bluuebunny/crossref_metadata_2025_split huggingface dataset:
P197 An interpretative phenomenological analysis to explore the experiences of patients after speaking with a health adviser about partner notification
Authors: Tickle Laura , Symonds Merle , Sutcliffe Lorna 
Published: May 2024

IntroductionPartner notification (PN) is pivotal in controlling spread of sexually transmitted infections (STI) by reducing onward transmission and preventing reinfection. We explored the experiences of patients undergoing PN after being diagnosed with a STI.Methods259 patients diagnosed with a STI over a 3 week period were invited to complete a PN survey comprising quantitative and qualitative questions. Qualitative data was analysed using Interpretative Phenomenological Analysis (IPA).Results76 patients, 20 female and 24 male responded (not all questions were answered). Mean age was 31 (range 16-58). 21 identified as single and 16 partnered. 29% said this was their first clinic attendance, 65% said this was their first ever STI diagnosis and 36% said they attended as a STI contact. Eight main themes were identified: (1) infection source; (2) how to contact partners; (3) difficult information to discuss ‘specific sexual acts performed with every one of them’; (4) uncertainty of partner testing and treatment; (5) concern of providing partner details; (6) future expectations; (7) use of social media; and (8) Health Adviser (HA) qualities. Patients understand PN, but face barriers due to partnership dynamics and lack the skills required for PN. Further partners were contacted following consultation with a HA. Evidence of alternative PN being offered (i.e. provider referral) was limited.DiscussionIn line with BASHH guidelines, the importance of specialist staff in delivering PN was evident. Novel ways to facilitate sexual history taking and methods to contact partners (i.e. social media) are preferred and should be explored further.
P201 How can sexual history taking for sexually transmitted infection partner notification be improved?
Authors: Vojt Gabriele , Pothoulaki Maria , Estcourt Claudia , Flowers Paul , Mapp Fiona , Woode-Owusu Melvina , Mercer Cath , Saunders John , Cassell Jackie , Nandwani Rak , Symonds Merle 
Published: May 2024

IntroductionNational guidelines, standards and policies help health care professionals to elicit information during sexual history taking as part of partner notification (PN) for sexually transmitted infections (STI). Accurate information about sexual partners and sexual behaviours is vital to prevent onward transmission. This study focuses on patients’ experiences on how sexual history questions for the purpose of PN could be improved.MethodsWe conducted 12 focus groups with members of the public and patients at sexual health clinics in Glasgow and London. All patient participants had been diagnosed with a (non-HIV) STI in the past six months. Data were analysed using thematic analysis.ResultsAnalysis revealed a number of interrelated themes arising from participants’ experiences and perceptions. Shared beliefs about sensitivity and reflexivity of questions regarding the frequency, riskiness and contactability of sexual partners influenced the way in which patients experienced and responded in sexual health consultations. Congruence in language and clinician-led consideration of the context of individual sexual behaviour contributed to the extent to which information was shared.DiscussionSexual history taking for PN is embedded within a complex interaction between clinicians and patients. The need to accurately identify all partners is balanced against acknowledging that questions asked must be sensitive yet unambiguous. This study suggests that establishing congruence in language and investing time to examine contextual factors within the patient’s sexual behaviours can lead to active collaboration within a time-efficient window, and enhancing the accuracy of information shared thereby enabling health professionals to offer appropriate options for PN.
P204 A junior doctor-led programme is effective in educating young people about sexually transmitted infections and their local sexual health clinic
Authors: Kearney Jessica , Subburaj Kartik , Shanmugathas Nimlan , Patel Harish 
Published: May 2024

IntroductionIt is well recognised that people aged 15–24 have the highest rates of sexually transmitted infections (STIs). In an area failing to meet national targets on chlamydia detection in this age group and overall HIV testing, junior doctors are delivering sessions to educate young people. The project aims to increase attendance at sexual health clinics and improve sexual health in this high-risk group.MethodsSince 2012 junior doctors have been visiting secondary schools locally to deliver a 50-minute teaching session to 14–16 year olds covering condom application, symptoms of STIs and accessing their local sexual health clinics. The sessions have received positive feedback from teachers and students. This year a questionnaire has been introduced to quantify pre and post teaching knowledge.Results188 children completed the questionnaire. Pre-teaching scores included 25.9% on STI symptoms, 34.9% on where the local clinic is and 27% awareness of what happens there. The post-teaching scores showed an improvement of 49.8%. 89% students reported feeling more comfortable discussing STIs following the session.DiscussionWe have highlighted that there is a need to provide more information to 14–16 year-olds about the symptoms of STIs and their local sexual health clinic. We have also demonstrated that a junior doctor led programme is an efficacious method of delivering this. Education from a young age could contribute towards increasing screening and reducing STI rates.
P208 In an era of antibmicrobial stewardship is epidemiological treatment for syphilis still justified?
Authors: Wood Clare , Saxon Cara , Ahmad Sameena 
Published: May 2024

IntroductionThe BASHH guidelines for syphilis recommend the offer of epidemiological treatment or re-screening at 12 weeks (12w) after exposure for asymptomatic sexual contacts. We reviewed local practice and compliance with guidance in view of the increasing need for antimicrobial stewardship.MethodsWe conducted a retrospective case note review of patients coded as syphilis contact (PNS) between January 2015 and July 2016.ResultsWe identified 44 patients (40 [91%] male; 35 [80%] men who have sex with men) reporting syphilis contact. There were 12 (27%) symptomatic, who were all given treatment; 7 (63.6%) with subsequently positive syphilis serology. Of 32 (73%) asymptomatic patients 25 (78%) received treatment. All 25 reported ongoing sexual contact with the index partner or others within the window period (WP) and serology was consistent with active infection in 5 (20%). Of the 7 (21.9%) that didn’t receive epidemiological treatment 5 were outside the WP and tested negative; 1 declined treatment and tested negative at 12w; 1 contact of late latent syphilis tested negative within the WP but failed to attend 12w follow up. There were 8 (18%) with other STIs at presentation.DiscussionWhile penicillin-resistant syphilis is not an immediate concern, contacts may have other infections that could be partially treated with penicillin based or tetracycline antibiotics potentiating resistance. Over half our patients were at risk of re-infecting or transmitting to partners supporting the basis for epidemiological treatment but should we consider the option of treating symptomatics at presentation and abstinence advice pending results?
P211 Teens and sexting – a public health concern?
Authors: Handley Sally , Murray Rachael , Bains Manpreet 
Published: May 2024

IntroductionSexual messaging (sexting) has become a norm of peer-to-peer communication among young people. There are concerns about the negative impact sexting has on young people’s health and wellbeing. However, little is known about the nature of public health messages currently being provided on sexting. This study sought to understand the nature of information and advice on sexting available online for children, young people and adults.MethodsA document analysis explored online resources from national agencies involved in promoting the welfare of children and young people. Thirty-eight documents were identified which included audio-visual files. The nature of information was analysed thematically.ResultsDefinitions of sexting, the scope of the problem and the role of technology were key themes across the documents. Safeguarding prioritised the welfare of young people with advice and scenarios on legal issues. Immediate and longer-term consequences considered peer pressure, coercion, bullying and control, psycho-social distress, reputation damage and internet related crime. Advice focused on how to say ‘no’, minimising risk, dealing with the problem, relationship advice, safety and harm reduction including how to use social media.DiscussionSexting may play an important part in normative sexual development and sexual enquiry. Online digital relationships also create concern for some children and young people. This research found that there was a wealth of information and advice available and the nature of it is consistent across agencies. Harm reduction could be strengthened through a multi-agency commitment to promote inclusive, cross-curricular online safety and healthy peer relationship messages.
P213 The epidemiological features of herpes simplex virus cases in a cork sti clinic
Authors: Mitchell Jill , Cremin Suzanne 
Published: May 2024

IntroductionHerpes simplex virus (HSV) is the leading cause of genital lesions worldwide. The transmission of sexually transmitted infections (STI’s) and human behaviour are intrinsically linked. A clear understanding of the characteristics that increase the risk of acquiring these infections is vital for STI control. European evidence lists large intracountry and intercountry differences in the epidemiology of genital herpes across EuropeMethodsRetrospective chart review, examining demographic, behavioural and diagnostic data of patients who attended a Cork STI clinic from 2011 to 2015 inclusive. Multivariate logistic regression models were used to study the epidemiological features of patients with a genital HSV infection (n=296) in comparison to a control group of patients with negative screen (n=307).ResultsFemales (OR3.942, P<0.001) and those aged between 25 to 30 years (OR: 8.397, P<0.001) had increased odds of acquiring genital HSV. Subjects of non-Irish ethnicity (P=0.032) and females who engaged in sexual intercourse younger than 17 years of age were more likely to present with the infection (OR: 7.427, P<0.01). Alcohol and drug use were not significant predicting factors of HSV infection. High number of sexual partners was not associated with increased risk of the infection. Consistent condom use was very low in all subjects.DiscussionPublic health campaigns directed at young people, especially those engaging in sexual activity at a young age and non-Irish ethnic groups, may be beneficial. Increased distribution of condoms to at risk age groups should be considered. It is relevant to public policy design that classic risk taking behaviours were not associated with increased risk of genital HSV infection.
P226 ‘Agender for change’: representing gender and sexuality diversity in sexual health
Authors: Turner Kevin , Scofield Sara , Priestley Cecilia , Clarke Billy 
Published: May 2024

IntroductionTrans* identities are under-represented in UK sexual health data. One possible reason is that the traditional representation of gender within the restricted binaries of male and female contributes to the low numbers seen in sexual health services. We aimed to obtain a clearer understanding of the hidden gender and sexuality identities accessing an LGBT-targeted sexual health service.MethodsWe offered full sexual health screening in a community LGBT clinic during National HIV Testing Week in 2016. A self-completed triage form was used to register patients. Additional gender identity options were added to the form. This included an ‘other’ box with an option to specify any gender or sexual identities that had not been represented on the form.Results78 patients completed the registration form. 52 identified as male and 18 female. 8 (10%) described different gender identities; 2 trans*-men, 2 demi-boys, 1 gender fluid, 1 bi-gender and 2 non-binary.In terms of sexual orientation, 8 identified as heterosexual men, 50 as gay men, 2 as lesbian women, and 6 (2 male, 3 female and 1 non-binary) as bisexual. 11 identified themselves as pansexual and 1 (a demi-boy) as asexual.DiscussionIncreasing the options during registration captured a wide variation in reported gender identity and sexual orientation. To avoid a complex, multi-option question on the registration form, we would suggest that simplifying this to ‘please describe your gender’ and ‘please describe your sexuality’ would be advantageous for both the patient and health care professional.
P234 STI testing in HIV positive MSM patients: a missed opportunity?
Authors: Cain Charlotte , McCathie Radhika 
Published: May 2024

IntroductionApproximately 1 in 20 men that have sex with men (MSM) are infected with HIV. The risk of acquiring a sexually transmitted infection (STI) is higher in this population compared with heterosexuals. Therefore, it is important for HIV positive MSMs to have regular sexual health screening to reduce the risk of transmission of STIs and HIV.Consequently, the British HIV Association recommends that HIV positive MSMs should have annual STI screening. Furthermore, those that are classified as high-risk should be tested every 3 months.MethodsThis audit retrospectively gathered case notes of HIV positive MSMs that have been seen in the last 12 months, October 2015 to November 2016. The following criteria were assessed: annual or 3 monthly screening of STIs, hepatitis B and C immunity status, patient age, evidence of high-risk behaviours and year of HIV diagnosis. The criteria for high-risk behaviour included: multiple partners (>2 in the last 12 months) and drug use. The data will be used to assess what proportion of patients are screened in line with national guidelines and to identify ways the practice can increase the uptake of screening.ResultsThe results show that 84% of cases were not screened annually for hepatitis C and 40% of patients were not receiving the minimum screening for STIs. However, 78% of patients were vaccinated against hepatitis B.DiscussionIn conclusion, this audit shows that there is a failure to meet the minimum level of screening for this high-risk group. We aim to improve this via a new pro-forma and education.
P236 Awareness and resources for individuals who are transgender with autistic spectrum disorder- a healthcare professional’s perspective
Authors: Murphy Lauren , Livesey Anne 
Published: May 2024

IntroductionAutistic Spectrum Disorder (ASD) affected around 1% of the general population but has been reported in 7.8% of childhood gender identity clinic referrals. Gender identity is an increasing healthcare focus; the United Kingdom’s only childhood gender identity clinic witnessed a 930% increase in referrals in six years, with Sussex having the highest adult service referral rates. This study aims to assess healthcare professionals’ awareness of a co-occurrence between ASD and transgender, identify resources and determine how these could be improved, based on the needs and concerns of individuals.MethodsA service evaluation of healthcare professionals who frequently see individuals about ASD and/or gender identity was conducted in Brighton. An anonymised online questionnaire, created using Survey Monkey, was accessible from January 2017 until March 2017. Participants were contacted via NHS emailing lists with explanatory information and a survey link. Quantitative data was collated as raw data and percentages. Qualitative data was organised into tables and key themes identified.ResultsLimited evidence suggests that healthcare professionals were unaware of an association between ASD and transgender and most were unsure if resources existed. Most felt that training would improve care, with a particular focus on local and online resources, referral pathways and current research evidence. Mental health issues, family concerns about gender identity interventions, not being accepted and vulnerability were major concerns.DiscussionCo-occurring ASD and transgender is under-recognised by healthcare professionals. Future resources should focus on the specific needs and concerns of these individuals and aim to raise awareness.
P239 Returning sexually transmitted infection results to adolescents: a review of the literature
Authors: Jain Lakshmi , Francis Suzanna , Shahmanesh Maryam 
Published: May 2024

IntroductionSexually Transmitted Infections (STIs) are an important cause of poor reproductive and sexual health in adolescents. Prompt diagnosis and treatment are key to reducing long term sequelae. We reviewed the evidence on current methods of results delivery for STIs, with a focus on adolescent services.MethodThe literature was reviewed systematically between June and August 2016. Six databases were searched, reference lists reviewed and authors contacted for studies on methods of results delivery for STIs to adolescents (aged 15–25 years). Titles and abstracts were reviewed and full text obtained for quality assessment and data extraction.ResultsOf 549 studies identified, 19 fulfilled the inclusion criteria. Seven studies focused on adolescent populations, all in high-income settings. Three studies in low- and middle-income settings and nine included adolescents as a stratified group. Twelve studies were cross-sectional, two randomised control trials, the remaining employed mixed methods. Outcome measures varied widely, percentage preferences for method of results being the commonest measure. Findings show that mobile phone call and text were the commonest methods of returning results. Other modalities including text message, email and online notification demonstrated wide variations in acceptability. Preferences varied according to type of result, population type, location, client group and previous service use. Mobile phone calls and face-to-face consultations remain highly acceptable.DiscussionThe use of mHealth offers promising options for STI results delivery. Methods adopted must consider the target population accounting for gender, age, ethnicity and access to technologies. Customisation is recommended to meet user requirements for optimal health care delivery.
P241 Where there’s tea, there’s hope! – experience of green tea extract for treatment of genital warts
Authors: Megarity Stephen , McCarty Emma , O’Donnell Brian , Dinsmore Wallace 
Published: May 2024

IntroductionCatephen® 10% ointment is novel extract from green tea which is licenced for genital wart treatment and included in BASHH guidelines (2015). Recommended application is 3 times daily for 16 weeks. We present real life data of Catephen® experience.MethodsReview of patients treated with Catephen® and adjuvant cryotherapy between August 2016 – February 2017. Clinical outcomes and tolerability data were collected.Results33 patients identified, median age 26 years (32 male, 1 female). 2 HIV positive. Affected site; penis 23/33, perianal 7/33, both 2/33 and vulva 1/33. All cases were recurrences. 6 patients excluded as lost to follow-up. To date 17/28 have completed 16-week course Catephen® or achieved full clearance prior to this. Outcomes are still awaited for 2/27 patients and 8/27 discontinued treatment early. Of the 17 who have completed treatment, 11(65%) had total clearance and 6(35%) partial clearance. Mean time to clearance was 8 weeks with penile warts appearing to respond better than perianal. Catephen® was well tolerated with 43% stating they had fewer side effects than with previous treatments. Overall discontinuation rate was 8/27 (30%) with 1 report of vulval pain, 1 report of stained clothing and 6 reporting unsatisfactory response (mean duration of Catephen® use 6.5 weeks). An additional 3 patients reported skin discomfort but continued treatment.DiscussionCatephen® ointment appears well tolerated with satisfactory clearance rates. It appears to be an acceptable alternative to other topical treatments for genital warts. To date there is no trial data on continued use after 16 weeks.
P243 Could the current outbreak of hepatitis a in men who have sex with men in london have been predicted or prevented?
Authors: Lewer Dan , Mindlin Miranda , Cordery Rebecca 
Published: May 2024

IntroductionThe current outbreak of Hepatitis A and the recent Shigella outbreak in men who have sex with men (MSM) highlight the importance of faeco-orally transmitted organisms in this population. This may suggest that outbreaks could be predicted or prevented.MethodsWe compared the age, sex and travel history of notifications of Hepatitis A with notifications of Shigella in South London between January 2010 and November 2016. We also reviewed documentation of previous outbreaks of Hepatitis A in MSM in London.ResultsMale and female cases of Hepatitis A had similar age profiles and a similar proportion reported recent travel. In contrast, Shigella cases peaked in males aged 30–39 with no travel history. Case notes for Hepatitis A notifications since January 2013 suggested fewer than five in MSM. Although this review suggested very few cases in recent years, outbreaks of Hepatitis A among MSM in London were documented in the late 1990s and in 2003. The second outbreak was associated with strains that caused concurrent outbreaks in MSM across Europe. Public health response to these outbreaks recommended health promotion and opportunistic immunisation.DiscussionHepatitis A outbreaks occur sporadically in a transnational population of MSM. Few cases may occur between outbreaks and preventative actions may be deprioritised. However, group immunity is likely to be highest after an outbreak and then wane in the absence of immunisation, increasing the risk of another outbreak. Health promotion and immunisation may be valuable outside of outbreak contexts.
O33 Significantly higher rates of chlamydia found in army personnel compared with non-military clinic attendees
Authors: Iveson Helen , Galbally Kate , Morris Georgina 
Published: May 2024

IntroductionOur Sexual Health service covers a county-wide population, including large numbers of Army personnel. Despite military personnel being recognised as high risk for sexually-transmitted infections (STIs), accurate data on STI and HIV epidemiology within the military is lacking (1).The latter is compounded by difficulties differentiating military from civilian patients attending Sexual Health clinics. We introduced a local code (‘ARMY’) from April 2016. This has enabled us to monitor numbers of Army attendees and compare STI rates and risk factors with non-military patients.MethodsLocal ‘ARMY’ code added by clinicians at time of consultation, based on information including: patient self-reported occupation, garrison address, military uniform.Electronic patient records for all male new or rebook attendees between 15/4/16 and 31/10/16 with an ‘ARMY’ code were reviewed (n = 234). These were compared with a non-military group of patients (n=234) attending during same time period and were matched for age group, gender, sexuality and presence/absence of symptoms.ResultsArmy personnel were found to have significantly higher levels of chlamydia positivity (19.2%) compared with non-military attendees (11.1%) (p= 0.020, Fisher’s exact 2-tail). This higher rate of chlamydia was found despite comparable numbers of: sexual partners in prior three months, presentations as chlamydia contacts and high-risk alcohol users. Rates of gonorrhoea, warts, HSV, HIV and syphilis did not differ significantly. Army personnel were significantly more likely to be of non- white British ethnicity (11.1%) than non-military attendees (2.1%), reflecting local population (p =0.0001, Fisher’s exact 2-tail).DiscussionOur findings support promotion of sexual health screening for military personnel and targeting of chlamydia testing. Military personnel often go home to other areas of UK and overseas during leave and could disseminate infections.