bluuebunny/crossref_metadata_2025_split huggingface dataset:
P104 Self-service sexual health: pipedream or reality?
Authors: Horn Kate , Hawkins Michelle 
Published: May 2024

IntroductionFinding smarter ways of working which meet the needs of increasingly IT-savvy clients and support their busy lifestyles is a priority and an opportunity to innovate.To meet these demands, we developed a national web-based hub, streamlining access to sexual health information and local services, while signposting to services nationally. User insight helped inform the design which was mobile first.MethodsFollowing launch of the hub, we recorded a number of metrics to assess acceptability to users and impact on existing services.ResultsIn the first 5 months of operation we have seen: 45% more people visiting our national website than all local websites combined, with users staying longer and engaging with well-being content. 75+% accessing from a mobile device. Peak use in 18–34 year olds, with all age groups represented. 151% increase in visits to LARC self-help online content and use of pre-consultation videos. 10% reduction in call volumes to services, equating to 213 hours of admin time. Improved patient experience and choice as evidenced through user survey. Very easy or easy to find information and advice online: 92%. Very likely or likely to recommend to a friend: 96%DiscussionInitial results are encouraging and suggest the online hub is acceptable and helpful to users. Increasing available self-management options in the next phase of this project will include free postal sampling kits for asymptomatics (aged 16+), with the aim of increasing access to screening, reducing unnecessary clinic visits and releasing capacity in services for those requiring clinician input.
P113 Domestic violence – do we ask? will they tell?
Authors: Dearing Nicola , Akala Oyeyemi , Peycke Jennifer , Carter Helen 
Published: May 2024

IntroductionExperience of domestic violence is reported as 28.3% in women and 14.7% in men. It causes significant harm and screening sexual health clinic attendees is recommended. Proformas used within our service include a question on domestic violence however screening practice among clinicians varies.AimInvestigate the prevalence of domestic violence among our clinic attendees and determine if current practice is successful at identifying this.MethodsPatients attending a clinic on 9th January 2017 were asked to complete an anonymous questionnaire including questions on domestic violence, mental health, unplanned pregnancy and STI’s. A retrospective audit of documentation of domestic violence in patient’s records was then undertaken for all patients attended on that day.ResultsTotal number of attendees on 9th January was 111, 57 completed questionnaires (52% female and 50% male attendees). Domestic violence was reported by 27% female attendees and 16% male attendees (10% in heterosexual male, 33% in MSM). Females suffering domestic violence more commonly reported sexual assault, mental health problems and unwanted pregnancy.34% female attendees had a documented enquiry regarding domestic violence. 24% of these reported domestic violence. Among male attendees 38% had a documented enquiry with 9% reporting domestic violence. Reporting of domestic violence by men to clinicians was lower than predicted by the survey.DiscussionWith our current practice we can expect to miss 10 women and 5 men a day who have suffered domestic violence. Routine enquiry is to be recommended. Reluctance to disclose domestic violence may still be a barrier to identifying this hidden problem.
P120 Detection of syphilis and other pathogens associated with genital lesions using plexpcr
Authors: Erskine Simon , Windsor Madeline , Njuguna Peter , Tucker Rachel , Wee Rachel , Tan Litty , Azzato Franca , Mokany Elisa 
Published: May 2024

IntroductionSyphilis is an STI caused by the bacteriumTreponema pallidumthat can result in substantial morbidity and mortality. Recently, there has been an alarming global resurgence of syphilis with infections rising to unprecedented rates. As such, it is increasingly pertinent to test genital lesions for syphilis. Moreover, Herpes simplex virus types 1 and 2 (HSV–1 and HSV–2) and Varicella zoster virus (VZV) cause lesions in cutaneous and mucocutaneous sites. Recent publications have found VZV in genital specimens, suggesting that reactivation of VZV in this atypical presentation is not as uncommon as previously believed, further necessitating the importance of identifying these organisms at these sites.MethodsThe PlexPCR HSV-1&2, VZV, Syphilis test (SpeeDx) is a single-well multiplex qPCR for testing genital lesions for the targets HSV-1, HSV-2, VZV andT. pallidium. The performance of the assay was evaluated on 90 genital specimens for which in-house PCR results for syphilis had been determined.ResultsThe multiplexed assay detected 54/57 syphilis positives, corresponding to a sensitivity and specificity of 94.7% and 100.0%, respectively. The assay also detected four HSV–1 and two HSV–2 infections (2 and 1 syphilis co-infections, respectively). All assays demonstrated analytical sensitivity to 10 copies per assay.DiscussionThe lesion assay offers simultaneous detection and differentiation of pathogens that cause genital lesions. In response to the current emerging syphilis outbreak, this assay could provide a rapid and effective method of determining the infectious agent responsible for genital lesions, supporting earlier detection and rapid treatment to reduce morbidity or worse outcomes.
P124 Exploring health care professionals’ perceptions and knowledge of trans* patients’ sexual health needs: a need to update the curriculum?
Authors: Crow Madeleine 
Published: May 2024

IntroductionNo current competencies for transgender issues exist in genito-urinary or community sexual and reproductive health training curricula. This gap is currently being addressed and curriculum changes on the topic are being proposed. The aim of this study is to assess doctor’s knowledge regarding specific trans* issues and their attitudes to proposed curriculum changes.MethodsPurposive, convenience sampling was used. A self-completed questionnaire was distributed via the British Association for Sexual Health and HIV newsletter and at the Faculty of Sexual and Reproductive Health annual conference. It consisted of 15 closed and open-ended questions on demographics, previous experience and training, knowledge of specific trans* health issues, and attitudes to curriculum changes. Analysis was done using Stata.ResultsFrom the 110 eligible responses only 37% had received previous training on trans* issues and 81% supported adding trans* issues to the curriculum. The need for training was demonstrated in the high proportion, 86%, with concerns around managing trans* patients. Confidence was lacking in clinical scenarios, especially performing genital examinations and cervical screening. Knowledge gaps were identified in all areas, particularly regarding management of post-operative complications.DiscussionThis study highlights the need for doctors’ training to improve knowledge and confidence on trans* issues, as well as the positive receptivity of training. Concerns mostly revolve around how to make competencies logistically feasible in the face of an already packed mandatory curriculum and lack of opportunities for exposure to these patients.
P133 Using a cross sectional survey to establish a national picture of the activity, governance and delivery of condom distribution schemes in england, in the financial year 2015/16
Authors: Ratna Natasha , Nardone Anthony , Hadley Alison , Brigstock-Barron Owen 
Published: May 2024

IntroductionCondoms remain a key intervention to prevent sexually transmitted infections (STI), pregnancy and HIV. C-Card is a type of condom distribution scheme (CDS) with condom demonstration and risk assessment at registration, after which free condoms are available to young people, in accessible locations.AimReview delivery and C-Card activity in England and its regions in financial year 2015/16, to inform policy, best practice, future monitoring and evaluation.MethodsAn online survey was disseminated to sexual health commissioners of 152 upper tier local authorities (UTLA) in England between 17/12/2016 and 10/02/2017. Questionnaire domains collated information on service delivery structure, governance, user information, spend, product availability and provision, and other CDS.Results64% (98/152) of UTLAs completed the survey. 20 had both C-Card schemes and CDS, 57 had C-Card schemes, 14 had CDS and 7 had neither. 60 reported 4,560 C-Card outlets. The three most common settings for C-Card schemes were pharmacies (1,363, 30%), youth organisation and educational settings (1,105, 24%) and general practice (996, 22%). In 2015/16, 77 UTLAs reported 65,762 new C-Card user registrations, of which 70% were repeat users. Of 70 reporting product availability, 60 (86%) distributed condoms and lubricants. 28 distributed 896,221 products, of which 85.8% were condoms, 13.7% were lubricants and 0.5% other. Estimated spend on condom schemes were £1,491,937.DiscussionAvailability of CDS in most UTLAs and high repeated use of C-Card schemes suggest acceptability and popularity. Improved evaluation of C-Card schemes for STI, pregnancy and HIV prevention is needed to demonstrate their value.
P142 Recreational drug use in heterosexual men in a sexual health clinic in east london: the forgotten majority?
Authors: Samra Ranjit , Khan Palwasha , Bansal Ciara , Bayley Jake 
Published: May 2024

IntroductionRecreational drug use is widely reported in the MSM population, however its use in the male heterosexual population is less well-described. We undertook a short survey to determine the prevalence of chemsex use in all men.MethodsSelf-directed questionnaires were given to all male attendees at a GUM clinic for three weeks in December 2016. Data on demographics, level of education, sexual risk and drug use (including ‘chemsex’ drugs and other recreational drugs).Results268 questionnaires were returned. 70% (182/260) were heterosexual and 63% (155/246) were of white ethnicity. 41% of both the heterosexual and MSM groups had ever tried one drug. Prevalence of recent use (less than 1 year) was 27% (40/149) in heterosexuals and 35% (24/68) in MSM. There was much less use of ‘chemsex’ drugs in heterosexuals versus MSM (20% versus 9%, p=0.03). Use of crystal methamphetamine and GHB were much lower in the heterosexual population. The highest prevalence of any previous drug use was found in white men vs non-white men (73/133 (55%) versus 11/65 (17%), p <0.05) a pattern was seen in both heterosexual and MSM groups.DiscussionThere were surprisingly high levels of recreational drug use in heterosexual men, especially those of white ethnicity. ‘Chemsex’ drugs still seem to be much more common among MSM, especially crystal methamphetamine and GHB, but the difference in mephedrone use is much less marked. These data highlight the necessity of asking all patients that attend GUM clinics about their drug use, and not only MSM.Abstract P142 Table 1Recreational drug use in Heterosexual and MSM.Ever UsedMSM n (%)Heterosexual men n (%)All29/70(41)59/144(41)Cocaine21/66(32)47/139(34)MDMA23/67(34)42/134(31)GHB11/65(17)3/131(2)Ketamine9/63(14)15/130(12)Mephedrone9/65(14)11/131(8)Crystal methamphetamine5/64(8)2/130(2)Legal1/61(2)9/128(7)Steroids0-3/130(2)Other4/62(6)12/124(10)
P144 Optimising chlamydia screening – a city and countywide approach in nottinghamshire
Authors: Handley Sally , Shaw Deborah , Neal Carl , Ford Carol , Romilly Nick , Gribbin Jonathan , Saunders John , Taylor Ruth , Carlin Elizabeth 
Published: May 2024

IntroductionThe Public Health Outcomes Framework detection rate indicator (DRI) sets a target of ≥2,300 chlamydia diagnoses per 100,000 15 to 24 year-olds. The 2014 DRI in Nottingham City and Nottinghamshire County was 2,807 and 1,900, respectively.We used the National Chlamydia Screening Programme’s Chlamydia Care Pathway (CCP) approach to review 2014 data and identify opportunities to improve the quality of screening and increase the DRI.MethodsRoutine surveillance data from GUMCAD and CTAD was used to populate the CCP for the region. Findings were discussed at the local strategic sexual health group and actions agreed.ResultsIssues identified were around unknown test offer-rate, low coverage in some districts and low retesting rates following treatment. In response: existing GUMCAD codes were used to infer the offer of a test; health promotion activities focused on raising awareness of testing among key populations, primary care and providers of other young person services; re-testing pathways were audited and a text reminder system for re-screening at 3months was implemented in one of the units.DiscussionThe CCP provided a strategic focus to increase understanding of screening at all stages of the pathway. It confirmed the need for an integrated screening approach across sexual health providers, primary care and broader health services who engage with young people. There was potential to achieve ‘quick wins’ by using the CCP to focus on each specific stage of the programme. 2017 data will be reviewed using the CCP to evaluate the impact of the plans which have been implemented.
O02 What are the motivations and barriers to effective HIV pre-exposure prophylaxis (PREP) use for black men who have sex with men (BMSM) aged 18–45 in london? results from a qualitative study
Authors: Witzel T Charles , Nutland William R , Bourne Adam H 
Published: May 2024

IntroductionPrEP has the potential to transform the HIV epidemic in the UK. BMSM experience a significantly higher HIV prevalence compared with other MSM meaning that PrEP rollout should be attentive to reducing health inequalities in this group. This research aims to describe the motivations and barriers to PrEP use for BMSM aged 18–45 in London.MethodsTwenty-five BMSM were recruited through social sexual apps for semi-structured interviews. All participants reported sexual behaviours consistent with PrEP candidacy. Interviews were transcribed verbatim and analysed using a thematic framework informed by inter-sectionality theory.ResultsAn ‘ideal’ PrEP candidate was frequently perceived to embody characteristics that participants themselves did not necessarily identify with (e.g. that they were insufficiently risky or sexually active to require PrEP). Many already felt marginalised by virtue of being both black and gay, or felt ‘type-cast’ as sexually dominant within the gay scene. Concern was expressed that taking PrEP may exacerbate such marginalisation by suggesting that they were also promiscuous. For others, however, taking PrEP meant avoiding another marginalised identity: that of someone with HIV. Participants tended to prefer conveniently located clinics outside of traditionally ‘black’ areas. Accessing services from staff of similar ethnic backgrounds was difficult for many, except for staff also perceived as gay.DiscussionMarginalisation remains a key barrier for this group, and should be considered when developing PrEP interventions. Existing services are acceptable for delivering PrEP interventions, but staff need to be mindful, sex affirmative and focus on developing rapport with BMSM of similar ethnic backgrounds as themselves.
P160 To see or not to see
Authors: Seacombe Sarah , Lomax Nicola , Cousins Darren 
Published: May 2024

IntroductionDetermining which patients need to be seen on the day they attend. Sexual Health Services are challenging given the increasing demand for services and limited capacity. A new questionnaire based triage system was implemented in a busy, urban, Level 3 Sexual Health Service. We have reviewed the outcomes of implementing this triage process to assess how many triaged patients were seen the same day and the symptoms they reported, how many received future appointments and of those, how many returned. We also assessed the safety of a questionnaire based process for triage.MethodsPatients triaged in November 2016 were identified and their notes reviewed.ResultsOf 255 recorded triages, 119 notes have been reviewed to date. Of these, 92 (77%) were seen the same day but 2 left before being seen. 27(23%) received a follow-up appointment, and 89% of these attended.Of the 92 given a same day appointment, 36 (39%) reported pain/dysuria, 23 (25%) were contacts of an STI, 2 required PEP, 6 had discharge, 3 recurrent HSV, 2 patients had been diagnosed with Chlamydia elsewhere, 2 had non-specific symptoms, 1 requested a TOP and 1 reported sexual assault. 12 had lumps or itching, 4 were asymptomatic.DiscussionThis review demonstrated that questionnaire based triage is effective and as it is quicker than face to face triage, capacity can be increased. 77% of patients were offered same day review which highlights the importance of flexibility within services to ensure patients can be seen within 48hrs when appropriate.
P164 Audit of the management of genital herpes infection in colchester sexual health clinic
Authors: Munasinghe Sujeevani , Shah Michael , Ramogi Malaki 
Published: May 2024

IntroductionGenital Herpes infection, caused by Herpes simplex virus is one of the common sexually transmitted infections in the UK. According to Public Health England STI report (2015) the percentage increase of newly diagnosed Herpes infection from 2006 to 2015 is 67%. BASHH published new Herpes management guidelines in 2014. We evaluated the management of Herpes infection at our clinic against these guidelines using electronic patient records over a six month period in 2015.MethodsRetrospective case notes review of all patients diagnosed with genital herpes infection (coded C10A) from July to December 2015. Individual case records were scrutinised and evaluated against auditable outcome measures outlined in BASHH 2014 guidelines.ResultsThere were 102 newly diagnosed Cases of HSV in this 6 month period. All patients had HSV detection by PCR confirmation and 100% had at least one detected HSV typed. Recommended antiviral therapy offered to 95% of the patients who presented within 5 days of onset of symptoms (target 97%). The percentage of patients who were given verbal and written information about HSV was 54%.DiscussionOur audit shows we met the BASHH standards by virologically confirming and typing all diagnoses of genital herpes infection. We failed to meet the standards on patient education and documentation. Since April 2016, our service has switched to new electronic patients records which has a dedicated section on patient education This will help improve our performance. This will be re audited next year.
P172 Enjoy yourself, its later than you think!
Authors: Megarity Stephen , Dinsmore Wallace , Bell Laura , McCarty Emma 
Published: May 2024

IntroductionErectile Dysfunction (ED) affects 10% of men and those affected may present at Genitourinary Medicine clinics. It may indicate significant underlying pathology and is often the first presenting symptom of cardiovascular disease (CVD) and diabetes.MethodsAll new referrals to the sexual dysfunction clinic in 2006 were identified. Electronic medical records were reviewed to determine clinical outcomes 10 years after initial attendance.Results138 patients identified; 9 were excluded due to unavailable records. Mean age at referral was 47 years. 68% (n=88) had predominantly organic ED (mean age 52 years) while 32% (n=41) were diagnosed with an underlying psychological cause (mean age 37). Of those with an organic cause, 20% (n=18) had known CVD and 17% (n=15) had diabetes. By 2016, 10% (n=13) of all patients had died. Of those alive, 30% (n=35) remained on treatment for ED. In the intervening years, a further 10 patients were diagnosed with CVD, 9 diabetes, 3 peripheral vascular disease, 3 Parkinson’s disease and 2 with stroke. Of those initially referred with ED, after 10 years, 41% had proven CVD, 27% were diabetic and 10% developed other associated conditions.Discussion10-year outcomes for patients presenting with ED are associated with significant levels of morbidity and mortality. The incidence of underlying vascular disease and chronic conditions in this cohort of patients is significant. Recognition of ED is important in GUM settings to enable early detection of significant underlying co-morbidities.
P176 Clinical pharmacology of the HIV integrase strand transfer inhibitor bictegravir
Authors: Zhang Heather , Custodio Joseph , Wei Xuelian , Wang Hui , Wu Amanda , Ling John , Martin Hal , Quirk Erin , Elliott Cindy , Kearney Brian 
Published: May 2024

IntroductionBictegravir(BIC), an investigational, once-daily, HIV integrase strand transfer inhibitor(INSTI) with potent in vitro activity against most INSTI-resistant variants, is currently in development as a single tablet regimen(STR) coformulated with FTC/TAF.MethodsBIC exposure was dose proportional following SD of 25–100mg. Steady-state accumulation was approximately 1.6x, consistent with the observed half-life of approximately 18 hours. Balanced glucuronidation and oxidation contributed to the major clearance pathways. The DDI study showed increased BIC AUC(61-74%) by CYP3A4 inhibitors voriconazole and DRV/COBI but showed a greater increase(~4x) by potent dual inhibitors of UGT1A1 and CYP3A4, ATV and ATV+COBI. Coadministration with a potent CYP3A4/UGT1A1/P–gp inducer, rifampin resulted in a 75% decrease of BIC AUC a lesser reduction(38%) was associated with the moderate CYP3A4/P–gp inducer, rifabutin. BIC was well tolerated at all doses studied.ResultsThe favourable BIC PK profile supports once daily dosing. DDI results are consistent with its ADME profile in which both CYP3A4 and UGT1A1contributed to BIC elimination. BIC was safe and well tolerated in healthy volunteers.DiscussionThe favourable BIC PK profile supports once daily dosing. DDI results are consistent with its ADME profile in which both CYP3A4 and UGT1A1contributed to BIC elimination. BIC was safe and well tolerated in healthy volunteers.
P182 Chlamydia positive testing to treatment turnaround time (TAT) april to december 2016
Authors: Proctor Gordon , Sarner Liat , Symonds Merle 
Published: May 2024

IntroductionReduction in time to treatment for those with STIs is key for reducing negative sequelae, identifying and treating STIs in partners and preventing onward transmission. BASHH 2014 Standards stipulate that results should be available within 10 working days of testing but there are no standards published for time from test to treatment. In our service patients are told to access results after 7 days. Our results management team contact untreated patients 7 days after testing.AimsTo ascertain the time period between STI test date, availability of result and receipt of treatment for those testing positive for chlamydia within a large multi-site service.MethodsA retrospective audit of the sexual health service electronic patient record (EPR) was undertaken from April to December 2016 identifying all chlamydia positive results across our service. Date of test, availability of result and treatment received was analysed. The following data was analysed.Results2897 patient records were identified for analysis. 550 were excluded due to incomplete data. 2347 records were analysed. 63.9% of results were available in 72 hours (mean 48 hours) and 96.2% in 7 days. 51.7% were treated within 48 hours of result availability, 56% within 7 days, 92.2% within 14 days and 97.5% by 28 days.DiscussionThe majority of results are available within 72 hours however <60% of patients were treated within 5 days. Patients will now be advised to access the results within 3 days and the service will contact untreated patients within 5 days of a positive result.