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.

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.

scholarly journals P17.11 Public sexual health clinics increase access, hiv testing and re-testing among higher risk gay and bisexual men

2015 ◽  
Vol 91 (Suppl 2) ◽  
pp. A227.1-A227
Author(s):  
MS Jamil ◽  
D Callander ◽  
H Ali ◽  
G Prestage ◽  
V Knight ◽  
...  
Keyword(s):  
Sexual Health ◽  
Hiv Testing ◽  
Gay And Bisexual Men ◽  
Bisexual Men ◽  
Health Clinics ◽  
And Bisexual ◽  
Sexual Health Clinics

scholarly journals Anorectal swabs as a marker of male-to-male sexual exposure in STI surveillance systems

2017 ◽  
Vol 145 (12) ◽  
pp. 2530-2535 ◽  
Author(s):  
F. H. AMPT ◽  
C. EL HAYEK ◽  
P. A. AGIUS ◽  
A. L. BOWRING ◽  
N. BARTNIK ◽  
...  
Keyword(s):  
Sexual Health ◽  
Predictive Value ◽  
Area Under The Curve ◽  
Risk Behaviour ◽  
Health Clinic ◽  
Surveillance Systems ◽  
Internal Validation ◽  
Sexually Transmitted ◽  
Sex With Men ◽  
Sexual Health Clinics

SUMMARYIdentification of priority populations such as men who have sex with men (MSM) is important in surveillance systems to monitor trends of sexually transmitted infections (STIs). We explored using routinely collected non-behavioural data as a means to establish MSM status in surveillance by assessing anorectal swab as a marker of male-to-male sexual exposure. We used chlamydia testing data from a sexual health clinic, 2007–2012. Men reporting any male sexual partner(s) in the previous 12 months were considered MSM. The dataset was split into development and validation samples to develop a univariate predictive model and assess the model fit. The dataset included 30 358 individual men and 48 554 episodes of STI testing; 45% were among reported MSM and an anorectal swab was performed in 40% of testing episodes. Anorectal swabbing had good diagnostic performance as a marker for MSM status (sensitivity = 87%, specificity = 99%, positive predictive value = 98·6%, negative predictive value = 90·3%). The model showed good fit against the internal validation sample (area under the curve = 0·93). Anorectal swabs are a valid marker of MSM behaviour in surveillance data from sexual health clinics, and they are likely to be particularly useful for monitoring STI trends among MSM with higher risk behaviour.

scholarly journals Rapid HIV Testing Is Highly Acceptable and Preferred among High-Risk Gay And Bisexual Men after Implementation in Sydney Sexual Health Clinics

PLoS ONE ◽  
2015 ◽  
Vol 10 (4) ◽  
pp. e0123814 ◽  
Author(s):  
Damian P. Conway ◽  
Rebecca Guy ◽  
Stephen C Davies ◽  
Deborah L. Couldwell ◽  
Anna McNulty ◽  
...  
Keyword(s):  
High Risk ◽  
Sexual Health ◽  
Hiv Testing ◽  
Gay And Bisexual Men ◽  
Bisexual Men ◽  
Rapid Hiv Testing ◽  
Health Clinics ◽  
And Bisexual ◽  
Sexual Health Clinics

Understanding the Targeting and Uptake of HIV Testing Among Gay and Bisexual Men Attending Sexual Health Clinics

2017 ◽  
Vol 22 (2) ◽  
pp. 513-521
Author(s):  
Muhammad S. Jamil ◽  
◽  
Hamish McManus ◽  
Denton Callander ◽  
Garrett Prestage ◽  
...  
Keyword(s):  
Sexual Health ◽  
Hiv Testing ◽  
Gay And Bisexual Men ◽  
Bisexual Men ◽  
Health Clinics ◽  
And Bisexual ◽  
Sexual Health Clinics

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 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 Developing a co-produced, systems-informed, sexually transmitted infection contact tracing intervention for gay and bisexual men who have sex with men and their one-off sexual partners

2021 ◽  
Author(s):  
Paul Flowers ◽  
Sarah Lasoye ◽  
Jean McQueen ◽  
Melvina Woode Owusu ◽  
Merle Symonds ◽  
...  
Keyword(s):  
Health Care ◽  
Social Media ◽  
Sexual Health ◽  
Health Care Professionals ◽  
Gay And Bisexual Men ◽  
Contact Tracing ◽  
Bisexual Men ◽  
Sexually Transmitted ◽  
And Bisexual ◽  
Sex With Men

Objective: Gay and bisexual men who have sex with men (GBMSM) bear a disproportionate burden of sexually transmitted infections (STIs). Most STIs are asymptomatic and people infected wont know to seek care unless they are told about their exposure. Contact tracing, is the process of identifying and contacting sex partners of people with STIs for testing and treatment. Contact tracing is sometimes particularly challenging amongst GBMSM because of the kinds of sexual relationships which GBMSM enjoy. These include one-off partners who are particularly important for transmission dynamics as they contribute disproportionately to onwards transmission. The effectiveness of contact tracing interventions within sexual health are patterned by sexual-partner type. Contact tracing and management for one-off partners is an on-going public health challenge. Low motivation amongst index patients, high resource burden on health care professionals and problems with contactability are key barriers to contact tracing. Using insights from complex adaptive systems thinking and behavioural science, we sought to develop an intervention which addressed both the upstream and down-stream determinants of contact tracing and change the system in which many inter-dependent contact tracing behaviours are embedded. Setting UK community-recruited GBMSM, stakeholders, sexual hcp, dating app providers Method Using the MRC complex intervention framework and insights from the INDEX study, a three-phase intervention development process was adopted to specify intervention content. Phase one consisted of an inter-professional and community-member stakeholder event (n=45) where small mixed groups engaged in exploratory systems-mapping and the identification of hot spots for future intervention. Phase two used a series of focus groups with GBMSM (n=28) and interviews with representatives from key dating app providers (DAPs) (n=3) to further develop intervention ideas using the theoretical domains framework, the behaviour change wheel and the behaviour change technique taxonomy. In Phase 3 we again worked with key stakeholders expert health care professionals (HCPs) (n=5) and key workers from community-based organisations (CBOs) (n=6) to hone the intervention ideas and develop programme theory using the APEASE criteria. Results The co-produced intervention levers change simultaneously across the system within which contact tracing is embedded. Multiple change-agents (i.e., GBMSM, CBOs, HCPs) work together, sharing an overall vision to improve sexual health through contact tracing. Each make relatively modest changes that over time, synergistically combine to produce a range of multiple positively-reinforcing feedback loops to engender sustainable change around contact tracing. Agreed intervention elements included: a co-ordinated, co-produced mass and social media intervention to tip cultural norms and beliefs of GBMSM towards enabling more contact tracing and to challenge enduring STI- and sex-related stigmas; complementary CBO-co-ordinated, peer-led work to also focus on reducing STI stigma and enabling more contact tracing between one-off partners; priming GBMSM at the point of STI diagnosis to prepare for contact tracing interactions and reduce HCP and sexual health-service burden; changes to SHS environments and HCP-led interactions to systematically endorse contact tracing; changing national audits and monitoring systems to directly address one-off partner targets; delivering bespoke training to HCPs and CBO staff on one-off partners and the social and cultural context of GBMSM; DAPs active involvement in mass and social media promoting appropriate contact tracing messaging. Conclusion Our combination of multiple data sources, theoretical perspectives and diverse stakeholders have enabled us to develop an expansive, complex intervention that is firmly based in the priorities of those it will affect, and which has a solid theoretical foundation. Future work will assess if and how it will be possible to evaluate it. The resulting intervention is profoundly different than other ways of enhancing contact tracing, as it simultaneously addresses multiple, multi-levelled, upstream and social determinants of contact tracing.

scholarly journals Gonorrhoea gone wild: rising incidence of gonorrhoea and associated risk factors among gay and bisexual men attending Australian sexual health clinics

Sexual Health ◽  
2019 ◽  
Vol 16 (5) ◽  
pp. 457 ◽  
Author(s):  
Denton Callander ◽  
Rebecca Guy ◽  
Christopher K. Fairley ◽  
Hamish McManus ◽  
Garrett Prestage ◽  
...  
Keyword(s):  
Sexual Health ◽  
Cox Regression ◽  
Cohort Analysis ◽  
Temporal Trends ◽  
Gay And Bisexual Men ◽  
Anatomical Site ◽  
Bisexual Men ◽  
Health Clinics ◽  
And Bisexual ◽  
Sexual Health Clinics

Background Gonorrhoea notifications continue to rise among gay and bisexual men in Australia and around the world. More information is needed on infection trends, accounting for testing and complimented by demographics and risk practices. Methods: A retrospective cohort analysis was undertaken using repeat gonorrhoea testing data among gay and bisexual men from 2010 to 2017, which was extracted from a network of 47 sexual health clinics across Australia. Poisson and Cox regression analyses were used to determine temporal trends in gonorrhoea incidence rates, as well as associated demographic and behavioural factors. Results: The present analysis included 46904 gay and bisexual men. Gonorrhoea incidence at any anatomical site increased from 14.1/100 person years (PY) in 2010 to 24.6/100 PY in 2017 (P&lt;0.001), with the greatest increase in infections of the pharynx (5.6-15.9/100 PY, P&lt;0.001) and rectum (6.6–14.8/100 PY, P&lt;0.001). After adjusting for symptomatic and contact-driven presentations, the strongest predictors of infection were having more than 20 sexual partners in a year (hazard ratio (HR)=1.9, 95% confidence interval (CI): 1.7–2.2), using injecting drugs (HR=1.7, 95%CI: 1.4–2.0), being HIV positive (HR=1.4, 95%CI: 1.2–1.6) and being aged less than 30 years old (HR=1.4, 95%CI: 1.2–1.6). Conclusions: Gonorrhoea has increased dramatically among gay and bisexual men in Australia. Enhanced prevention efforts, as well as more detailed, network-driven research are required to combat gonorrhoea among young men, those with HIV and those who use injecting drugs.

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