Sexual health care of HIV-positive patients: an audit of a local service

2003 ◽  
Vol 14 (7) ◽  
pp. 493-496 ◽  
Author(s):  
Jane Hutchinson ◽  
Penny Goold ◽  
Hugh Wilson ◽  
Kevin Jones ◽  
Claudia Estcourt
Keyword(s):  
Health Care ◽  
Sexual Health ◽  
Hiv Care ◽  
Hiv Positive ◽  
Hiv Diagnosis ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Sexual Health Care ◽  
Patient Appointment ◽  
Health Screen

The sexual health care of 175 HIV-positive patients attending the two HIV clinics at Barts and the London NHS Trust was audited for the first time. The audit standard was that 100% of patients should be in receipt of a sexual health screen within six months of their first HIV out-patient appointment. Overall, 44.5% of patients had a sexual health screen, of which 46 (60.5%) were diagnosed with a sexually transmitted infection. Those screened were younger than those who were not. Five factors were identified which were significantly associated with not having a genitourinary screen performed; site of HIV care, setting of HIV diagnosis, stage of HIV disease, specialty of HIV physician and whether a screen was recommended by the HIV physician. A number of recommendations have been implemented to improve the uptake of sexual health screening amongst HIV-positive patients.

UK national audit of sexual health care for people with HIV infection: case-notes audit

2007 ◽  
Vol 18 (9) ◽  
pp. 639-642 ◽  
Author(s):  
Chris Carne ◽  
Hugo McClean ◽  
Paul Bunting ◽  
Ed Wilkins ◽  
Linda Tucker ◽  
...  
Keyword(s):  
Health Care ◽  
Sexual Health ◽  
Hiv Infection ◽  
Sexual History ◽  
Hiv Diagnosis ◽  
Sexually Transmitted ◽  
Sexual Health Care ◽  
Outbreak Areas ◽  
Hepatitis B Testing ◽  
Syphilis Serology

The case-notes of 3210 patients with HIV infection were audited. A sexual history was documented within four weeks before or after initial HIV diagnosis in 69% of cases (regional range 45–84%), and in the six months before attendance during the audit interval in 34% (12–53%). An offer of tests for sexually transmitted infections was documented within four weeks before or after HIV diagnosis in 58% (30–83%), and in the prior six months in 28% (14–47%). Syphilis serology was offered in the previous three months to 45% (14–100%) of cases resident in syphilis outbreak areas and to 25% (7–62%) of other cases. Hepatitis B testing was performed for 98% (95–100%) of cases and for hepatitis C, for 91% (79–100%). Cervical cytology results in the past year were documented for 73% (43–94%) of eligible women. Considerable inter-regional variation in performance exists. Interventions are needed to improve the sexual health care of people with HIV infection.

UK national audit of sexual health care for people with HIV infection: clinic policies

2007 ◽  
Vol 18 (9) ◽  
pp. 635-638
Author(s):  
Hugo McClean ◽  
Chris Carne ◽  
Paul Bunting ◽  
Ed Wilkins ◽  
Linda Tucker ◽  
...  
Keyword(s):  
Health Care ◽  
Sexual Health ◽  
Hiv Infection ◽  
Service Providers ◽  
National Standard ◽  
Care Pathways ◽  
National Audit ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Sexual Health Care

A national audit of the sexual health care for people with HIV infection (PWHIV) was conducted in genitourinary medicine clinics and other clinics providing care for PWHIV in the UK in the summer of 2006. Data were aggregated by region and clinic, allowing practice to be compared between regions, as well as to national averages and against various guidelines. In this, the first of two papers, clinics were surveyed on their local policies. In total, 126 clinics participated. Only 38 clinics (30%, regional range 0–60%) had written local care pathways on management of sexually transmitted infection in PWHIV, while 73 (58, 20–100%) had unwritten policies. This compares with the national standard that 100% of service providers should be able to provide documentation of local care pathways for sexually transmitted diseases in people with HIV. Clinics should consider creating policies especially where standards are not being met.

Novel outreach settings to enhance sexually transmitted infection/HIV awareness, diagnosis and treatment in hard-to-reach populations

2017 ◽  
Vol 29 (3) ◽  
pp. 266-272 ◽  
Author(s):  
T Lampejo ◽  
R Turner ◽  
C Roberts ◽  
K Allen ◽  
L Watson ◽  
...  
Keyword(s):  
Sexual Health ◽  
Large Scale ◽  
Contact Tracing ◽  
Health Clinic ◽  
Hiv Screening ◽  
Hiv Diagnosis ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Risk Reduction Behaviour ◽  
Hard To Reach Populations

Despite recent rises in the number of cases of sexually transmitted infections (STIs) such as syphilis and gonorrhoea in England and increasing rates of HIV diagnosis among several men who have sex with men populations, many individuals are still not engaging with sexual health services. The John Hunter Clinic for Sexual Health, Chelsea and Westminster Hospital, London set up outreach clinics at the two world’s largest adult lifestyle exhibitions in 2013 and 2015. This was the first time that a sexual health screening and promotion service was available at these large-scale (over 10,000 attendees at each) adult lifestyle events. A total of 381 individuals underwent STI screening across the two events. Nineteen (5.0%) patients were diagnosed with an infection. Twelve (3.1%) patients with Chlamydia trachomatis, three (0.8%) patients with syphilis, one (0.3%) patient with Neisseria gonorrhoeae, one (0.3%) patient with HIV, one (0.3%) patient with hepatitis B and one (0.3%) patient with hepatitis C. All 19 patients were promptly contacted with their results and had arrangements made for treatment or were referred for specialist follow up. Where possible, contact tracing was also performed. Implementing such outreach-based projects is challenged by lack of on-site laboratory support, high staffing demands and potentially high costs. However, we achieved a total HIV screening uptake rate of 94.5% amongst our outreach clinic attendees (versus 67% nationally in conventional sexual health clinic attendees) with an HIV positivity rate of 0.3% (versus 0.2% nationally in high HIV prevalence band populations). Additionally, 30.7% had never been tested for HIV previously (versus 20.7% nationally). Our work demonstrates that these strategies can help to address issues related to lack of STI/HIV screening in hard-to-reach populations and promote risk reduction behaviour.

scholarly journals 745. Operationalization of Comprehensive Sexual Wellness Clinic at a Large Urban Emergency Department

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S333-S333
Author(s):  
Aniruddha Hazra ◽  
Jessica Schmitt ◽  
Alvie Bender ◽  
Michelle Moore ◽  
Cheryl Scott ◽  
...  
Keyword(s):  
Primary Care ◽  
Emergency Department ◽  
Sexual Health ◽  
Social Services ◽  
Medical Center ◽  
Academic Medical Center ◽  
Health Clinic ◽  
Hiv Diagnosis ◽  
Transmitted Infection ◽  
Sexually Transmitted

Abstract Background Due to the closure of surrounding city-run sexually transmitted infection (STI) clinics, uninsured and underinsured patients living near an urban academic medical center have been relying on the Emergency Department (ED) for their sexual health needs. A novel Sexual Wellness Clinic (SWC) was created to provide comprehensive sexual healthcare and primary care linkage to patients presenting to the ED with STI complaints. Methods SWC-eligible patients are identified at ED intake and undergo a Medical Screening Exam (MSE) by a triage physician before transport to clinic. Notable exceptions to the SWC are patients who are pregnant, younger than 18 years of age, victims of sexual assault, or deemed to require higher acuity care. Once at the SWC, patients undergo a complete history and physical examination, comprehensive STI testing, and, if indicated, empiric treatment as well as same-day initiation of Pre-Exposure Prophylaxis (PrEP). Social services within the clinic also assist in arranging primary care follow-up either at the medical center or an affiliated Federally Qualified Health Center (FQHC). Results During its initial 8 weeks, 28 patients were seen in the SWC; 35.6% were cis-female and 64.2% were cis-male. All female patients identified as women who have sex with men, 89% of male patients identified as men who exclusively have sex with women. Patient ages ranged from 18 to 55 with a mean age of 25. Overall, 17.8% of patients tested positive for gonorrhea; 7.1% tested positive for chlamydia, and 0% tested positive for syphilis. One new HIV diagnosis was identified. Same-day PrEP was initiated in 28.5% of patients of which 62.5% (n = 5) were female and 37.5% (n = 3) were male. SWC linked 79% of patients to primary care. Conclusion We demonstrated the feasibility of this unique workflow bringing patients from the ED to a specialized sexual health clinic. The majority of patients visiting SWC identified as heterosexual men and women, which differs from other metropolitan STI clinics. Identifying these populations with untreated STIs and other HIV risk factors for targeted intervention is integral to local and national HIV elimination efforts. Disclosures All authors: No reported disclosures.

Characteristics of newly diagnosed HIV-positive service users using a pan-London e-sexually transmitted infection screening service

2021 ◽  
pp. 095646242110147
Author(s):  
Sara Day ◽  
Kaywaan Khan ◽  
Adrian M Kelly ◽  
Sophie Jones ◽  
Ryan Kinsella
Keyword(s):  
Health Clinic ◽  
Hiv Positive ◽  
Minority Ethnic Group ◽  
Service Users ◽  
Hiv Screening ◽  
Specialist Care ◽  
Hiv Diagnosis ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Hiv Test

Maximising opportunities and removing barriers to HIV testing can help reduce the undiagnosed HIV population. Digital STI/HIV screening services have increased in availability and can improve access and testing coverage. We identified the characteristics of individuals who tested HIV positive using a regional, integrated, self-sampling STI service. The e-notes of service users with reactive HIV screening results were reviewed. Between 8 January 2018 and 31 December 2019, 0.097% (144/148,257) users received a reactive HIV result, 30/144 (20.8%) of whom had previously diagnosed HIV infection. All of the remaining 114 users were notified of their screening result, an estimated 109/114 (95.6%) received confirmatory testing (CT) at a sexual health clinic (SHC) and the confirmatory outcome was documented in 102/114 (89.5%) of cases: 34/114 (29.8%)were HIV positive, 68/114 (59.6%) HIV were negative and the result was unknown in 12/114 (10.5%). All new diagnoses transitioned to HIV outpatient care. These individuals were median age 28 years; 94.1% (32/34) male; 88.2% (30/34) men who have sex with men and 11.8% (4/34) heterosexual; 58.8% (20/34) of white/‘white other’ ethnicity and 42.2% of Black, Asian and minority ethnic group; 50%(17/34) had a concurrent STI; 9% and 21% had never tested for HIV or attended a SHC before. n HIV test reactivity rate of 0.1%(95% CI) was observed. Confirmed new HIV diagnoses comprised 0.023% of all HIV tests performed. All individuals where CT confirmed a new HIV diagnosis transitioned to HIV specialist care.

scholarly journals Does online sexually transmitted infection screening compromise care? A service evaluation comparing the management of chlamydial infection diagnosed online and in clinic

2021 ◽  
Vol 32 (6) ◽  
pp. 528-532
Author(s):  
Nur Gasmelsid ◽  
Benjamin CB Moran ◽  
Tom Nadarzynski ◽  
Rajul Patel ◽  
Elizabeth Foley
Keyword(s):  
United Kingdom ◽  
Health Services ◽  
Sexual Health ◽  
Sexually Transmitted Infections ◽  
Sexually Transmitted Infection ◽  
Chlamydial Infection ◽  
Service Evaluation ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
The United Kingdom

Patient demand on sexual health services in the United Kingdom is so high that many services have introduced online screening to accommodate more patients. There are concerns that these services may not be accessible to all. This service evaluation was undertaken to determine whether online screening is accessible by those patients most at need by comparing the demographics and number of asymptomatic chlamydial infections detected online and in clinic. No difference was found in the age nor level of deprivation, demonstrating that online services are an accessible way to screen for sexually transmitted infections without overburdening established services.

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