Objectives The aim of the study was to assess the impact of electronic checklists in enhancing sexually transmitted infection (STI) screening in routine HIV care. Methods This was a retrospective cohort study. In two HIV clinics, new STIs were recorded for three consecutive 12‐month periods between 2009 and 2012 in a cohort of 882 HIV‐infected patients. These three years coincided with the introduction of enhanced STI screening based on prompts within the electronic patient record (EPR) system. Results The number of diagnoses and the incidence of STIs more than doubled between 2010–2011 and 2011–2012 in both men who have sex with men (MSM) [from 18 of 115 (15%) to 42 of 132 (32%), a rise in STI incidence from 15.6 to 31.8/100 person‐years; P < 0.001] and heterosexual patients [from six of 716 (0.8%) to 19 of 749 (2.5%), a rise in STI incidence from 0.8 to 2.5/100 person‐years; P < 0.005]. The rise was significant in MSM for infections with chlamydia [from seven of 115 (6%) to 14 of 132 (11%), a rise in incidence from 6.0 to 10.6/100 person‐years; P < 0.05], gonorrhoea [from five of 115 (4%) to 12 of 132 (9%), a rise in STI incidence from 4.3 to 9.1/100 person‐years; P < 0.05] and early syphilis [from four of 115 (3%) to 13 of 132 (10%), a rise in incidence from 3.5 to 9.8/100 person‐years; P < 0.001], but not for hepatitis C virus (HCV) and Lymphogranuloma venereum (LGV) infections. The rise was significant in heterosexual patients for infection with chlamydia [from four of 716 (0.6%) to 13 of 749 (1.7%), a rise in incidence from 0.6 to 1.7/100 person‐years; P < 0.0001] but not for gonorrhoea, syphilis or Trichomonas vaginalis (TV). Conclusions These data show that implementing systematic, frequent and routine STI screening led to a large increase in detected STIs in this HIV‐infected cohort. This process is greatly enhanced by the use EPRs.
Background/introductionWe introduced HPV4 vaccination for younger MSM under 27 years into our sexual health services in 2012. We report on the attendance behaviour, clinical outcomes, completion rates and factors associated with vaccination completion in our cohort.Aims(1) To deliver 3 dose HPV4 vaccination to younger MSM. (2) To increase engagement and STI testing by younger MSM at integrated sexual health services.MethodsHPV4 vaccine was offered at Time 0, 2–4 and 6–12 months, with STI testing, clinic call/recall, alongside care and support as appropriate. We conducted a retrospective electronic case note (EPR) review of all eligible MSM at end 2015. Completion rates are censored at 1 year.Results893/930 (96%) offered vaccine accepted 1st dose.Abstract O026 Table 1HPV4 vaccination 3 dose completion within 1 year (2015 figures pro rata), STI testing and detection rates2013No. (%)2014No. (%)2015No. (%)STI screen/Total No. (%)STI +ve/Total No. (%)STI +ve/No. Tested (%)Dose 1239255399880/893(99)283/893(32)283/880(32)Dose 2187(78)194(76)243/324(75)556/658(84)77/658(12)77/556(14)Dose 3148(62)140(56)111/200(56)372/427(87)60/427(14)60/372(16)Factors associated with 3 doses in 1yrNo.s/Total (%)No.s/Total (%)p valueBOLD indicates higher completionAge<21yrs57/119 (48)>21yrs232/375 (62)p = 0.008HIV statusHIV -ve228/420 (54)HIV +ve61/74 (82)p = 0.0001Prior HPVYes41/57 (72)No248/438 (56)p = 0.03OrientationH*231/379 (61)Bis*38/77 (49)p = 0.02Ethnic Group WB*81/172 (47)WO*66/102 (65)p = 0.006Asian*65/98 (66)p = 0.003Black* 54/80 (68)p = 0.003*H = Homosexual, Bis = Bisexual, WB = white British, WO = white Other, Asian = All asian ethnicities, Black = All black ethnicities by UK Census Ethnicity categoriesDiscussion/conclusionWe observed 3 dose completion rates commensurate with outcomes expected from a catch up vaccination programme. Completion was associated with older age, HIV infection, prior known HPV infection, self-identifying homosexual men and non- white british ethnicities. We observed high rates of STI testing and infection in this cohort. Delivering HPV vaccination within sexual health care services is an effective engagement strategy for young MSM.
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