bluuebunny/crossref_metadata_2025_split huggingface dataset:
P186 The usefulness of diagnostic genital skin biopsies in genito urinary clinical settings
Authors: Patrick Helen , Jayasekara Niroshan , Fitzpatrick Colin , Finnerty Fionnuala , Wijerathna I , Murdock Rebecca , Richardson Daniel 
Published: May 2024

IntroductionIt can be difficult to ascertain the exact aetiology of genital dermatoses as there are a several causative factors including inflammatory, neoplastic & infective. Genital skin biopsy can be a useful tool to provide definitive diagnosis.MethodsWe reviewed the electronic patient records of patients diagnosed with genital dermatoses in our clinic over a six month period. We compared clinical diagnoses with final histological diagnoses.ResultsA total of 56 patients were given a clinical diagnosis of genital dermatosis during the study period – Lichen Planus (8), Lichen Sclerosus (27), Seborrheoic Keratosis (1), Psoriasis (5), Zoon’s Balanitis (7), malignancy (3) and atypical lesions (5). Of these, 32 (57%) underwent a genital biopsy (see table one). Clinical and histological diagnosis correlated in 21 cases (66%). No additional malignant lesions were found following biopsy.DiscussionIn our clinic, correlation between clinical and histological diagnosis of genital dermatoses was good and no additional malignancies were found over and above clinical suspicion. 32 patients (57%) of patients seen with genital dermatoses underwent a genital skin biopsy.Abstract P186 Table 1Genital DermatosesClinical DiagnosisNumberNumber BiopsiedClinical Diagnosis ConfirmedLichen Planus80503Lichen Sclerosus271308Sebhorreic Keratosis010101Psoriasis050403Zoon’s Balanitis070504Malignancy030301other050101
O23 Impact of service relocation on neisseria gonorrhoeae culture sensitivities
Authors: Wallace Harriet , T Coates Marshall , Inns Helen , Wilson Janet , Page Emma 
Published: May 2024

IntroductionOur hospital-based GUM clinicNeisseria gonorrhoeae(NG) cultures were directly plated, stored in a CO2-enriched incubator and portered twice daily to onsite microbiology. Service relocation in November 2015 to a citycentre hub and 4 community sites forced change due to distance from microbiology. Community samples are taken on charcoal swabs, taxied to the hub at close of clinic for plating. Hub samples are directly plated. All plates are incubated 48–72hrs and transported daily in CO2-enriched environment (not temperature controlled).Aims/objectivesEvaluate sensitivity for NG culture against positive NAAT before and after service relocation.MethodsCases of NAAT positive NG with a culture taken January–June 2015 were compared with cases January–June 2016. Hub and community results were merged in 2016 due to small numbers from community.ResultsOverall sensitivity per infected patient (any positive NAAT and culture from any site) 2016 176/253 (70%) versus 2015 218/279 (78%), OR 0.64 (95% CI 0.43–0.94), p=0.02. Total sites with positive NAAT and associated culture processed: 2015 n=375, 2016 n=333.Culture sensitivity by site of positive NAAT 2016 versus 2015: Urogenital 78% versus 85% (OR 0.63(0.37–1.08);p=0.09), Rectal 39% versus 55% (OR 0.52(0.29–0.94);p=0.03), Pharynx 33% versus 51% (OR 0.49(0.25–0.96);p=0.04).DiscussionDespite extensive review of evidence to identify systems that would maintain NG culture sensitivity, the overall sensitivity of NG culture has dropped significantly since the community move. There has been a non-significant decline in urogenital culture sensitivity but significant reductions in rectal and pharyngeal sensitivities. A new method for NG transportation is now under consideration.
P190 Genitourinary medicine: more than just sti screening and treatment
Authors: Priestley Cecilia , Scofield Sara 
Published: May 2024

IntroductionSince the transfer of commissioning, some local authorities have taken a narrow view of sexual health, defining it as STIs and contraception only, and some have not funded the complex non-STI genital conditions that are a core part of GUM. However patients attend because they have a problem, which may or may not be an STI, that affects their sexual health. We aimed to give a snapshot of a GUM consultant’s clinical caseload.MethodsA record was kept of all GUM patient consultations over a 2 week period.ResultsA total of 43 patients were seen. All but one were follow-ups. Nine (21%) were long-term attenders. The rest were referred by other clinic staff 20 (47%), consultants in other specialties 10 (23%) and GPs 4 (9%). The average age was 41 (19–87).The commonest conditions seen were genital dermatoses (20), chronic/recurrent PID (13), recurrent candida (9; two with resistant species), VIN (6), atrophic vulvo-vaginitis (6), vulvodynia (5), and CPPS (4). STIs included HSV (3), chlamydial PID (3) SARA (1) and conjunctivitis (1), and an MSM with syphilis, rectal gonorrhoea and warts.Nine patients had more than one genital infection and nine both a genital infection and a genital dermatosis.DiscussionThis snapshot demonstrates both the complexity of patients and the holistic care provided by a GUM consultant. While other specialties are able to manage some of the conditions seen in GUM, few would have the expertise to manage patients with co-existing STIs and other genital infections, chronic pain conditions and genital dermatoses.
P195 How prepared are gum and hiv clinics in london to respond to the hepatitis a outbreak? a survey of vaccination policy and logistics
Authors: Brook Gary , Mindlin Miranda , Menon-Johansson Anatole 
Published: May 2024

IntroductionFrom late 2016, Hepatitis A virus (HAV) infection in MSM increased in incidence in the UK and has reached outbreak status. By February 2017, 42 confirmed or suspected cases had been reported in London. An outbreak committee was convened by Public Health England and as part of this work data was gathered to ascertain current levels of vaccination and future needs in MSM attending GUM/HIV clinics.MethodsClinical leads for GUM and HIV services in London were e-mailed a survey asking about past HAV vaccination policy, requirements for vaccine, logistics of vaccine provision, acute HAV infection reporting and contact tracing policy.Results14/17 (82%) NHS Trusts, representing 23 clinics responded to the survey.Abstract P195 Table 1HAV Vaccination Provision for MSM in GUM and HIV clinics in LondonNever stopped in GUMStopped in GUM in last 2 yearsStopped in GUM in last 2–10 yearsStopped in GUM >10 years ago3/23 (13%)6/23 (26%)7/23 (30%)7/23 (30%)Offered to all HIV+ patientsOffered to selected HIV+ patients only20/23 (87%)3/23 (13%)4/23 (17%) GUM clinics restarted routine vaccination in 2017. Only 3 HIV clinics were able to estimate background HAV immunity in their MSM as being 70–90% immune/vaccinated. The barriers to roll out of vaccination were identified as cost/funding (17/23 74%); logistics of provision (11/23 48%) and vaccine supply difficulties (7/23 30%). All clinics would contact trace acute HAV cases internally, 6/23 (23%) would notify the Health Protection Team by phone and the rest would notify using the BASHH/PHE notification form.DiscussionThe provision of HAV vaccination for MSM in London GUM clinics has been variable, leading to a significant proportion of MSM potentially remaining non-immune. The main barriers to vaccination have been funding, logistics and vaccine supply. If the outbreak is to be halted, these barriers need to be overcome.
P198 Chemsex and antiretroviral therapy non-adherence in HIV-positive men who have sex with men: a systematic review
Authors: Perera Sean , Bourne Adam H , Thomas Sara 
Published: May 2024

IntroductionChemsex is associated with ART non-adherence and may therefore negatively influence HIV disease progression. However, there is no systematic examination of evidence for this association. Our objective was to summarise the extent of ART non-adherence among chemsex drug-using HIV-positive MSM worldwide and to quantify the effect that chemsex has on ART non-adherence by comparing chemsex drug-users to non-chemsex drug-users.MethodsPubmed and Embase were searched from inception to 25.06.15. Prevalence and analytical studies were included. Bias was assessed using a risk-of-bias assessment tool. Assessment of heterogeneity was conducted using I2 and Cochran-Q Chi2 statistics. Metaanalyses were conducted using fixed or random-effects methods. Metaregression assessed for formal statistical evidence of heterogeneity.Results3288 published and unpublished records were screened. Prevalence of ART non-adherence among chemsex drug-users (10 studies) ranged from 6% to 81%. 7 studies provided 10 effect measures for the association between chemsex drug-use and ART non-adherence. Chemsex drug-users had 23% higher odds of being ART non-adherent compared with non-chemsex drug-users (OR 1.23, 95%CI 1.10–1.38, I2 0%, p=0.372). Studies that used less specific definitions of chemsex drug-use found weak statistical evidence for an association (OR 1.96, 95%CI 0.52–7.31, I2 78.9%, p=0.009). Meta-regression failed to provide statistical evidence of why the effect varied between studies.DiscussionIn HIV-positive MSM, the prevalence of ART non-adherence among chemsex drug-users varied widely. There was evidence of an association between chemsex drug-use and ART non-adherence. Paucity of studies and substantial heterogeneity between studies limited interpretation of results. Further well-conducted studies in a variety of settings are needed.
P199 Are we testing in the right locations? use of public health mapping to investigate young people, chlamydia and socioeconomic status
Authors: Cousins Darren , Jefferies Grace , Gibbon Rhys , Fina Laia , Philips Amy , Thomas Daniel 
Published: May 2024

IntroductionChlamydia testing is universal and routine in all local sexual health clinics. Projected local population increases and expansion of the university sector necessitate the appraisal of current services and future planning to meet population need.ObjectiveTo investigate whether the current locations of Chlamydia testing services match areas of high need.MethodWe obtained data from the Sexual Health in Wales Surveillance Scheme (SWS) on Chlamydia diagnoses in integrated sexual health clinics by middle super output area (MSOA) of residence for patients living in our local area. Mapping software is used to overlay Chlamydia testing behaviour and positivity against locations of FE colleges, STI testing clinics, areas of high deprivation and areas with a high proportion of young residents.ResultsBetween 2012 and 2016, 3,450 chlamydia diagnoses were recorded in Cardiff and Vale residents. The maps suggest that Chlamydia diagnoses were most common in areas usually habited by students. Furthermore, mapping fifths of deprivation suggested lower rates of Chlamydia in the more deprived areas, despite more testing venues.DiscussionThe maps suggest University students are frequent testers and have a high positivity for Chlamydia whereas those from more deprived areas have lower rates for Chlamydia. This descriptive analysis suggests that local chlamydia testing services may not be mapped to populations at greatest need. This association is difficult to measure without a robust statistical test and more analysis is needed to quantify the association. Alternative testing paradigms outside clinic settings could help manage demand on clinical services.
P203 The ‘lexicon of love’: understanding types of relationships as primary contexts of STI transmission
Authors: Pothoulaki Maria , Vojt Gabriele , Mapp Fiona , Woode-Owusu Melvina , Flowers Paul , Estcourt Claudia , Mercer Cath , Saunders John , Wayal Sonali , Cassell Jackie , Nandwani Rak , Symonds Merle 
Published: May 2024

IntroductionSocial contextual factors are often not taken into account when examining STI transmission. Understanding relationship types is central to targeting sexual health services, such as partner notification. This study examines the public’s understandings of the language used to describe different types of partners and sexual relationships.MethodsA qualitative study, involving six focus groups was conducted in Scotland and England. Purposive sampling recruited 38 participants, including young heterosexuals (n=22) and gay men and other men who have sex with men (n=16). A semi-structured topic guide was used to facilitate the discussion, which included interactive tasks. An integrative thematic analytic approach was adopted by synthesising both textual data and the data derived from the interactive tasks.ResultsFindings highlighted the diverse ways that relationships are understood and the fluid nature of partner types. Themes illustrated the importance of a range of contextual factors such as the variable nature of sexual relationships and key differences in their affective elements, the importance of peer context, social identities and developmental trajectories and the role of online communication in developing and shaping sexual networks and partnership formation.DiscussionSocial identities and people’s historical and geographic context ‘shape’ the way people talk about relationships. Fluidity and contextualisation are two key elements to be taken into consideration in understanding the language and terms used to describe relationships. From a public health perspective, understanding relationship types can unveil pathways to understand transmission patterns of STIs and provide more effective sexual health services.
O25 ‘Side chicks’, and ‘side dicks’: understanding typologies and drivers of concurrent partnerships to prevent sti transmission among people of black caribbean ethnicity in england
Authors: Wayal Sonali , Mercer Catherine , L. Gilbart Victoria , Garnett Emma , J. Sutcliffe Lorna , Weatherburn Peter , Hughes Gwenda 
Published: May 2024

IntroductionIn Britain, STI diagnoses rates and concurrent partnerships are higher among black Caribbeans than other ethnic groups. Concurrency (having sexual partnerships overlapping in time), especially when condoms are not used, can enhance STI transmission probabilities. We sought to understand concurrency typologies and drivers among black Caribbeans in England.Methods52 black Caribbeans (n=20 men) aged 15–70 years were recruited from community settings and STI clinics. 4 audio-recorded focus group discussions (n=28 participants) and in-depth interviews (n=24) were conducted from June 2014–December 2015. Transcribed data were thematically analysed to identify concurrency typologies and reasons.ResultsOpen, situational, and experimental concurrent partnerships were described. Open concurrent partnerships involved having a main partner and additionally men and women having sex with ‘side chicks’/‘thots’and‘side dicks’, respectively. Situational partnerships involved sex with an ex-partner, especially their child’s parent, while also having another partner. These partnerships were usually long-term, and condomless sex was common due to emotional attachment, to ‘entice’the ex-partner back, or because the relationship was founded on sexual pleasure. Experimental partnerships, common among single participants who were unsure about the type of partner to settle down with, were usually short-term and mostly involved condom use. Concurrency was perceived to be normalised in black Caribbean popular music, on social media, and fuelled by ease of ‘ordering sex via app’.DiscussionUnderstanding of different types of concurrent partnerships experienced by black Caribbeans during clinic consultations can increase the likelihood of effective partner notification. Interventions addressing normative drivers of concurrency are also needed.
P209 What makes expedited partner therapy (EPT) and accelerated partner therapy (APT) work for partner notification for bacterial stis? a systematic review of interventions
Authors: Mapp Fiona , Pothoulaki Maria , Vojt Gabriele , Estcourt Claudia , Wayal Sonali , Cassell Jackie , Kanwar Tavishi , Patel Krish , Flowers Paul , Copas Andrew , Johnson Anne , Low Nicola , Mercer Cath , Roberts Tracy , Saunders John , Symonds Merle 
Published: May 2024

IntroductionExpedited Partner Therapy (EPT) treats the sex partners of persons with STIs without prior clinical evaluation. These interventions have been shown to reduce rates of re-infection and treat a higher proportion of sex partners. EPT which includes remote medical assessment of sexual partners is known as Accelerated Partner Therapy (APT) and meets UK prescribing guidance. Understanding the sequential active behaviour change components of such partner notification (PN) interventions and their use of theory, enables their optimisation and translation to the UK health context.MethodsWe searched eight databases for studies detailing EPT and APT interventions for STIs implemented in high-income countries which included process and outcome data. Abstracts were screened and full-text articles analysed. Data were extracted relating to population, context, intervention components and associated behaviour change techniques (BCTs).ResultsWe included 15 of 723 studies covering interventions implemented between 1996–2013 in the UK and USA. EPT interventions are composed of complex sequences of diverse components, representing heterogeneous ‘relay’ behaviour change interventions. They involve diverse behavioural targets and target populations (index patient, partners, healthcare professionals). However they employ a broadly consistent range of behaviour change techniques including: ‘how to perform a behaviour’ and ‘information about health consequences.’DiscussionEPT interventions are atheoretical, developed in response to patient and provider needs. Systematically identifying the key behaviour components and processes involved in EPT/APT may help explain intervention effectiveness. Developing an explicit theoretical framework using identified BCTs will help in training healthcare professionals to deliver EPT/APT, improving generalisability of interventions and PN outcomes.
P220 Child sexual exploitation and the association with sexually transmitted infections in under 16 year olds attending genitourinary medicine clinics
Authors: Ward Chris , Hughes Gwenda , Mitchell Holly , Rogstad Karen 
Published: May 2024

IntroductionChild sexual exploitation (CSE) can be difficult to identify, with few clinical symptoms or signs. There is limited evidence that markers such as sexually transmitted infections (STIs) are predictors of CSE. We present updated data and analysis from a study investigating the relationship between STI presentation at sexual health clinics (SHCs) and CSE.MethodsSHCs with >18 STI diagnoses in 13–15 year-olds in 2012 were identified using the genitourinary medicine clinic activity dataset (GUMCAD). Cases with confirmed bacterial or protozoal STIs were matched by age, gender and clinic with non-STI controls. Lead clinicians were asked to complete an online questionnaire on CSE-related risk factors irrespective of STI presence. Associations between STI outcome and CSE-related risk factors were analysed using conditional logistic regression.ResultsData was provided on 466 13-15 year-olds; 414 (88.8%) were female. 340 (80.0%) were aged 15, 108 (23.2%) 14 and 18 (3.9%) 13. In matched univariate analysis, an STI diagnosis was significantly associated with ‘highly-likely/confirmed’ CSE (OR 3.87, p=0.017) and safeguarding concerns (OR 1.94, p=0.022). A weak association between STI diagnosis and ‘highly-likely/confirmed’ CSE persisted after adjustment for partner numbers and prior clinic attendance (OR 3.85, p=0.053).DiscussionPresentation with bacterial or protozoal STIs by 13–15 year-olds at SHCs may be considered a potential marker for CSE. It would be prudent to consider CSE, in depth assessment and potential referral for any under 16 year-old presenting with an STI.
P223 Impact of national chlamydia screening programme in children aged <16 years attending a sexual health clinic: 10 years later
Authors: Kawsar Mohanarathi , Kakowa Memory 
Published: May 2024

IntroductionThe objectives of this study were to compare the rates of sexually transmitted infections (STIs) and the uptake of chlamydia test in a Level 3 sexual health clinic during pre and post National chlamydia screening programme (NCSP) periods. The programme has also included children aged <16 years if they are found to be Fraser competent.MethodsThe study period1stSeptember 2002 – 31stAugust 2016. Data were collected retrospectively from the Lilie Sexual Health Management System.ResultsTotal of 894 (N=894) children were studied; of whom 80% were girls. Age range was 13-15 years. Demographic details were similar in pre and post- NSCP periods.Abstract P223 Table 1STI and testing ratesOverall STI rateChlamydia rateTest UptakePre-NSCP2003&2004 (n=160)19%6%46%Introduction of NSCP locally in 2004Post- NSCP2005&2006 (n=155)23%13%59%2007&2008 (n=156)21%15%60%Level 2 young people sexual health service was introduced in 20082009&2010 (n=140), 5 years later14%7%64%2011&2012 (n=107)8%4%66%2013&2014(n=94)12%8%66%2015&2016 (n=82), 10 years later9%3%67%DiscussionThe rate of genital chlamydia infections had peaked during the immediate post- NSCP period. This is probably related to increased uptake of chlamydia test using the less invasive method. However, the overall trend has shown some reduction in both chlamydia and other STI rates in children aged 13-15 years attending our clinic for the past eight years. The reduction might have been contributed by NSCP in addition to changes in the sexual health services locally.
P225 Do commuters have time for safe sex? delivering an outreach quick check STI & contraception service to london commuters
Authors: Brown Mary , Mastin Jo Ann , Curnock Pauline , Apea Vanessa 
Published: May 2024

IntroductionSexual health services are under growing pressure to provide resource efficient STI screening and contraception services. At the same time busy people are seeking time efficient, convenient services to fit in with busy working lifestyles. By establishing an asymptomatic screening and contraception service in a well-known brand pharmacy at a busy mainline London railway station we hoped to meet both these needs.Two weekly outreach sessions are provided by an Independent Nurse Prescriber covering both a lunchtime (12–4) and evening (4–8) session on different days. Appointments are booked online with minimal walk-in availability. Prescriptions are issued via FP10’s and collected from the pharmacy.MethodsOf 1425 attendances in a one year period a retrospective case note review was done for a 3 month period July – Sept 2016 (329 attendances).ResultsOf these 329 patients 75% (248) women and 25% (81) men, of whom 3 MSM. Age range 18–51 (mean age 27yrs) 51% (169) new patients, 187 asymptomatic screens done (1% positivity CT). 147 contraception issued (72% COCP, 21% POP, 5.4%, VR, 1.3% Patch), New contraception 15% (22/147), Maintain 78% (114) Change method 6.8% (10). 26 patients required EHC.DiscussionThere is a high attendance and low DNA rate demonstrating this is a well-used, well positioned timely clinic to meet the needs of a busy commuter population. With more women expressing difficulty getting GP appointments for routine contraception more sessions like this would be appealing for the working population. The service is cost-efficient with low staffing and overheads.