Sexual health advice for MSM and WSW in general practice

2019 ◽  
Vol 30 (5) ◽  
pp. 232-236
Author(s):  
Sally Kelsey
Keyword(s):  
Sexual Health ◽  
Health Needs ◽  
Sexually Transmitted ◽  
Practice Nurses ◽  
Sexual Behaviours ◽  
Increased Risk ◽  
Health Advice ◽  
Sex With Men ◽  
Asymptomatic Individuals ◽  
Specific Health

Men who have sex with men and women who have sex with women need specialised health considerations regarding their sexual health. Sally Kelsey describes what these health needs are and what practice nurses can do to ensure health inequalities are reduced People who identify as lesbian, gay or bisexual (LGB) make up a minority of the population, but carry a large burden of sexually transmitted infections (STIs). Some behaviours among men who have sex with men lead to an increased risk of some STIs and women who have sex with women have specific health needs. While specialist sexual health services are well placed to provide services for these patients, many people choose not to or are not able to access these services. Therefore, primary care has a prime opportunity to offer advice and screening for asymptomatic individuals, and to offer opportunistic advice. Health professionals should be educated in these specific health needs, develop awareness of patient risks and discuss sexual behaviours and risks in an open and non-judgmental way.

scholarly journals Sexual behaviours and sexually transmitted infection outcomes in a cohort of HIV-negative men who have sex with men attending sexual health clinics in England

2018 ◽  
Vol 29 (14) ◽  
pp. 1407-1416 ◽  
Author(s):  
S Desai ◽  
F Burns ◽  
G Schembri ◽  
D Williams ◽  
A Sullivan ◽  
...  
Keyword(s):  
High Risk ◽  
Sexual Health ◽  
Receptive Anal Intercourse ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Sexual Behaviours ◽  
Increased Risk ◽  
Sex With Men ◽  
Clinical Records ◽  
Hiv Negative

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.

Associations between economic dependence, sexual behaviours, and sexually transmitted infections among young, Black, gay, bisexual and other men who have sex with men living with and without HIV in Jackson, Mississippi, USA

Sexual Health ◽  
2018 ◽  
Vol 15 (5) ◽  
pp. 473 ◽  
Author(s):  
Kalysha Closson ◽  
Rachel Vickers Smith ◽  
Gbolahan Olarewaju ◽  
Richard Crosby
Keyword(s):  
Sexual Health ◽  
Relationship Power ◽  
Hiv Status ◽  
Economic Dependence ◽  
Sti Prevention ◽  
Sexually Transmitted ◽  
Sexual Behaviours ◽  
Sexually Transmissible Infections ◽  
The Usa ◽  
Sex With Men

Background In the USA, young Black gay, bisexual or other men who have sex with men (YBMSM) bear the largest burden of HIV incidence. The aim of this study is to examine the independent associations between economic dependency on a sexual partner and several HIV risk behaviours and sexual health outcomes among YBMSM living in Jackson, Mississippi, USA. Methods: Baseline data from 589 YBMSM, with a median age of 22.0 years (IQR = 15–25) participating in a brief sex-positive HIV and STI prevention intervention, were used to measure the association between six sexual behaviours, sexually transmissible infections (STIs) status at baseline and economic dependence. Bivariate χ2 associations were tested and regression models adjusted for education level (≤ high school), employment and HIV-status. Results: In regressions, of the six sexual behaviours reported in the last 90 days and six STIs tested at baseline, economically dependent YBMSM were more likely to report condomless anal receptive sex (aOR = 2.19, 95%CI = 1.25–3.83), ≥3 partners as a top (aOR = 1.99, 95%CI = 1.17–340), ≥3 sex partners as a bottom (aOR = 2.07, 95%CI = 1.24–3.45), ≥3 sex acts as a bottom (aOR = 2.10, 95%CI = 1.16–3.82) and testing positive for oral gonorrhoea (aOR = 2.39, 95%CI = 1.18–4.83) after controlling for HIV status, employment and education. Conclusions: Interventions should consider how poverty, unemployment and economic dependence interact to influence relationship power imbalances, condom use and sexual positioning agency, and sexual health for key populations of MSM.

scholarly journals Sexually transmitted infections in young people and factors associated with HIV coinfection: an observational study in a large city

BMJ Open ◽  
2019 ◽  
Vol 9 (5) ◽  
pp. e027245 ◽  
Author(s):  
Alexis Sentís ◽  
Mario Martin-Sanchez ◽  
Maider Arando ◽  
Martí Vall ◽  
María Jesus Barbera ◽  
...  
Keyword(s):  
Young People ◽  
Sexually Transmitted Infections ◽  
Large City ◽  
Epidemiological Surveillance ◽  
Sexually Transmitted ◽  
Factors Associated ◽  
Hiv Coinfection ◽  
Increased Risk ◽  
Sex With Men ◽  
Epidemiological Characteristics

ObjectivesYoung people are a critical target group for sexually transmitted infections (STI) surveillance due to their particular behavioural and social related vulnerability. The aim of this study was to describe the epidemiological characteristics and trends in the incidence of gonorrhoea, syphilis, HIV and venereal lymphogranuloma (LGV) among 15–24-year-olds in Barcelona, and to determine factors associated with HIV coinfection.DesignWe performed a population-based incidence study covering the 2007–2015 period.ParticipantsAll new cases of STI—HIV, gonorrhoea, infectious syphilis and LGV—notified to the epidemiological surveillance system in Barcelona between 2007 and 2015. 1218 cases were studied: 84.6% were men, 19.3% were 15–19 years old and 50.6% were born in Spain. Among men, 73.7% were men who have sex with men (MSM); among women, 85.6% were women that have sex with men.Primary and secondary outcomesIncidence of HIV, gonorrhoea, infectious syphilis and LGV. HIV coinfection.ResultsThere was an increase in the incidence of gonorrhoea, from 1.9 cases per 10 000 people in 2007 to 7.6/10 000 in 2015 (p<0.01), in MSM from 27.1 to 228.8/10 000 (p<0.01). The incidence of syphilis increased from 0.4/10 000 in 2007 to 3.1/10 000 in 2015 (significant in men only, p<0.01), in MSM from 18.1 to 116.9/10 000 (p<0.01). The incidence of HIV showed a non-significant increase in men (p=0.27), and that of LGV remained stable (p=0.59). Factors associated with increased risk of HIV coinfection included being MSM (adjusted OR[ORa]=14.14, 95% CI 3.34 to 59.91) and having >10 sexual partners (ORa=4.11, 95% CI 1.53 to 11.01) or STI diagnosis during the previous 12 months (ORa=2.06; 95% CI 1.13 to 3.77).ConclusionsThe incidence of gonorrhoea and syphilis among 15–24-year-olds increased, while HIV infection remained stable but with a high incidence among MSM. Being MSM, having sex with multiple partners and having a diagnosis of an STI in the previous 12 months were factors associated with HIV coinfection.

Attitudes, knowledge and sexual behavior among Finnish adolescents before and after an intervention

2019 ◽  
Vol 35 (4) ◽  
pp. 821-830
Author(s):  
Marja Pakarinen ◽  
Jari Kylmä ◽  
Mika Helminen ◽  
Tarja Suominen
Keyword(s):  
Health Promotion ◽  
Sexual Behavior ◽  
Sexual Health ◽  
First Year Students ◽  
Sexually Transmitted ◽  
Increased Risk ◽  
Before And After ◽  
Class Room ◽  
Information Materials

Abstract Adolescents are an important target group for sexual health promotion, and there are numerous programs and interventions carried out in this field. The aim of this study is to describe adolescents’ attitudes, knowledge and sexual behavior before and after a sexual health promotion intervention. The intervention was developed in the study and consisted of three elements: (i) class-room session, (ii) information materials and (iii) free condom distribution. The study was carried out in eight randomly selected vocational schools in Finland. The participants were first year students aged 15–19 years. The data were collected using an electronic questionnaire before intervention (intervention baseline n = 500, control baseline n = 183) and two times after the intervention (intervention first follow-up n = 173/second follow-up n = 202, control first follow-up n = 115/second follow-up n = 46). There were significant differences before and after the intervention concerning better knowledge and more frequent testing for sexually transmitted infections (STIs). Schools are an important environment to reach adolescents during the phase where their sexual health is developing and there is an increased risk of STI transmission. More school-based interventions are therefore needed, and the results of this study can be utilized when developing sexual health promotion interventions among adolescents.

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.

Fuckbuddy partnerships among men who have sex with men – a marker of sexually transmitted infection risk

2017 ◽  
Vol 29 (1) ◽  
pp. 44-50 ◽  
Author(s):  
Vincent J Cornelisse ◽  
Christopher K Fairley ◽  
Tiffany Phillips ◽  
Sandra Walker ◽  
Eric PF Chow
Keyword(s):  
Sexual Health ◽  
Health Centre ◽  
Romantic Attachment ◽  
Sexual Partners ◽  
Health Clinic ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Hiv Prevention Strategies ◽  
Sex With Men ◽  
Exposure Prophylaxis

‘Fuckbuddies’ are a type of regular sexual partner with whom men have ongoing sexual contact, generally in the absence of romantic attachment. We surveyed 989 men who have sex with men (MSM) at the Melbourne Sexual Health Centre, Australia, with the aim of determining the frequency of ‘fuckbuddy’ partnerships among sexual health clinic attendees and assessing their sexual risk. The majority (60%) of 1139 regular partnerships were described as ‘fuckbuddies’. Most MSM (63%) with a ‘fuckbuddy’ had multiple ‘fuckbuddies’. MSM with ‘fuckbuddies’ were more likely to also have casual sexual partners (odds ratio [OR] 5.7; 95% confidence interval 3.6–8.9) and had more casual sexual partners (median of 4 versus 1, p < 0.001) and more rectal chlamydia (12.4% versus 5.7%; adjusted OR 2.3; p < 0.05) than MSM without ‘fuckbuddies’, and this risk persisted after adjusting for total numbers of sexual partners. Our findings suggest that patients with ‘fuckbuddies’ are at particular risk of sexually transmitted infections. We argue that clinicians should specifically ask about ‘fuckbuddy’ partnerships as part of their risk assessment during patient interviews, as these patients may benefit from HIV prevention strategies such as pre-exposure prophylaxis (PrEP).

scholarly journals Outbreak of lymphogranuloma venereum among men who have sex with men in Barcelona 2007/08 – an opportunity to debate sexual health at the EuroGames 2008

2008 ◽  
Vol 13 (25) ◽  
Author(s):  
M Vall Mayans ◽  
E Caballero ◽  
P Garcia de Olalla ◽  
P Armengol ◽  
MG Codina ◽  
...  
Keyword(s):  
Chlamydia Trachomatis ◽  
Sexual Health ◽  
Sexually Transmitted Infection ◽  
Western Europe ◽  
Lymphogranuloma Venereum ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
First Case ◽  
Sex With Men

Lymphogranuloma venereum (LGV) is a systemic sexually transmitted infection (STI) caused by Chlamydia trachomatis (L serovars L1, L2 or L3). Since 2003, several outbreaks of rectal LGV affecting men who have sex with men (MSM) have occurred in western Europe [1]. The first case in Spain was confirmed in Barcelona in 2005 [2], but no further cases have been detected in this city since until September 2007. We briefly summarise the characteristics of the LGV cases diagnosed at the outpatient STI clinic in Barcelona between September 2007 and April 2008.

scholarly journals Choose to test: self-selected testing for sexually transmitted infections within an online service

2019 ◽  
Vol 95 (3) ◽  
pp. 171-174
Author(s):  
Jonathan Syred ◽  
Gillian Holdsworth ◽  
Chris Howroyd ◽  
Kez Spelman ◽  
Paula Baraitser
Keyword(s):  
Health Service ◽  
Sexual Health ◽  
Sexually Transmitted Infections ◽  
Online Service ◽  
Sexually Transmitted ◽  
Blood Tests ◽  
Syphilis Testing ◽  
Routinely Collected Data ◽  
Sexual Health Service ◽  
Sex With Men

ObjectiveTo describe the outcomes of user-led, choice of test within an online sexual health service.MethodsWe analysed routinely collected data from a free, online sexual health service in Essex, UK that enabled users to select their tests. The service website provided information on all sexually transmitted infections, recommended a testing package based on sexuality and ethnicity, and invited users to modify this if they chose. Data on orders were analysed for the 6 months before (May–October 2016) and after (October–April 2017) implementation.ResultsWe compared 7550 orders from 6253 users before and 9785 orders from 7772 users after implementation. There was no difference in the proportion of chlamydia (p=0.57) or gonorrhoea (p=0.79) tests that were positive between the two periods. HIV and syphilis positives were too few in our sample during both periods for analysis. During implementation, men who have sex with men (530 users) were offered genital, rectal and oral chlamydia and gonorrhoea testing plus HIV and syphilis testing. In 17.2% of orders, users removed tests. Black or ethnic minority users excluding those who reported as men who have sex with men (805 users) were offered chlamydia, gonorrhoea and HIV testing. In 77.9% of orders, users added a test. All other users were offered chlamydia and gonorrhoea tests only. In 65.2% of orders, users added tests. We observed a reduction in orders of 3083 blood tests (31%).ConclusionUsers engaged with the ‘choose to test’ intervention. Although a majority added tests, the intervention was cost saving by reducing the HIV and syphilis tests ordered.

Association between rectal douching and HIV and other sexually transmitted infections among men who have sex with men: a systematic review and meta-analysis

2019 ◽  
Vol 95 (6) ◽  
pp. 428-436 ◽  
Author(s):  
Peiyang Li ◽  
Tanwei Yuan ◽  
Thomas Fitzpatrick ◽  
Kumi Smith ◽  
Jin Zhao ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Rectal Mucosa ◽  
Sexually Transmitted ◽  
Increased Risk ◽  
Rectal Douching ◽  
B Virus ◽  
Newcastle Ottawa Scale ◽  
Sex With Men ◽  
Health Education Materials

BackgroundMen who have sex with men (MSM) are disproportionately affected by HIV and other STIs worldwide. Rectal douching, which is commonly used by MSM in preparation for anal sex, may increase the risk of HIV and other STIs by injuring the rectal mucosa. Results from individual studies reporting associations between rectal douching and HIV and other STIs among MSM are inconsistent. We performed a systematic review and meta-analysis to estimate the association between rectal douching and HIV and other STIs among MSM.MethodsWe searched PubMed, Embase, Scopus and Web of Science for studies published from January 1970 to November 2018. Studies that reported ORs and 95% CIs of associations between rectal douching and infection with HIV/STIs, or reported enough data to calculate these estimates, were included. We assessed risk of bias using the Newcastle-Ottawa Scale. ORs were pooled using a random effects model.ResultsTwenty-eight eligible studies were identified in our review, of which 24 (20 398 participants) were included in the meta-analysis. Rectal douching was associated with increased odds of infection with HIV (OR 2.80, 95% CI 2.32 to 3.39), and any STI other than HIV (including hepatitis B virus (HBV), hepatitis C virus (HCV), chlamydia, gonorrhoea, syphilis and human papillomavirus) (OR 2.46, 95% CI 1.95 to 3.11) among MSM. For specific STIs, douching was associated with increased odds of viral hepatitis (HBV, HCV) (OR 3.29, 95% CI 2.79 to 3.87), and chlamydia or gonorrhoea (OR 3.25, 95% CI 2.02 to 5.23). These associations remained significant in studies that adjusted for potential confounders.ConclusionRectal douching may put MSM at increased risk for infection with HIV and other STIs. Longitudinal studies are needed to clarify this association, and health education materials should inform men of the potential for increased risk of infection with rectal douching.

Sexually transmitted infection screening and diagnosis among adolescent men who have sex with men, three US cities, 2015

2019 ◽  
Vol 31 (1) ◽  
pp. 53-61
Author(s):  
Qian An ◽  
Kyle T Bernstein ◽  
Alexandra B Balaji ◽  
Cyprian Wejnert ◽  
Keyword(s):  
Transmitted Infection ◽  
Sexually Transmitted ◽  
National Hiv Behavioral Surveillance ◽  
Increased Risk ◽  
Characteristics Analysis ◽  
Young Msm ◽  
Sex With Men ◽  
Stis And Hiv ◽  
Associated Risk Factors ◽  
Screening And Diagnosis

Adolescent men who have sex with men (MSM) are at increased risk for sexually transmitted infections (STIs) and HIV; however, data documenting STI screening, STI burden, and associated risk factors for STIs are extremely limited. Using 2015 data from the National HIV Behavioral Surveillance among Young MSM, we examined self-reported STI screening and STI diagnosis of chlamydia, gonorrhea, or syphilis among sexually active adolescent MSM by selected characteristics. Analysis of STI diagnosis was limited to participants who reported an STI screening. Differences in STI screening and STI diagnosis and factors associated with screening and diagnosis were examined using bivariate and multivariable binomial regression models. Less than half of adolescent MSM reported having ever been screened for an STI. Among these, more than a quarter reported having ever been diagnosed with chlamydia, gonorrhea, or syphilis. STI screening was associated with visiting a healthcare provider in the past 12 months and having ever been tested for HIV. Having ever had an STI diagnosis was associated with the participant age of 18 years and having sex before 13 years old. Among adolescent MSM, STI screening was suboptimal and STI burden was significant. STI intervention and prevention programs are urgently needed to promote STI awareness, timely screening, and early diagnosis to interrupt transmission among this vulnerable population.

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