AHS) and each PFSHS. The proportion of diagnoses made by PFSHSs was calculated at the state and AHS level according to five geographical regions: inner and outer metropolitan, regional, rural and remote. Results: The overall proportions of diagnoses made by NSW PFSHSs were syphilis, 25%; gonorrhoea, 25%; HIV, 21%; and chlamydia, 14%. Within each zone, the proportions of these STIs were (respectively): (i) inner metropolitan: 32%, 26%, 21% and 13%; (ii) outer metropolitan: 41%, 24%, 43% and 9%; (iii) regional: 62%, 15%, 23% and 10%; (iv) rural: 8%, 29%, Conclusions: NSW PFSHSs contribute a large proportion of diagnoses for syphilis, gonorrhoea and HIV, but less so for chlamydia. Across AHSs and zones, there was considerable variation in the proportions. These data support the role of PFSHS in identifying and managing important STIs in high-risk populations.

Download Full-text

Chlamydia Screening for High Risk Populations

10.22371/07.2019.013 ◽

2019 ◽

Author(s):

Kathryn Dickson

Keyword(s):

High Risk ◽

Chlamydia Screening ◽

High Risk Populations

Download Full-text

Qualitative interviews with healthcare staff in four European countries to inform adaptation of an intervention to increase chlamydia testing

BMJ Open ◽

10.1136/bmjopen-2017-017528 ◽

2017 ◽

Vol 7 (9) ◽

pp. e017528 ◽

Cited By ~ 2

Author(s):

Cliodna McNulty ◽

Ellie J Ricketts ◽

Hans Fredlund ◽

Anneli Uusküla ◽

Katy Town ◽

...

Keyword(s):

General Practice ◽

Health Services ◽

Sexual Health ◽

Complex Intervention ◽

Primary Healthcare ◽

Qualitative Interviews ◽

Randomised Trial ◽

Action Planning ◽

Chlamydia Screening ◽

Chlamydia Testing

ObjectiveTo determine the needs of primary healthcare general practice (GP) staff, stakeholders and trainers to inform the adaptation of a locally successful complex intervention (Chlamydia Intervention Randomised Trial (CIRT)) aimed at increasing chlamydia testing within primary healthcare within South West England to three EU countries (Estonia, France and Sweden) and throughout England.DesignQualitative interviews.SettingEuropean primary healthcare in England, France, Sweden and Estonia with a range of chlamydia screening provision in 2013.Participants45 GP staff, 13 trainers and 18 stakeholders.InterviewsThe iterative interview schedule explored participants’ personal attitudes, subjective norms and perceived behavioural controls around provision of chlamydia testing, sexual health services and training in general practice. Researchers used a common thematic analysis.ResultsFindings were similar across all countries. Most participants agreed that chlamydia testing and sexual health services should be offered in general practice. There was no culture of GP staff routinely offering opportunistic chlamydia testing or sexual health advice, and due to other priorities, participants reported this would be challenging. All participants indicated that the CIRT workshop covering chlamydia testing and sexual health would be useful if practice based, included all practice staff and action planning, and was adequately resourced. Participants suggested minor adaptations to CIRT to suit their country’s health services.ConclusionsA common complex intervention can be adapted for use across Europe, despite varied sexual health provision. The intervention (ChlamydiA Testing Training in Europe (CATTE)) should comprise: a staff workshop covering sexual health and chlamydia testing rates and procedures, action planning and patient materials and staff reminders via computer prompts, emails or newsletters, with testing feedback through practice champions. CATTE materials are available at: www.STItraining.eu.

Download Full-text

Prevalence of hepatitis B immunity and infection in home self-sampling HIV service users

Sexually Transmitted Infections ◽

10.1136/sextrans-2021-055071 ◽

2021 ◽

pp. sextrans-2021-055071

Author(s):

Rachel Roche ◽

Ruth Simmons ◽

Louise Logan ◽

Juan Ledesma ◽

Caroline Sabin ◽

...

Keyword(s):

High Risk ◽

Hepatitis B ◽

Health Services ◽

Sexual Health ◽

Multinomial Logistic Regression ◽

Risk Groups ◽

Hbv Infection ◽

High Risk Population ◽

Susceptibility To Infection ◽

Hiv Test

ObjectivesAlthough hepatitis B virus (HBV) vaccination for high-risk groups including gay, bisexual and other men who have sex with men (MSM) is recommended in the UK, data on HBV immunisation coverage are limited. This study aimed to understand the prevalence of HBV infection, susceptibility and immunity due to immunisation among a high-risk population of MSM and heterosexuals who are less likely to attend sexual health services.MethodsResidual HIV-negative serology samples archived from a national HIV self-sampling service in 2016 were tested for HBV markers using an unlinked anonymous approach. Prevalence of HBV infection, evidence of immunisation and susceptibility were calculated and stratified by individuals’ characteristics. Multinomial logistic regression was used to estimate relative risk ratios (RRRs) associated with covariates.ResultsOf 2172 samples tested, 1497 (68.9%) were from MSM and 657 (30.2%) were from heterosexuals. Susceptibility to HBV infection was 66.1% among MSM and 77.0% among heterosexuals. Only 29.9% of MSM and 17.4% of heterosexuals had serological evidence of immunisation. Current infection was 1.1% in heterosexuals and 0.2% in MSM. Adjusted analysis showed evidence of immunisation was lower among heterosexuals (RRR 0.66, 95% CI 0.50 to 0.86) and those with no previous HIV test (RRR 0.41, 95% CI 0.31 to 0.54), and higher in those of other white or other ethnicity.ConclusionsAmong MSM and heterosexual users of a self-sampling HIV service, evidence of immunisation to HBV infection was low and susceptibility to infection was comparatively high, suggesting suboptimal delivery of HBV immunisation in sexual health services.

Download Full-text

Telephone-triage services do not lead to an increased wait time for assessment of gonorrhoea in symptomatic patients

International Journal of STD & AIDS ◽

10.1177/0956462421999280 ◽

2021 ◽

pp. 095646242199928

Author(s):

William Jasper ◽

Madeleine Macdonald ◽

Danayan Luxmanan ◽

Elizabeth Foley ◽

Rajul Patel

Keyword(s):

High Risk ◽

Health Services ◽

Sexual Health ◽

Wait Time ◽

Wait Times ◽

Telephone Triage ◽

Access To Services ◽

Duration Of Symptoms ◽

Significant Difference ◽

Service Change

In Spring 2017, Southampton and Portsmouth Sexual Health Services (SHSs) replaced an overstretched walk-in service with a telephone-triage service: patients calling that were symptomatic, vulnerable or at high risk of having an STI were invited into a clinic, whereas others were signposted to remote self-sample NHS postal testing services. This study aimed to establish whether patient care was disadvantaged by the introduction of the triage service. Electronic patient notes for all patients attending for treatment of gonorrhoea for two years before and for two years after the service change were interrogated; the site of infection and duration of symptoms before testing were compared. Of all patients attending for treatment of gonorrhoea in the study period, 499 patients (39% of cases) were symptomatic at testing: 364 had urethral symptoms, 45 had rectal symptoms and 18 had pharyngeal symptoms. 72.4% of patients with urethral symptoms were seen after the introduction of the triage system. Median wait times for patients with urethral symptoms rose from 6 (IQR = 3–7) to 7 (IQR = 3.75–14) days – although this increase was not statistically significant ( p = 0.064). There was not a statistically significant difference between the rectal symptom groups ( p = 0.422) and too few patients attended with pharyngeal symptoms to warrant analysis. Despite some outliers, the telephone-triage service did not increase wait times for patients attending STI services with symptomatic gonorrhoea and may have inadvertently increased access to services for those most at risk.

Download Full-text