bluuebunny/crossref_metadata_2025_split huggingface dataset:
P219 Vaccinating against human papillomavirus is not associated with risky sexual behaviours among men who have sex with men in australia
Authors: Chow Eric , Aung Ei , Chen Marcus , Bradshaw Catriona , Fairley Christopher 
Published: May 2024

IntroductionA recent systematic review has concluded that vaccinating against human papillomavirus (HPV) does not lead to risky behaviours among females but there has been no studies examining this association among men who have sex with men (MSM). We aimed to examine the association between sexual behaviours and HPV vaccination status among men who have sex with men.MethodsWe analysed MSM aged 16–40 years attending a sexual health centre in Australia for their first visit in 2016. Chi-squared test was used to examine the differences in sexual behaviours (e.g. number of male partners and condom use in last 3 and 12 months) between vaccinated and unvaccinated MSM.ResultsA total of 1332 MSM were included in the analysis with a median age of 27 (IQR 23–31). Six percent (n=81) of MSM had been vaccinated against HPV. The median number of male partners in the last 3 and 12 months was 2 (IQR 1–5) and 5 (2–10), respectively. The proportion of men used condoms always in the last 3 and 12 months was 39.2% (n=797) and 36.5% (n=774), respectively. There were no significant differences in number of partners and always condom use in both last 3 and 12 months between vaccinated and unvaccinated MSM (p>0.05).DiscussionVaccinating against HPV is not associated with increased sexual activity and condomless anal sex practice among MSM, particularly among sexually-active men attending a sexual health service.
P222 Bisexual men – twice the fun or double the risk?
Authors: Dearing Nicola , Lamont Callum 
Published: May 2024

IntroductionMen who have sex with men and women (MSMW) are a group with unique sexual health needs, increased risk of STI’s and the potential to bridge homosexual and heterosexual populations. Information is lacking regarding sexual health behaviour among this group.AimsInvestigate STI testing behaviour of MSMW attending a sexual health clinic, recent sexual behaviour and STI diagnosis.MethodsRetrospective review of sexual health clinic electronic case notes of men attending with a new episode whose sexual orientation was recoded as bisexual from 1/4/2016 to 31/6/2016. Information was obtained on demographics, recent sexual partners, STI testing performed and diagnosis.Results78 MSMW attended during the audit period. Uptake of STI screening was high (95% genital Chlamydia and Gonorrhoea testing, 87% HIV and Syphilis testing). Extra genital site testing was performed in 70% patients. 79% had all appropriate sites tested according to their sexual history (oropharyngeal testing lacking in 12%, anal testing lacking in 1%, 8% unclear from documentation). In the previous 3 months 61% reported multiple sexual partners, 40% reported sex with both male and female partners and 66% reported unprotected sex with a new partner. Forty men reported a current regular female partner of which 29 also reported a recent male partner (27 unprotected). 23% were diagnosed with an STI following their clinic attendance.DiscussionMSMW showed high risk sexual behaviour and prevalence of STI’s. Concordant male and female partners highlight the need to encourage regular screening in this group, record a detailed sexual history and offer all appropriate tests.
P227 Factors associated with sexually transmitted infections in <16’s attending a gum clinic
Authors: Evans Megan , Dore Eoin , Prime Katia 
Published: May 2024

IntroductionWe established whether number of sexual partners and vulnerability factors were associated with sexually transmitted infections (STIs) in <16 year olds.MethodsData was captured on <16’s attending a GUM clinic 01/01/15–31/12/15, using a standardised electronic proforma. Data collected: Demographics, appointment type, postcode, STIs, pregnancy, contraception, number of sexual partners and vulnerability factors (mental health, drug use, history of abuse, known to outside agencies, gang involvement).Results236 attendances by 124 patients; 89/124 (72%) new, 35/124 (28%) rebook. 50/124 (40%) <16s resident in GUM clinic borough, 59/124 (48%) from neighbouring boroughs. 107/124 (86%) female. Ethnicity: 54/124 (43%) White British, 32/124 (30%) Caribbean, 15/124 (12%) African. Median age at first attendance 14.6 years (range 12–15). 447/88 (53%) patients using contraception and 23/107 (21%) females had pregnancy test; 2/23 (8.7%) positive. 31/124 (25%) were diagnosed with or were contact of an STI (Chlamydia n=22, Gonorrhoea n=5, PID n=2, HSV n=2, HIV n-1), of whom 9/31 (29%) reported ≥ one vulnerability factor. Average number of sexual partners in this group was 3.45 (Range 0–15). 93/124 (75%) were not diagnosed with an STI, of whom 27/93 (29%) reported ≥ one vulnerability factor. Average number of sexual partners was 1.75 (Range 0–20).Discussion29% of patients (36/124) attending the clinic had ≥ one vulnerability factor. <16s diagnosed with an STI were not significantly more likely to have a vulnerability factor than those who were not. However, those diagnosed with an STI had a greater number of sexual partners than those without a diagnosis.
P230 Sexual health workers are at higher risk of poor sexual health: a pilot study
Authors: Woodroffe Tamara , Davies Julia , Richardson Daniel 
Published: May 2024

IntroductionThe effects of occupation on personal heath have been described, but there is a paucity of literature on how working in sexual health affects an individual’s sexual behaviour.MethodsWe gained informed consent from a focus group of 6 female and 2 male sexual health workers in 2010. The focus group was tape recorded, anonymised and transcribed. We used thematic analysis to generate themes.ResultsSexual health workers feel confident in making an assessment of their own sexual behaviour; yet acknowledge that this self-assessment is not consistently reliable. Access to medication (including antibiotics and emergency contraception) leads to an increase in sexual risk taking in this group. Self-medication occurs for unplanned risks rather than pre-planned. There is reluctance on the part of sexual health workers to consult colleagues due to concerns about lack of anonymity, confidentiality and how positive results will be managed. Sexual health workers feel that these behaviours are a barrier to good sexual health. They also feel that both patients and sexual partners expect them to be more sexually experienced; this can lead to discord in personal relationships. Sexual health workers feel that due to the nature of their work, they have a greater and more realistic insight into sexual relationships; in particular monogamy. They also have greater confidence in their ability to discuss sex with their children and families.DiscussionThis pilot study suggests that sexual health workers may be at risk of poor sexual health and have specific sexual health needs not currently addressed.
P231 Understanding sexual practices, attitudes and sexual health service provision in the over 50s
Authors: Vracar Sandra , Taylor Ruth 
Published: May 2024

IntroductionSince 2011 STI incidence has increased in the over-50 population in the UK.Higher divorce rates, lack of awareness, poor service provision and low pregnancy risk have all been suggested as contributing to these changes.We examined sexual practices and attitudes of >50s in our city centre clinic, and assessed service accessibility.MethodsAnonymous questionnaires distributed opportunistically to 50 attendees (23 male 27 female), examining sexual practices, STI awareness and attitudes towards service provision.ResultsAlmost half had divorced previously. 50% men never used condoms, 67% women; reasons given included ‘married’, ‘no pregnancy risk’, ‘too old’, ‘don’t like it’. 60% used at least one regular medication and 10% were using >6 drugs. 37% of women and 20% of men were ‘too embarrassed’ to discuss sex with GP. 44% women, 26% men were first-time attenders. All the women in our sample were white heterosexual. There was more ethnic diversity in men, and 30% MSM. There was good awareness of STIs and safer sex, and 70% felt that current services met their needs.DiscussionReassuringly, many were attending for the first time suggesting ease of access. However, a lack of diversity in female attendees may indicate unmet needs in some groups. Despite being aware of good sexual health, there was low condom use and a lingering embarrassment to discuss problems with family doctor. This survey suggests unmet needs still exist, even in those who already access services. A similar project in primary care is planned to further assess this.
P232 Somewhere over the rainbow: establishing acceptable locations for sti screening and support for MSM
Authors: Turner Kevin , Priestley Cecilia , Clarke Billy 
Published: May 2024

IntroductionOver the Rainbow is a community based LGBT support service and level 3 GUM clinic in Bournemouth, currently under threat due to funding cuts. In May 2016, a patient consultation was undertaken to explore alternative options for service provision.MethodsA survey was distributed online and in clinic to capture views on the provision of local sexual health services for MSM.Results96 people responded to the survey after visiting the service for STI screening (60%) or one to one support (40%). 40% of these would not be happy attending a mainstream GUM or CASH clinic, or GP for STI screening. 34% would not be happy to access STI screening on-line. One third would be unwilling to attend alternative agencies for counselling or support.80% of the 86 online respondents had attended Over the Rainbow in the past. Responses indicated that even fewer (44-56%) would be happy to attend a mainstream GUM or CASH clinic or GP for STI screening, with a similar proportion reluctant to attend other community settings.Comments highlighted that service users valued a dedicated LGBT service, in the heart of the gay community. It was described as a safe haven.DiscussionFuture service design and provision must consider community need. Patients expressed a preference for LGBT specific community based services, able to accommodate their sexual health needs within a holistic framework. Many value a face-to-face consultation rather than accessing STI screening on-line.
P233 Sexual dysfunction: primary, secondary or a by-product of secret issues?
Authors: Hamilton Rochelle 
Published: May 2024

IntroductionTo explore the referral diagnosis of sexual dysfunction from a psychosexual basis.MethodsA retrospective analysis of 50 women who were referred to a clinical sexologist for varying aspects of sexual dysfunction during January 2016 – December 2016.ResultsAlthough 100% of women exhibited a variety of sexual dysfunction, 44% displayed variables of sexual abstinence due to real and perceived problems that directly impacted on their ability to participate in sexual intimacy. Factors not explored or discussed by the referring Health Care Professional (HCP) included urinary incontinence, religious/spiritual beliefs, perception of guilt relating to previous sexual behaviours and ill health of the partner.DiscussionSexual Dysfunction referrals encompass a broad range of issues. These fall into sub-categories being further classified as primary and secondary. It is identified that a reasonable proportion is still incorrectly identified by the HCP, missing the underlying true reason for sexual abstinence. The ability to ask/frame questions within the assessment is significant to unlocking the contributing or causal problem. Incorporating specific questions assists in decreasing/removing any sense of guilt the woman may have around this.
P237 Are the over 50s being let down by sexual health clinics? – an audit of sexual history taking in over 50s
Authors: Ladipo Zana 
Published: May 2024

IntroductionAgeing and Human Immunodeficiency Virus (HIV) has been very topical for a long time but not much has been said of ageing and sexually transmitted infections (STI). The Public Health England STI 2015 update indicates there has been an increase in the rate of STIs in the over 45s since 2011.Methods50 random case notes of patients over 50, seen between April 2015 and March 2016 in Sefton Sexual Health Clinic, Southport, North West England. These cases were audited against the 97% target in Sexual History taking 2013 guidelines.ResultsThere were 31 men (62%), 4 of whom were homosexual, and 19 (38%) women, all heterosexual. Patients were aged between 50 to 75 years old. 78% were symptomatic. 16% had casual partners, 38% of these used commercial sex workers. 44% were asked about previous STIs and 60% of patients were offered STI screening and off these 13% declined. 82% of patients were asked if they had ever had an HIV test and of these 44% had. Of the 56% that said they had never had a test, 100% were offered a test and 87% accepted. The commonest diagnosis was the first episode of herpes and herpes reoccurrence (both 12%), then first episode of warts (10%) and wart reoccurrence (8%). No patients tested positive for Chlamydia or Gonorrhoea.DiscussionSTI and BBV screening at any age should be guided by an accurate sexual health history and not an assumption. It is a disservice to simply assume low risk due to age.
P246 An audit of the diagnosis and the management of genital herpes in an integrated sexual and reproductive health service
Authors: Heanue Johanna , Kumar Vinod 
Published: May 2024

IntroductionThe psychological impact of genital herpes simplex virus (GHSV) can be significant but appropriate antiviral therapy and counselling can reduce anxiety and improve quality of life during recurrences. We evaluated the management of GHSV in our integrated sexual health clinics.MethodsRetrospective case notes audit of patients who were clinically diagnosed with first episode of GHSV, or managed with suppressive therapy for recurrent herpes, between March 2016 and May 2016. The case notes were identified from GUMCADv2 dataset (code C10a/C10b). The data were collected using a standard audit record sheet, developed using BASHH guidelines.ResultsOf 103, 58% were female. The median age was 26 years (range 16 – 59 yrs). A HSV PCR swab was obtained in all patients presenting with a first episode of GHSV (n = 73). Type 1 and Type 2 HSV were typed in 52% and 38% of cases respectively. Syphilis testing was offered to 84% patients. Aciclovir was given to 85% patients. Verbal information giving was good (78%), whereas provision of written information was poor (19%). In patients (n=30), who were managed with suppressive therapy for recurrences, Type 2 HSV was typed in 83% cases. A reason for commencing suppressive therapy was recorded in 77% cases. A clear plan regarding duration of suppressive treatment and follow-ups were recorded 23% and 67% cases respectively.DiscussionThis audit demonstrated many areas of good practice but also identified potential gaps between national recommendations and current clinical practice. Recommendations are made to reach the standards set by BASSH.
P249 Audit of adherence to referral pathway for pregnant women with history of genital herpes booked at a tertiary referral maternity hospital, aug 2015 – aug 2016
Authors: Cunningham Orla , Deegan Nikita , O’Connell Michael 
Published: May 2024

IntroductionGenital Herpes Simplex Virus (HSV) can be transmitted in the perinatal period with the potential for serious and devastating consequences for the fetus/infant. Transmission from mother to infant most commonly occurs due to exposure during delivery (85 – 90%). Early 2014, the team caring for women with Infectious Diseases in pregnancy identified that women, with a history of genital HSV or an outbreak in pregnancy, were an at-risk group without a specific care pathway, often with differing clinical decisions regarding their care.MethodsA retrospective audit was undertaken to ascertain adherence to a newly introduced referral pathway for pregnant women who gave a history of genital herpes booking into a tertiary referral Maternity Hospital, August 2015 – August 2016.ResultsOur initial audit over a 9 month period demonstrated that there was an overall deficit in knowledge regarding the new referral pathway. The 9 month audit showed that only 13 of 49 (26%) of women were referred to specialist services at any time during their pregnancy. Our subsequent audit showed 54% of women were referred for specialist consult in the period following re-education; a large improvement in awareness of our referral pathway.DiscussionAudit of practice and in particular following an introduction of a new care pathway, is an essential tool for demonstrating compliance as well as highlighting gaps which require addressing. Education targeting the team of midwives who ascertain women’s history on booking into the maternity services, has improved referrals as per our 4 month follow-up audit.
P250 An audit of the care and monitoring of patients co-infected with HIV and hepatitis C in gum in edinburgh: need for better documentation identified
Authors: Pollitt Helen , Raha Durba 
Published: May 2024

IntroductionHepatitis C (HCV) in HIV patients increases risk of cirrhosis and hepatocellular carcinoma (HCC).MethodsWe used the BHIVA guidelines on co-infection to formulate our data fields to audit our compliance with these guidelines. We gathered information from 4 different IT systems used locally and paper notes; looking back over 5 years. Data fields include: Dates of HIV and HCV diagnoses, GP contact, transmission risk, latest CD4 count, ARV regimen, date ARV started, CD4 at ARV start, was HCV diagnosed when ARV started?, HCV treatment regimen, if acute HCV was treatment started within 6-12 months, referral to specialist, transplant, drug, alcohol and mental health services, HEV screening, HAV and HBV serology and vaccine, fibroscan, LFTs, liver biopsy, risk reduction discussion, cirrhosis on liver ultrasound, AFP, endoscopy, if no HCV treatment do they have annual fibrosis assessment?ResultsAbstract P250 Table 1Number of patients identified under GUM with HCV-HIV co-infection = 16Patients referred to speciality12/16Patients treated6/16Mode of transmission documented2/16Discussion of risk of transmission documented1/16Cirrhosis3/16Ever had fibroscan5/16Patients referred to speciality12/16Patients treated6/16Mode of transmission documented2/16Discussion of risk of transmission documented1/16Cirrhosis3/16Ever had fibroscan5/16AFP in last year2/3Endoscopy documented2/3HCV treated2/3Non-treated patients (10)Annual fibrosis assessment0/10Cirrhotic patients (3/16)DiscussionIn our HIV patients documentation of HCV care is spread over four IT systems and paper notes. The collation of data to ensure each patient is receiving appropriate care and monitoring is time-consuming and unwieldy, probably the main cause for incomplete monitoring. This audit identifies a need for a cohesive way of documentation for these patients.
O30 Treatment failure in mycoplasma genitalium among gum clinic attendees
Authors: Ovens Katie , Cross Elizabeth , Rickwood Lucinda , Reynolds-Wright John , Hassan-Ibrahim Mohammed Osman , Soni Suneeta 
Published: May 2024

IntroductionMacrolide resistance inMycoplasma genitalium(MG) is of growing concern in countries where azithromycin is used to treat non-gonococcal urethritis(NGU) but UK data is lacking. Patients with NGU or pelvic inflammatory disease (PID) are routinely tested for MG at our clinic and offered test of cure (TOC) 4 weeks post-treatment. We aim to determine rates of MG-positivity 4 weeks after treatment and their associations.MethodsNotes of MG-positive cases between December 2015 and November 2016 were reviewed and data collected on management.Results114 cases of MG were identified. 91(80%) were symptomatic and 12(11%) were MG contacts. Should be 52/339(15%) men with NGU and 15/160(9.4%) women with PID were MG-positive.80/114(78%) were given an azithromycin regimen first line. 59/114(53%) returned for TOC and 24/59(40%) were positive (23 following azithromycin; 1 following moxifloxacin). 19 returned for a second TOC and 14 were negative (1 following azithromycin and 13 following moxifloxacin second line). 5/19(26%) were positive (3 following azithromycin and 2 following moxifloxacin second line). One male patient with confirmed resistance to macrolide and quinolone therapy achieved microbiological cure with pristinamycin.Having a positive TOC was significantly associated with risk of reinfection (p=0.01) and being symptomatic at TOC (p<0.001), but not significantly associated with gender, sexual orientation, HIV status, concurrent STI (p=0.053) and azithromycin use.DiscussionMG-positivity rates at 4 week TOC are high raising concerns of treatment failure although re-infection may also contribute. As commercial assays are imminently available, diagnoses of MG will increase and where possible should be accompanied by antimicrobial resistance testing.
O38 The contraception choices interactive decision-aid: development, content and design
Authors: Bailey Julia , Gubijev Anastazia , Walton Lisa , Blandford Ann , D-Souza Preethy , Oliver Sandy , Rait Greta , Stephenson Judith 
Published: May 2024

IntroductionWomen have many concerns about contraception which can put them off using reliable methods, and their worries may not surface in consultations with health professionals. An online intervention can offer convenient help with decisions. We describe the design and development of the Contraception Choices website which addresses myths and misconceptions about contraception, and provides tailored recommendations for contraceptive methods.MethodsWe gathered several sources of evidence: 1) A qualitative synthesis of systematic reviews of factors influencing contraceptive choice; 2) Views on contraception expressed on YouTube (35 videos); 3) A meta-analysis of randomised controlled trials of interactive digital interventions for contraceptive decision-making; 4) A narrative synthesis of reviews of interventions for contraceptive decision-making; 5) Seven focus groups with 75 women aged 15 to 30 recruited in clinical settings, to explore beliefs and concerns about contraception and suggestions for website content.YouTube videos and qualitative data were analysed thematically. Themes from the qualitative field work and findings from the evidence reviews were tabulated, and implications for the design of the Contraception Choices website were debated.ResultsThe most common myths and misconceptions about contraception were worries about hormones being unnatural, weight gain, altered bleeding patterns, cancer and future infertility. The Contraception Choices website addresses women’s concerns through videos, information which highlights contraception benefits, and an interactive tool which gives tailored suggestions for contraceptive methods.DiscussionThe role of digital decision-aids for contraception will be discussed. The website will be tested in a pilot randomised controlled trial starting in March 2017.