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

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).

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Fall in new HIV diagnoses among men who have sex with men (MSM) at selected London sexual health clinics since early 2015: testing or treatment or pre-exposure prophylaxis (PrEP)?

Eurosurveillance ◽

10.2807/1560-7917.es.2017.22.25.30553 ◽

2017 ◽

Vol 22 (25) ◽

Cited By ~ 53

Author(s):

Alison E Brown ◽

Hamish Mohammed ◽

Dana Ogaz ◽

Peter D Kirwan ◽

Mandy Yung ◽

...

Keyword(s):

High Risk ◽

Sexual Health ◽

Hiv Testing ◽

Health Clinics ◽

High Risk Populations ◽

Sex With Men ◽

Sexual Health Clinics ◽

Exposure Prophylaxis

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.

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

International Journal of STD & AIDS ◽

10.1258/ijsa.2008.008153 ◽

2008 ◽

Vol 19 (11) ◽

pp. 752-757 ◽

Cited By ~ 14

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.

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Audit of HIV testing frequency and behavioural interventions for men who have sex with men: policy and practice in sexual health clinics in England

Sexually Transmitted Infections ◽

10.1136/sextrans-2012-050679 ◽

2013 ◽

Vol 89 (5) ◽

pp. 404-408 ◽

Cited By ~ 11

Author(s):

Monica Desai ◽

Sarika Desai ◽

Ann Kathleen Sullivan ◽

Malika Mohabeer ◽

Danielle Mercey ◽

...

Keyword(s):

Sexual Health ◽

Hiv Testing ◽

Policy And Practice ◽

Behavioural Interventions ◽

Health Clinics ◽

Testing Frequency ◽

Sex With Men ◽

Sexual Health Clinics

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HPV16 and HPV18 seropositivity and DNA detection among men who have sex with men: a cross-sectional study conducted in a sexual health clinic in London

Sexually Transmitted Infections ◽

10.1136/sextrans-2020-054726 ◽

2020 ◽

pp. sextrans-2020-054726

Author(s):

Eleanor M King ◽

David Mesher ◽

Pam Sonnenberg ◽

Ezra Linley ◽

Kavita Panwar ◽

...

Keyword(s):

Sexual Health ◽

Hpv Vaccination ◽

Hpv Infection ◽

Cross Sectional Study ◽

Health Clinic ◽

Cross Sectional ◽

Hpv Dna ◽

Health Clinics ◽

Sex With Men ◽

Sexual Health Clinics

ObjectivesMen who have sex with men (MSM) have an increased risk of human papillomavirus (HPV) infection and related diseases compared with men who have sex exclusively with women. From April 2018, there has been a phased roll-out of HPV vaccination offered to MSM aged up to 45 years old who are attending sexual health clinics and HIV clinics in England. The vaccine is most effective if delivered prior to HPV infection. We estimated the proportion of MSM with no current vaccine-type infection and no serological evidence of prior infection, in a study undertaken prior to vaccine introduction.MethodsWe conducted a cross-sectional study among 484 MSM aged 18–40 years old who attended a sexual health clinic in London between 2010 and 2012. We estimated the prevalence of current and past infection by testing for HPV DNA in anogenital samples and for serum antibodies to HPV16 and HPV18.ResultsThe median age was 30 years (IQR 25–35). The prevalence of HPV16 and HPV18 DNA was 13.2% and 6.2%, respectively. Seropositivity for HPV16 and HPV18 was 28.5% and 17.1%, respectively, with 11.4% seropositive for both types. Seropositivity for the same HPV type was strongly associated with anogenital DNA detection. 279 MSM (57.6%) tested negative for both HPV16 and HPV18 serology and were DNA negative for these two types; only 5 MSM (1.0%) were seropositive and DNA positive for both HPV types.ConclusionsThis is the first study to determine both the prevalence of HPV DNA in anogenital samples and HPV seroprevalence among MSM attending a sexual health clinic in the UK. Over half of MSM in this study had no evidence of a previous or current infection with either of the high-risk HPV types included in the quadrivalent vaccine, which supports the rationale for opportunistic HPV vaccination of MSM attending sexual health clinics.

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Is it time to move to nucleic acid amplification tests screening for pharyngeal and rectal gonorrhoea in men who have sex with men to improve gonorrhoea control?

Sexual Health ◽

10.1071/sh10134 ◽

2011 ◽

Vol 8 (1) ◽

pp. 9 ◽

Cited By ~ 20

Author(s):

Christopher K. Fairley ◽

Marcus Y. Chen ◽

Catriona S. Bradshaw ◽

Sepehr N. Tabrizi

Keyword(s):

Nucleic Acid ◽

Antimicrobial Resistance ◽

Sexual Health ◽

Nucleic Acid Amplification ◽

Nucleic Acid Amplification Tests ◽

Health Clinics ◽

Sex With Men ◽

Sexual Health Clinics

The use of nucleic acid amplification tests (NAAT), as well as or in preference to culture for non-genital sites is now recommended both in Australia and overseas because of their greater sensitivity and improved specificity. A survey of 22 Australian sexual health clinics who each year test over 14 500 men who have sex with men (MSM) show that culture remains the predominate method for detecting gonorrhoea at pharyngeal (64%) and rectal (73%) sites. This editorial discusses the potential disadvantages of using culture over NAAT in relation to optimal gonorrhoea control among MSM and advocates that significantly improved control would be achieved by moving to NAAT with the proviso that culture samples are taken wherever possible on NAAT-positive samples and from clients with urethritis to ensure continued surveillance for antimicrobial resistance.

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