bluuebunny/crossref_metadata_2025_split huggingface dataset:
P151 Developing an asymptomatic screening pathway for men who have sex with men
Authors: Cook Sinead , Lomax Nicola , Drayton Rachel 
Published: May 2024

IntroductionMany sexually transmitted infections (STIs) are known to disproportionately affect men who have sex with men (MSM) in the UK; therefore regular easily accessible asymptomatic screening is vital among this group. Asymptomatic screening pathways that allow healthcare support workers (HSCWs) to see patients can reduce long clinic waits, which may encourage more people to attend for screening and increase capacity for screening.MethodsWe developed and trialled an asymptomatic pathway for MSM within our service. This extended our existing pathway, which allowed asymptomatic service users to complete a questionnaire and see a HCSW, to include MSM, as it previously had not. The service was piloted, then implemented and audited.ResultsA 5 month audit of 45 notes showed that the pathway is generally being used appropriately. 93% (27/29) service users were offered referral to a health advisor when indicated by the pathway and two were offered referral without any clear indication. This resulted in 29(64%) men seeing a health advisor for health promotion after completing their STI screen as 2 men declined. All patients received appropriate Chlamydia, Gonorrhoea, HIV, Syphilis and Hepatitis B testing, but 7(16%) were not tested for Hepatitis C when indicated by the pathway. 4(9%) men had an STI (Chlamydia or Gonnorhoea).DiscussionWe believe this model can reduce clinic visit duration. This should increase accessibility and acceptability and also allow trained staff to manage more complex patients, while allowing for risk identification and health promotion among asymptomatic MSM who may also be at higher risk.
P156 What is telephone access really like for gum clinic patients in the U.K.?
Authors: Agathangelou Gabriela , Khatun Azra , Yekini Stephen , Rose Tom , Foley Elizabeth , Patel Raj 
Published: May 2024

IntroductionHow patients fare when accessing care by telephone at GUM clinics in the UK can be assessed by ‘mystery shopping’ methods. This study aimed to establish current access levels when contacting clinics by telephone and investigate the potential barriers.MethodsDuring October – November 2016 all 262 GUM Clinics in the UK were called during clinic opening times on eight occasions, each by male and female researchers posing as patients requesting to be seen as soon possible.ResultsOverall 1589/1905 (83.4%) calls were offered an appointment. Of these, 63.7% of ‘patients’ were invited to attend a walk-in service. Most clinics were consistently contactable, with 72.9% of calls being answered on the first attempt, however 22.9% of clinics were un-contactable at on at least one occasion. Contacting a clinic over four calls can establish the probability of clinic access, with 68.8% of clinics accommodating a minimum of 6/8 callers.The time to speak to a human ranged from 1 second – 39 minutes. The mean length of conversation was 93 seconds, with longer speaking time increasing chance of success. Although male and symptomatic ‘patients’ spent longer on the phone, females were 14.6% more likely to offered an appointment (p=0.037). Symptomatic scenarios did not have improved access over asymptomatic contacts (p=0.074).DiscussionAccess appears to be falling further below the BASHH standard. Various difficulties in establishing contact were identified, including long hold times and the need for multiple call attempts, that may be barriers to patient access.
P157 Utility of chlamydia care pathway for standardisation of quality measures for management of chlamydia trachomatis
Authors: Chung Emily , Saunders John , Robinson Angela 
Published: May 2024

IntroductionThe Chlamydia Care Pathway (CCP) describes individual steps of comprehensive case management for Chlamydia trachomatis (CT) providing standardised methodology to compare outcomes. We audited CCP in a central London service to identify aspects requiring service improvement.MethodsAll patients diagnosed with CT in 6 months in 2016 were identified from the electronic patient record system. A random sample of 60 notes was assessed against each step of the CCP.ResultsThere were 35,995 new patient appointments and 1700 patients had positive CT results. Of the sample, 32 were male, 28 female. Median age for men was 34, range 20–71 years, women 24, range 17–28 years. 14/32 of males were MSM, 18/32 heterosexual. All females were heterosexual. 14/60 of patients were contacts of CT and 11 of the male patients were diagnosed with non-specific urethritis and were treated on the same day. Test turnover time was median 6, range 2–10 days. 50/60 patients were informed on the day the results were available. Of the 35/60 patients requiring treatment, time taken for them to attend was median 1, range 0–50 days. 56/60 had documented contacts informed, 18/60 had documented contacts treated. 19/60 attended for repeat tests 3 months later of whom 2 had new infections.DiscussionThis review identified areas for improvement, such as partner notification documentation and test turnover time. Review of other sites within the sustainability and transformation footprint is planned. This tool may be useful to commissioners for standardising quality measures and comparing performance of testing sites in a locality.
P165 HIV inpatient experience
Authors: Malik Seema , Chapman Cordelia 
Published: May 2024

Introduction‘Standards of care for people living with HIV 2013’ provides recommendations for the clinical care of HIV positive patients, including inpatients. We conducted an audit to describe patterns of service use with particular reference to time to diagnosis of HIV, presenting illness, medication, length of stay and follow up.MethodsData was collected retrospectively from notes of 36 inpatients from 1stJanuary to 31stDecember 2014.Results4 patients were newly diagnosed with HIV, of which, 3(75%) presented with an AIDS defining illness. HIV test was performed in MAU on 2 patients (50%). In the remaining 32 patients, 8 presented with AIDS defining illness. 11% had evidence of drug-drug interactions. 37% had no evidence of HIV Team inpatient review. 25 patients were discharged within 7 days, however, 4 stayed for more than 28 days. Only 41% were seen in HIV Outpatients within 4 weeks after discharge. After admission with AIDS defining diagnosis, all patients were alive at 30 days and 72% alive at 6 months.DiscussionComplex care accounted for a sizeable proportion of our inpatient work. Current BHIVA recommendation of immediate commencement of HAART will significantly reduce disease progression and inpatient admission. This audit highlights the need for continued effort to raise awareness of HIV testing among non-HIV specialists and GP’s.
O21 HIV testing in abortion services: missed opportunities for earlier diagnosis
Authors: Logan Louise , Folkard Kate , Connor Nicky , Ncube Fortune , Nardone Anthony 
Published: May 2024

IntroductionThe 2016 National Institute of Clinical Excellence (NICE) HIV testing guidelines reiterated the need to include HIV testing in abortion services. This survey aimed to determine whether HIV testing was commissioned in abortion services and how much testing was performed.Methods143 CCGs were invited to provide service specifications and monitoring data for the number of women seen for care, tested for HIV and diagnosed as HIV positive.ResultsOf 103 CCGs that responded, 45 (42%) stipulated that HIV testing should be offered to all women, 10 (9%) requested that providers work towards this, 27 (26%) requested sign-posting and 21 (20%) had no mention of HIV. All 10 CCGs in extremely high HIV prevalence areas (where diagnosed HIV is >5/1000) commissioned HIV testing. 54% (14/26) of CCGs in high prevalence areas (diagnosed HIV is 2–5/1000) and 45% (30/367) of CCGs in low prevalence areas (diagnosed HIV is <2/1000) did so. 40 of 103 CCGs reported testing data. Of 35,023 women reported as seen for care, 35% (12,179) were tested for HIV and 0.14% (17) tested positive. Uptake ranged from 0% to 97% and positivity ranged from 0% to 0.53%.DiscussionOverall positivity rates exceed those required to make HIV testing cost effective. Less than half the CCGs reported commissioning HIV testing in abortion services, including 54% in high prevalence areas. These gaps in service provision mean opportunities to diagnose women earlier; thereby improving their prognosis and reducing undiagnosed infection were missed. Further advocacy for testing HIV testing in abortion services is required.
P169 Gonorrhoea culture audit in a community setting
Authors: Rejaei Yasmin , Ladipo Zana 
Published: May 2024

IntroductionGonorrhoea (GC) accounted for 10% of all STI diagnoses in 2015. Diagnoses increased by 11% from 2014 to 2015, continuing an established trend beginning in 2012. BASHH guidelines recommend that cultures are routinely taken as it is cheap and offers antimicrobial susceptibility testing which is of increasing importance given the emergence of resistant GC strains. The primary aim of this audit was to assess the rate of GC culture and the outcome of the culture results in a community service.Methods20 cases, coded positive for GC, were recruited over a 19 month period. The standard for GC culture rate was set at 100%, with positive GC culture set at 85–95%. Standards were established from BASHH GC management and testing guidelines.ResultsOf the 20 patients 55% had a sample for GC culture taken. The sex distribution of culture sampling was 10:1, male to female. Of these 11 patients 45% had a positive culture, despite all patients having a positive NAAT. These rates are almost half of the expected standards.DiscussionCultures for GC are not routinely taken at this service. It is plausible that the incorrect storage of samples and delay in plating are contributing factors to the increased false negative rate. This may be a nationwide effect as services move into the community and transport times to laboratories increase. The audit results have been presented to staff at the service and discussion is ongoing with the laboratory regarding expediting transport of samples.
P170 Improving staff integration through means of a combined clinic rota
Authors: Connolly Noel B , Stott Cheryl , Babu Chitra 
Published: May 2024

IntroductionWith the national move to integrated sexual health services confusion regarding staff leadership and roles can increase already high levels of stress and anxiety. Costs for professional rota management services can vary so we aimed to achieve an in-house system.MethodsThough co-located in the same building SRH and GU/HIV clinics were traditionally staffed separately. The local tender was awarded to the University Hospital clinic as hub with spokes providing an equitable city-wide service. Previously there were four separate rotas to staff SRH, GUM, and HIV services. Bringing together a group of health professionals with varying degrees of dual training can be difficult so we took this opportunity to ensure an adequate skill mix was available for each clinic, help staff identify who was available for advice, improve cross-specialty training and thereby enhance the overall patient experience. A clinic co-ordinator doctor role was established to provide focus for leadership and advice (GU/HIV) with corresponding clinic co-ordinator nurse staffed by senior contraception clinicians.DiscussionRotas were combined onto a single colour-coded template. Editing rights were restricted to named individuals aware of staff mix and availability. Numbers were calculated at the start of each day and communicated to reception to ensure spread of appointments. The CCD role was utilised to help teach SRH colleagues in GU with the CCN providing a reciprocal service for contraception. Combining the rota encouraged staff to integrate and get to know each other so that perceived fears were dealt with in a safe reassuring environment.
P173 Artistic representations of HIV in northern ireland: how the arts can contribute to HIV awareness, prevention and stigma-reduction in a conservative environment
Authors: Campbell Alyson 
Published: May 2024

IntroductionThe International AIDS conference in Melbourne in 2014 gave rise to a diverse set of cultural responses around HIV and AIDS, including my own practice-as-research performance installation,GL RY, in a public square throughout the conference. Using the concept of a hole as metaphor for transmission and transformation, it asked what histories, secrets, stigma, information, art, affects might slip through a small hole?MethodsIn 2016 the work had a new iteration in Belfast for the Outburst Queer Arts Festival. We worked closely with people living with HIV in Northern Ireland to find ways to convey their experiences safely in a public arena. It took up the challenge from 2014 where, working alongside long-time HIV activist and artist Kim Davis, it became clear that women are particularly marginalised in the public discourses and representations of HIV and AIDS. This resulted in a performance installation in a shopfront in Belfast city centre, focusing on the experience of women and asking for solidarity with women living with HIV through participation.ResultsThree new works on HIV and AIDS made in Belfast in November 2016 with collection of data including audience and participant feedback.DiscussionThe paper argues that art can intercede in powerful ways in public discourses, in modes that other forms of information and education cannot. In creating a sound archive based on interviews with people living with HIV, I suggest that this work could productively be used in therapeutic use in clinics and in HIV agencies and medical training.
P175 Vacuum therapy in ed: outcomes from a specialist vacuum clinic
Authors: Megarity Stephen , Dinsmore Wallace , Bell Laura , McCarty Emma 
Published: May 2024

IntroductionVacuum devices are a safe and inexpensive treatment for erectile dysfunction (ED) particularly when other treatments are not tolerated or contraindicated.MethodsChart review of patients attending specialist vacuum clinic over 2 year period was conducted. Data collected included outcomes with previous treatments and vacuum device.Results55 patients (median age of 65 years) were prescribed a vacuum device. The median time from initial assessment at ED clinic to prescription of the device was 18 months. The majority had significant underlying co-morbidities: 25/55 diabetes, 23/55 CVD, 3/55 prostate surgery, 2/55 stroke, 1/55 spinal injury and 1/55 MS. All patients received prior ED treatment with PDE5i inhibitor and/or intracavernosal alprostadil. With regards to PDE5i, 43/55 reported poor/no response, 1/55 failed to tolerate, and in 11 patients a PDE5i was contraindicated. All 55 patients were subsequently offered intracavernosal alprostadil injections however 17 declined. Of the 38 patients who accepted, 27 reported poor/no response, 7 discontinued due to pain and 4 enquired about alternative treatments. On initial assessment at specialist vacuum clinic 32 patients consented to physical demonstration and all achieved an erection suitable for penetration. 36/55 were discharged after their initial vacuum assessment with no re-referrals. Of the19 reviewed only 1 patient discontinued use of the device and 6 patients continued on additional ED treatments.DiscussionVacuum devices are a well-tolerated treatment option in those who fail or are deemed unsuitable for other treatments. To date, reported outcomes have been excellent with only 1 patient discontinuing use.
P179 Erectile dysfunction clinic: exploring drivers and barriers to seeking help
Authors: Megarity Stephen , Dinsmore Wallace , Bell Laura , McCarty Emma 
Published: May 2024

IntroductionErectile dysfunction (ED) may affect up to half of men in their lifetime. Barriers can prevent discussion of symptoms with their GP and on occasions they will present at GUM clinics. Understanding these barriers can be useful in assessing their experiences and expectations of treatment.MethodsAnonymous self-administered questionnaire issued to new patients attending ED clinic. The Sexual Health Inventory for Men (SHIM) score used to classify ED severity.Results75 patients with median age of 52 years (range 19–78 years) participated. 93% had significant co-morbidities or vascular risk factors. In regard to SHIM, 47% classified as severe ED, 16% moderate, 26% mild-moderate and 11% mild. Duration of ED prior to attendance was greater than 5 years in 53% of patients. 50% reported significant impact on quality of life and notably 40% had underlying depression and/or anxiety. Seeking treatment was important/very important in 96%. Relationship difficulties prompted 65% patients to seek help. Barriers to seeking treatment included embarrassment in 47% and lack of treatment awareness in 29%. Initial discussion about ED was prompted by the patient in 85%. Regarding support, 73% discussed the issue with their partner and 16% with a friend/relative. 7% self-sourced treatment prior to attendance. The majority of patients (88%) reported limited knowledge of ED with 77% suggesting patient information leaflets would be useful prior to clinic attendance.DiscussionPatients presenting with ED often delay seeking advice. Medical comorbidities, relationship difficulties and embarrassment are significant issues affecting patients which should be taken into consideration during consultations.
P181 Is promotion of blood donation in the GU clinic all in vein?
Authors: Wood Clare , Saxon Cara , Ahmad Sameena 
Published: May 2024

IntroductionIn the UK less than 3% of the population donate blood. The blood donation service faces a constant challenge of recruiting new donors and stocks remain at critically low levels.The histories we take in genitourinary (GU) clinics match closely with screening questions asked by the donation service and we wanted to explore whether there would be any value in utilising this similarity in promoting blood donation to our often young and otherwise healthy patient population.MethodsWe conducted a prospective review of 100 consecutive patients seen during clinic, adding one extra question (regarding recent travel) to our usual history proforma to match the screening questions.ResultsOf the 100 patients 25 (25%) would never be able to donate blood (18 sexually active men who have sex with men (including 4 with HIV), 6 with precluding health conditions, 1 ex-intravenous drug user). There were 13 (13%) not eligible to donate blood for up to 12 months (9 ‘high risk’ sexual contact in last 12 months, 2 travel related, 1 pregnant, 1 on PEP post needlestick). Of these and the remaining eligible patients (62%), only 18 (24%) have donated (or attempted donation) previously.DiscussionWe may not think of a GU clinic as a location to identify blood donors, however we found that 75% of the patients seen were potentially eligible. No additional time was needed to identify potential donors and only a brief intervention or posters in the clinic could be used to promote or signpost blood donation.
P185 Sex & relationships education (SRE): focusing on the positives
Authors: Pak Sea Ming 
Published: May 2024

IntroductionWith the focus of SRE mainly unwanted pregnancies and STIs, due to the growing statistics, is that enough to educate and empower young people (YP) to help reduce them, or should we focus on the positives, like sexual pleasure and what sex actually is, to really engage young people and motivate behaviour change? In 2014, while working for a sexual health charity in West London, a College student approached the mobile sexual health clinic that I partnered with to encourage young people to STI test. He concluded that SRE was too ‘negative’ and just about STIs and unwanted pregnancies and so I invited him to help me develop a resource that makes SRE more ‘positive’. Preceding that incident, ‘Talking to Young People about sexual pleasure’ training facilitated by Sussex University Researcher, Ester McGeeney (EM), was attended.MethodsIn partnership with the student and EM, we put together a questionnaire to gather qualitative research to find out what YP want from SRE and what they understood about good and bed sex. From July 2014 – Dec 2015, 297 young people (148 females, 148 males, 2 unknown) were interviewed anonymously at 14 locations (6 × YP Hostels; 4 × Youth Centres; 2 × YP Charities; 3 × Colleges) with the majority of those YP residing in West London (60%; 25% from South; 2% from North; 5% from East London and 8% unknown). The majority of the participants were BME (56% Black; 5% Asian; 23% Other) with 12% from a White background and 4% unknown.ResultsThe top 4 topics that the YP wanted to know about, are already on the curriculum – Relationships (13%); Safe sex, condom use & negotiation (12%); STIs (12%); Being ready for sex/Consent (10%). However, the topics of Pleasure (7%) and the act of sex (8%) weren’t far behind. The top 6 answers on what the YP understood what good sex was included Pleasure/Satisfaction (23%); Having a connexion (13%); Feeling/Being in Love (11%), Safe sex (10%); Mutual Feelings (9%); Passionate (8%). The top 5 answers on what YP understood what bad sex was, included Rape (18%), Mechanical/No feelings/Just for pleasure (15%); Unsatisfying/Incompatible/Disappointing (14%); Too quick/Premature Ejaculation (11%); Unprotected sex.DiscussionThis shows that if YP know that good sex is about pleasure and having a connexion with someone, and bad sex involves no consent, no pleasure and no feelings, then surely we need to be adding more about sexual pleasure and how this relates to healthy relationships and consenting to sex, to SRE?
P189 Reflections on school sex education from young adults: a survey via social media
Authors: Powell Bethan , Barber Tristan 
Published: May 2024

IntroductionWith inconsistency of sexual education in schools, we used social media to ascertain opinions from a group aged 18-25 in the UK.MethodsA short survey of four questions was distributed via Facebook to immediate contacts to the primary author. 91 anonymous responses received (demographics not available).Questions were• Which topics were covered in your sex education during your time in school?• When do you think it is appropriate to begin sex education?• Which areas of sexual education would you like to see improved?• Is there anything that you wish you had been told during your sexual education?The first two were multiple choice; second two were free text.For analysis, ‘sex education’ was used as an umbrella term for education relating to sex (anatomy and practice), relationships, gender and sexuality. Responses for questions 3 and 4 were combined as they generated similar results.ResultsQuestion 1:Abstract P189 Table 1TopicsResponsesTopicsResponsesAnatomy of sex81(89%)Consent and rape26(29%)STDs79(87%)Sexuality14(15%)Safe sex77(85%)Sexual harassment11(12%)Female contraception58(64%)Gender identity3(3%)Drugs and alcohol58(64%)Non-heterosexual intercourse2(2%)63/91 (69%) believed sexual education should begin during primary school. 31/91 (34%) wished that consent had been covered better, often combined with the implication that this lack of education had affected their personal life.DiscussionWhile not without limitations, our short survey gave some interesting results worthy of further exploration, suggesting that UK sexual education needs reform before it meets the needs of modern young people.