bluuebunny/crossref_metadata_2025_split huggingface dataset:
P228 Sexual & reproductive healthcare outcomes among those at risk of child sexual exploitation: a retrospective review
Authors: Cassidy Seán , Solomons Neylya , Herbert Sophie , Forsyth Sophie , Ramsden Sophie , West Richard , Forbes Kimberley 
Published: May 2024

IntroductionThe purpose of Multi-Agency Sexual Exploitation (MASE) panels is to consider cases of high risk victims and offenders in relation to Child Sexual Exploitation (CSE) and the criminal justice response to offenders. A multiagency approach should ensure young people (YP) are supported by appropriate services including SRH.MethodsA retrospective review of a selection of MASE cohorts from 2016 from three services across England was undertaken. The names of YP were cross-referenced with the SRH clinic system in the locality to determine if they had accessed the service. Information was collected on reason for attendance, sexual health screening, contraception and gravidity. Data was analysed using Excel.ResultsOf 92 young people discussed at MASE panel, 64 (69.6%) were known to SRH services. The age range was 12–19 years (median 16). Sixty (93.7%) were female. The most common reasons for attendance were request for contraception (35.9%), pregnancy testing (25%) and disclosure of sexual assault (10.9%).19 (29.7%) individuals had tested positive for chlamydia on at least one occasion (25 episodes in total). Fourteen pregnancies were reported with 8 resulting in termination.DiscussionRates of chlamydial infection and pregnancy were high among the MASE cohorts reviewed. The multi-agency response should provide an opportunity to address health needs of this vulnerable group. Interventions should be targeted accordingly including prioritising referral into SRH services into the care plans of those identified to be at risk of CSE.
P242 Laser ablation treatment for complex HPV-related disease in a gum clinic setting
Authors: Gundrum Karl , Rayment Michael , Jones Rachael 
Published: May 2024

IntroductionGUM specialist services to treat complex HPV-related diseases unresponsive to conventional therapies are limited. Laser vaporisation following local anaesthesia is an established treatment for refractory warts and intraepithelial neoplasia. Several service specifications have called for these treatments to be delivered and funded outside of Level 3 GUM clinics. A specialist Laser Clinic was established within our centre in 2015. A specially trained clinician reviews individuals. Where the diagnosis is unclear, biopsies are performed. CO2 laser vaporisation is instituted following application of local anaesthesia. Post-operative pain relief is provided and attendees are asked to follow a post-laser pain control algorithm. All attendees are asked to complete a feedback form.MethodsThe case notes and patient feedback of all attendees to the Laser Clinic were reviewed.Results155 unique patients have been seen since January 2015. 134 laser procedures have been performed with no evidence of recurrence or reinfection. Diagnosed cases of ano-genital intraepithelial neoplasia: PIN: 14, AIN: 24, VIN: 7 (45/134).100% of attendees rated the service as excellent or good, with 95% stating that their pain was controlled throughout the procedure.Discussion30% of attendees were found to have intraepithelial neoplasia. Encouraging patient feedback, high rates of pathology and positive post-operative outcomes with no evidence of recurrence demonstrate that laser therapy is a valuable treatment option, avoiding the need for onward referral, general anaesthetic and more costly procedures outside of the GUM setting. This service illustrates the importance of maintaining complex service delivery within the GUM setting.
P244 An audit of hepatitis c testing in a sexual health service
Authors: Chou Matthew , Obeyesekera Sharmin , Theodore Cecelia , Dhairyawan Rageshri 
Published: May 2024

IntroductionWith new effective treatments for hepatitis C (HCV), identifying cases is increasingly important. The BASHH Viral Hepatitis Guidelines (2015) recommend HCV screening in sexual health services for people at high-risk. We carried out a retrospective audit in our clinic.MethodsWe reviewed our patient records and laboratory database for HCV antibody (AB) tests between 1stJanuary 2015 – 30thJune 2016. The management of those HCV RNA positive was compared with the BASHH auditable standards (2015).ResultsFrom 56483 attendances, 12008 HCV AB tests were taken. 18/12008 cases were HCV AB positive of which 11 were also HCV RNA positive giving a prevalence of 0.09%. 8/11 newly diagnosed; 6/11 male; 6/11 Eastern European, 3 White British, 2 Asian; 4 co-infected with HIV. Genotypes were available for 6/11 and of these 4 had G1a, 1 had G1b and 1 had G3a. 11/11 had LFTs/AFP (target 90%) and all had hepatitis B tests (target >95%). 11/11 were referred for ongoing care within 2 months (target 100%). All had a written follow up plan (target 97%) and all had a documented discussion regarding the natural history and transmission of HCV, but only 2 (18%) had documentation that written information was also given (target >95%). All had partner notification (target 97%).DiscussionThe prevalence of HCV infection in our screened population was lower than we expected (0.09%) for an area with a large migrant population. Our service met all auditable standards in management except for documenting that written information had been given.
P014 Does separation of HIV and sexual health services affect the management of stis in people living with HIV?
Authors: Colver Helen , Ball Rhiannon , Dhar Jyoti 
Published: May 2024

IntroductionThe presence of a bacterial STI increases the risk of HIV transmission. It is important that people living with HIV have easy access to STI treatment and that partner notification is robust. In our local area, HIV care is located and commissioned separately from the sexual health service. Does this affect STI treatment and partner notification?MethodsAll HIV positive patients with a diagnosis of gonorrhoea, Chlamydia or new/infectious syphilis during 2015 were identified from laboratory results and computer records. Demographic details for each patient were recorded and the management of their STI assessed according to BASHH standards.Abstract P014 Table 1Impact of separation of HIV and sexual health servicesInfectionNumber of patientsMean interval between test and informing patient (days)Mean interval between informing patient and attendance for treatment (days)Mean number of partners attending within 4 weeks [BASHH standard]Gonorrhoea2414.64.50.375 [0.6]Chlamydia2313.34.80.348 [0.6]Syphilis1622.640.20.125 [0.4]ResultsDiscussionBarriers to timely treatment included difficulty contacting patients, need to travel to a different service to obtain medication and difficulty arranging appointments at acceptable times. Particular delays were noted in the management of syphilis. Clarification of each service’s responsibilities with regard to contact tracing could improve partner notification rates. Even when HIV and sexual health services are not jointly commissioned, it is essential that both departments work together to develop robust pathways for the management of STIs identified in people living with HIV.
P015 Receiving 1g azithromycin as part of mass drug administration (mda) for the control of trachoma is associated with reduced genital mycoplasma genitaliumprevalence
Authors: Harrison Mark , Harding-Esch Emma , Marks Michael , Pond Marcus , Butcher Robert , Solomon Anthony , Tan NgeeKeong , Nori Achyuta , Kako Henry , Mabey David , Sadiq STariq 
Published: May 2024

IntroductionMass Drug Administration (MDA) with 1g oral azithromycin for ocularChlamydia trachomatis(CT) infection, a key component of trachoma control, can concomitantly reduce genital CT prevalence. However, this dose is known to be sub-optimal for the treatment of genitalMycoplasma genitalium(MG) infection. Here we investigate factors associated with MG infection in pre- and post-MDA sample sets.MethodsPre-MDA (T1) and 6 months post-MDA (T2) CT-negative self-collected vulvo-vaginal swabs from women attending three outpatient antenatal clinics (Honiara, Solomon Islands), were tested for MG infection using nucleic acid amplification. Logistic regression was used to determine factors associated with infection. Variables tested included: patient age, clinic attended, ethnicity, time spent in education, living in an urban or rural environment, marital status, living with spouse, presence of symptoms associated with a sexually transmitted infection (STI), having an STI in the last 12 months, current CT, Gonorrhoea orTrichomonas vaginalisinfection, and at T2 only receipt of MDA dose.ResultsMG positivity was found in 11.9% (95%CI: 8.3–16.6; 28/236) of women at T1 and in 10.9% (95%CI: 7.7–15.4; 28/256) at T2 (p=0.7467). The only factor associated with having an MG infection was history of not having received MDA with azithromycin at T2 (odds ratio 0.19, 95%CI 0.07–0.53, p=0.001).DiscussionNot having MG infection was associated with receiving 1g azithromycin as part of MDA for trachoma control six months previously. However there was no overall drop in population prevalence, indicating individual but not population benefits of MDA with regard to MG infection control.
P020 Comparison of the aptima mycoplasma genitalium tma assay and the fasttrack diagnostics (FTD) urethritis basic assay for detection of M. genitalium in gum specimens
Authors: Cliff Penny , Vidican Cristina , Hassan-Ibrahim Mohammed , Ovens Katie , Wilson Andrea , White John , O’Shea Siobhan , Soni Suneeta 
Published: May 2024

IntroductionTesting forM. genitaliumin the UK is limited and detection has relied on realtime PCR assays. The Hologic AptimaMycoplasma genitaliumTMA assay for use on the Panther® system is now available. This study compared a commercial realtime PCR and the Aptima assay using stored clinical specimens.MethodsClinical specimens (76 urines, 33 vaginal swabs, 2 rectal swabs, 1 pooled sample and 2 unknowns) from men with urethritis and women with pelvic inflammatory disease were tested forM. genitaliumDNA using the FastTrack Diagnostics (FTD) Urethritis Basic assay. Residual specimen was then transferred to an Aptima urine tube and tested for the presence ofM. genitaliumribosomal RNA using the Aptima TMA assay.ResultsOf the 113 specimens tested, 24 (21%) were positive and 87 (77%) negative on both assays. There were two discrepant results (1.7%) in urine specimens that were positive on the Aptima TMA assay and negative on the FTD Urethritis assay. One was confirmed as positive by the Reference Laboratory using their in-house MgPa PCR, indicating a false negative result on the FTD Urethritis assay. The other discrepant result was low level positive on the Aptima TMA assay and negative at the Reference Laboratory.Discussion98% of samples gave concordant results, indicating that both assays are appropriate for use in clinical service. However, the additional positive detected by the Aptima assay, explained by detection of target in multiple copies in each bacterial cell, suggests that this assay is more sensitive.
P021 Mycoplasma genitalium- testing and treating in a level 2 primary care service
Authors: Gonah Tamuka , Scrivener Jodie , Gando Isata , Richardson Daniel 
Published: May 2024

IntroductionMycoplasma genitalium (MG) is an emerging sexually transmitted infection causing up to 20% cases of urethritis in men and is a cause of PID. Most UK centres do not have access to MG testing. Locally we use an algorithm for testing and management of MG in collaboration with our level 3 service screening men with urethritis and women with PID.MethodsWe reviewed the electronic Patient records of patients tested for MG from January 2016 to February 2017.Results66 patients were screened, all with genital symptoms. 35(53%) were male. 10/66(15.2%) patients tested positive for MG, 6(9.1%) males and 4(6.1%) females: median age was 34. The clinical symptoms were: 4/66(6.1%) -penile discharge, 4/66(6.1%)-long history of increased vaginal discharge, 1/66(1.5%)-haematospermia, 1/66(1.5%) penile sores. 8/10(80%) were treated with 1st-line treatment (extended course of Azithromycin) in our primary care service while 2/10(20%) were referred to Level 3 service for assessment and treatment. Partner notification was done and documented in 50% of the positive cases but interestingly none of the 10 patients attended for test-of-care as advised.DiscussionWe have shown that MG testing and treatment is feasible in a level 2 primary care setting in collaboration with level 3 services and that MG prevalence is high in symptomatic patients using this service.
P024 Reducing repeated chlamydia and gonorrhoea infections
Authors: Raffe Sonia , Patrick Helen , Murdock Rebecca , Power Jozette , Dean Gillian 
Published: May 2024

IntroductionThe role of Sexual Health Services (SHS) is not only to treat sexually transmitted infections (STIs) but also to reduce repeat infection through appropriate antimicrobials, health education and partner notification (PN). We reviewed the management of patients with repeat infections.MethodsA retrospective case-note review of patients attending the SHS with more than one episode of chlamydia and/or gonorrhoea, July 2015 – June 2016.Results156 patients were identified of which a random sample of 30 (20%) were reviewed. All were male; median age 29.5 (range 21-58). 70% (21) were MSM, 23% (7) heterosexual, 7% (2) bisexual. 30% (9) were HIV positive. Risk-factors for unsafe sex (e.g. substance misuse/sex-work/mental-health diagnosis) were noted in 77% (23). 77% (23) had 2 infective episodes; 23% (7) had 3 episodes. Of the 67 infective episodes all were treated appropriately; 40% (27) were treated the same day, 9% (6) within 1-week, 24% (16) within 2-weeks, and 22% (15) within 2–4 weeks. Patients reported 1–100 partners in the 6-months prior to review. 73% (48) saw a health advisor (HA); in the remaining 28% the most common reason for not seeing a HA was being managed in non-sexual health clinics e.g. PEP/HIV-research/general HIV. PN was undertaken in 82% (55) of episodes although only completed in 52% (35) largely due to untraceable partners.DiscussionFocusing on addressing risk factors for unsafe sex may facilitate a reduction in repeat STIs. While most patients were able to access HA support, referral pathways from non-SHS clinics need improving. PN remains challenging in the context of multiple casual partners and novel strategies such as electronic PN should be urgently explored.
P028 Characterising neisseria gonorrhoeae (NG) infections and treatment in a large, urban cohort
Authors: Rashid Taslima , Jayaratne Nirmitha , Taher Marjan , Barber Tristan , Nwokolo Nneka , Rayment Michael 
Published: May 2024

IntroductionBetter detection and more frequent testing may explain increases in NG. We wished to characterise patients attending our clinics with NG, and audit management against BASHH standards.Methods300 sequential NG patients attending in 2016 were reviewed. Data collected: demographics, NAAT/culture positivity (per site), antimicrobial treatment and resistance, and test of cure (TOC).ResultsMean age was 34 (17–65); 92% male; 75% white; 86% MSM. 415 site specific infections captured. Site distribution by NAAT, culture concordance/sensitivities, and TOC are presented below:Abstract P028 Table 1Gonorhoea infectionsSexualityCulture resultsTest of CureNAAT+ by SITEMSMHetero – MaleHetero – FemaleCultures takenCulture negativeCiprofloxacin resistanceTOC DoneTOC FailureVVSNANA7%(21/300)76%(16/21)19%(3/16)7.6%(1/13)76%(16/21)0%(0/16)Urethra42%(126/300)7%(21/300)NA90%(132/147)3.7%(5/132)33%(43/127)53%(78/147)2.6%(2/78)Pharynx37%(111/300)0.7%(2/300)1%(3/300)68%(79/116)51%(37/72)43%(18/42)66%(77/116)5.2%(4/77)Rectum43%(128/300)0.3%(1/300)0.7%(2/300)63%(83/131)12%(10/83)48%(35/73)65%(85/131)3.5%(3/85)75% NAAT+ patients (310/415) had cultures performed. There was one case of ciprofloxacin and azithromycin resistance (MSM). 96% (287/300) received ceftriaxone plus azithromycin. Reasons for alternatives related to penicillin allergy. Median time to treatment 0 days (0-45d). 63% (189/300) attended for TOC (median time: 21d (7-188d)) and 94% (177/189) patients tested negative. Failed TOC was due to reinfection in 92%.DiscussionOur clinics maintain reasonable adherence to BASHH standards. Cephalosporin resistance was not observed. TOC times can be lengthy.
P033 Improving clinical standards in GU medicine: a retrospective audit of neisseria gonorrhoeae
Authors: Young Sarah , Bopitiya Shyamalie , Allan Sris 
Published: May 2024

IntroductionWe present a retrospective analysis of clinic performance in the 5 domains of management and treatment of Neisseria gonorrhoeae (GC) according to current British Association of Sexual Health and HIV (BASHH) guidelines.MethodsAll cases of GC diagnosed at our clinic between 1stJanuary and 30thJune 2016 were identified. The case notes were reviewed and assessed against current BASHH criteria. This was compared with data from the same clinic for the same six months (1stJanuary to 30thJune) in 2007-2015.Results87% of patients treated for GC were recommended to have a test of cure (TOC) (61% had a TOC.). 100% of with GC were screened for Chlamydia trachomatis or received presumptive treatment for this. 88% of patients with GC had partner notification carried out. 56% of patient’s received written information about GC. 97% of patients with GC received 1stline treatment, or the reason for not doing so was documented.DiscussionWe have demonstrated consistent improvement in 2 of the 5 domains compared with previous years’ data. Recommending a test of cure, partner notification and offering patient information leaflets have decreased over the last year. To address this, teaching sessions were carried out and a quality improvement project to ensure patient information leaflets are offered is underway.Further staff training and awareness of management of N.gonorrhoeae will be addressed on a regular basis and a re-audit is recommended next year.
P039 User experience of online booking tool for larc appointments
Authors: Siddiqui Farzana , Horn Kate 
Published: May 2024

IntroductionTimely access to contraceptive counselling and increased use of LARCs is recognised as the key to avoid unintended pregnancy. In line with national SRH strategy, we aimed to improve access to LARC by supporting women to make informed choices and reducing barriers. The Sexual Health hub includes access to sexual health, well-being and contraception information, with positive promotion of LARCs, in one accessible site. Delivering pre-LARC counselling through online videos enables women to attend for a single focussed LARC fitting appointment.MethodsWe recorded a number of metrics to assess uptake and impact on service provision and surveyed users to assess acceptability.ResultsIn the first 5 months we saw:151% increase in visits to LARC self-help content and use of pre-consultation videos11% of available bookable appointments made online, the majority out of hours10% reduction in call volumes to servicesImproved patient experience and choice as evidenced through user surveyVery easy or easy to book an appointment online: 84%.Very easy or easy to find information and advice online: 92%Very likely or likely to recommend to a friend: 96%Very likely or likely to use the website again: 95%Positive free text commentsDiscussionOur experience to date shows this approach is well received by patients who appreciate the flexibility it offers in their busy lives. It has also delivered efficiencies in administrative time, releasing staff for other tasks. We are monitoring the impact on uptake of LARC and anticipate data will further support this approach.
P045 Vaginal infections and contraception – results of a patient questionnaire
Authors: Wallace Harriet , Ekong Nadia , Loftus-Keeling Michelle , Ross Jonathan , Armitage Catherine , Wilson Janet 
Published: May 2024

IntroductionBacterial vaginosis (BV) and candida are common problems among females using contraception. Associations between BV/candida and different contraception are described but not proven.Aim(s)/objectivesEstablish knowledge of BV/candida among contraceptive users. Assess whether future research on BV/candida and contraception would interest patients.MethodsSurveys were distributed to females at two sexual health clinics and a student General Practice by staff not seeing patients. Responses were anonymous. Questions included knowledge of BV/candida, existing contraception, future contraceptive choices related to BV/candida and importance of research findings.Results298 completed a survey; 157/298 attending for contraception (90% using/starting a method), 141/298 attending for other sexual health reasons/GP consultation. Of 157 contraception patients, 22% were <20yrs, 96% were <35yrs. Overall, 40% had heard of BV and 39% of candida but in <20yrs, 26% had heard of BV, 17% candida. 47% were interested in outcomes of further research between BV/candida and contraception (30% neutral, 17% not interested), rising to 56% in those who had heard of BV and/or candida. Similar results were seen in surveys from 141 females not attending for contraception (58% interested if heard of BV and/or candida). 81% stated they would definitely/probably change from a contraceptive if it was proven to increase the development of BV/candida, and they acquired the infection.DiscussionThere is patient interest in further research assessing associations between contraception and BV/candida, which would influence contraception choices. Patients preferred more knowledge on any links between contraceptive types and BV/candida rather than number of recurrences or persistence of symptoms.
P049 Evaluating the use of long-acting reversible contraceptives; what can be done to improve uptake?
Authors: Gorman Caitlin , Tensel Wesley 
Published: May 2024

IntroductionDespite an improvement in the rate of unplanned pregnancies in England, the problem persists, particularly in the teenage population, with a large proportion of these conceptions being attributed to contraceptive failure. The OCP and male condoms remain the most widely used contraceptives, which considering their dependence on user-compliance is worrying. Long-acting reversible contraceptives are an alternative with much lower failure rates, partially attributable to the removal of this concern.MethodsAn audit was carried out at Wellfield Medical Centre in Manchester, one of the areas with persistent high teenage pregnancy rates.ResultsA review of records highlighted that the OCP remained the most commonly prescribed contraceptive in women over the preceding year. LARC accounted for only 29% of the new prescriptions given to 15–24 year olds and 41% of under-35s, with LARC being favoured only in the older population.DiscussionThis was in keeping with the literature, which suggested that social norms and negative experiences of friends and family are accountable, along with a lack of education of LARC compared with other methods. These findings indicate that an improvement in the awareness of safety and efficacy of LARC is necessary, particularly in this young population. This should be initiated in a practice context, but the wider reach of social media may be required to ensure an adequate impact. The skill and ability of providers to counsel women on LARC needs to be addressed, as does an increase in time available for counselling and detailed recording of these discussions.