A service evaluation comparing home-based testing to clinic-based testing for HIV, syphilis and hepatitis B in Birmingham and Solihull

2020 ◽  
Vol 31 (7) ◽  
pp. 613-618 ◽  
Author(s):  
Prita Banerjee ◽  
Vidya Madhwapathi ◽  
Nicola Thorley ◽  
Keith Radcliffe

The sexual health services in the Birmingham and Solihull area of the United Kingdom, called Umbrella, has been offering home-based testing for sexually transmitted infections to patients since August 2015. The aim of this service evaluation was to evaluate the uptake, return rate and new diagnosis rates of home-based testing in comparison with clinic-based testing for human immunodeficiency virus (HIV), syphilis (STS) and hepatitis B. Home-based testing, although popular, had low uptake amongst high-risk groups such as men who have sex with men (MSM), compared to the clinic-based group (1% versus 11%, p < 0.001). This resulted in low positivity rates for HIV (0.02%) and STS (0.17%) and no new cases of hepatitis B in the home-based group. Therefore, our results show that home-based testing is not a cost-effective method of testing for HIV and likely this is also the case for hepatitis B and STS. Our recommendation would be to encourage uptake of home-based testing in high-risk groups such as MSM and Black Africans to improve the diagnosis rates of HIV, STS and hepatitis B. Alternatively, the continuation of home-based blood testing in the Birmingham and Solihull area will need to be reviewed by Umbrella as a cost-saving strategy for the service in the future.

2018 ◽  
Vol 29 (10) ◽  
pp. 974-979 ◽  
Author(s):  
Prita Banerjee ◽  
Nicola Thorley ◽  
Keith Radcliffe

Home-based testing is an alternative, convenient and cost-effective method of testing for sexually transmitted infections compared to traditional clinic-based testing, in patients who are asymptomatic and, or, would otherwise feel stigmatised about attending sexual health clinics. The sexual health service in Birmingham and Solihull, called Umbrella, provides an online home-based testing service, which has been in operation since August 2015. The aim of this study was to evaluate the uptake and return rate of home-based testing kits and compare home-based testing to clinic-based testing in terms of diagnosis and treatment rates of Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC). Our study showed that home-based testing is a popular method of testing and relatively more popular amongst asymptomatic, young, heterosexual female and White patients than clinic-based testing, with a return rate of 48%. The diagnosis rates for CT/GC are comparable to patients who attend clinic for testing (8% vs. 10% in home-based and clinic-based groups, respectively, p < 0.001). The overall treatment rate was lower in the home-based compared to the clinic-based group (82% vs. 88%, p < 0.001). Umbrella will continue to provide this service within Birmingham and Solihull and aim to provide patients with alternative pathways for more convenient access to treatment.


1981 ◽  
Vol 15 ◽  
pp. 519-519
Author(s):  
Madhu Gudavalli ◽  
Catherine M P Kierney ◽  
Saul Krugman
Keyword(s):  

2019 ◽  
Vol 4 (1) ◽  
pp. 43
Author(s):  
Patricia Gita Naully ◽  
Perdina Nursidika

ABSTRAK Hepatitis B dan C dianggap paling berbahaya diantara jenis hepatitis yang lain karena keduanya dapat berkembang menjadi penyakit kronik, sering tanpa gejala, dan menyebabkan kematian. Salah satu upaya yang disarankan oleh WHO untuk mencegah peningkatan angka Hepatitis B dan C adalah melakukan kegiatan edukasi kesehatan bagi masyarakat, khususnya kelompok beresiko tinggi seperi Warga Binaan Pemasyarakatan (WBP). Oleh sebab itu, kegiatan penyuluhan ini bertujuan untuk meningkatkan pengetahuan WBP terkait penyebab, gejala, cara penularan, pencegahan, dan layanan kesehatan yang disediakan oleh pemerintah. Kegiatan ini dilakukan di Lembaga Pemasyarakatan (Lapas) Narkotika Kelas IIA Bandung dengan jumlah peserta sebanyak 30 orang WBP. Penyuluhan dilaksanakan dengan metode ceramah. Evaluasi kegiatan dilakukan dengan cara menganalisis hasil kuesioner dan nilai tes para peserta. Teknik analisis yang digunakan adalah analisis deskriptif. Hasil evaluasi membuktikan bahwa mayoritas WBP melakukan tindakan beresiko tinggi karena keterbatasan pengetahuan dan informasi, namun setelah mendapatkan materi penyuluhan terlihat adanya peningkatan nilai tes pada seluruh peserta. Kegiatan ini berhasil meningkatkan pengetahuan WBP di Lapas Narkotika Kelas IIA Bandung terkait penyebab, gejala klinis, cara penularan, pencegahan, serta beberapa layanan kesehatan pemerintah untuk mencegah, mendiagnosa, serta mengobati penyakit Hepatitis B dan C.Kata Kunci: hepatitis B; hepatitis C; penyuluhan; lembaga pemasyarakatanABSTRACTHepatitis B and C are considered as the most dangerous hepatitis types compared to the other, because both can develop into chronic diseases, asymptomatic, and cause death. One of the methods suggested by WHO to prevent an increase of Hepatitis B and C numbers is to conduct health education activities for the community, especially for the high-risk groups such as prisoners (WBP). Therefore, the aim of this extension activity was to upgrade the WBP's knowledge regarding the disease causes, symptoms, transmission methods, prevention, and health services provided by the government. This activity was conducted in Bandung Narcotics Penitentiary class IIA, with 30 WBP participants. The extention was done by the lecture method. Then, the activity evaluation was done by analyzing of questionnaire results and participants' test-scores. Besides, the analysis technique used was descriptive analysis. The evaluation result proved that the majority of WBP taking the high-risk action due to the limited of knowledge and information, but there was a test-score increase for all participants after obtaining counseling materials. This activity was successful to improve the WBP's knowledge in Bandung Narcotics Penitentiary class IIA related to the causes, clinical symptoms, modes of transmission, prevention, and also some government health services to prevent, diagnose, and treat the Hepatitis B and C.Keywords : extension; hepatitis B; hepatitis C; prison.


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.


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