ObjectivesThe 2008 UK National Guidelines for HIV testing recommended HIV testing should be offered to all general medical admissions aged 16–60 years in high prevalence areas, and that this should be evaluated to ensure this was effective in diagnosing previously undiagnosed HIV.MethodsHIV testing was introduced as a routine test for all patients admitted to the acute medical admissions unit, comparisons were made between the testing rates before, during and after this intervention.ResultsThe pilot was initiated in August 2009. Prior to the pilot the unit was carrying out 15 tests per month. However, when the pilot was introduced 82 tests were being carried out per month with a total of 10 new diagnoses since the start of the pilot. The proportion of patients tested versus those eligible for testing remained low varying between 6% and 22% month by month. 10 patients we found to be HIV positive with a prevalence of approximately 1%, 10 fold higher than the cut off for cost effectiveness used in the guidelines.ConclusionsOverall the pilot showed that HIV testing could be delivered without the use of extra resources and is acceptable to patients.
SUMMARY In a study of the sexual contacts of patients with primary and secondary syphilis, 65 of 127 (510o) contacts at risk developed syphilis. There was no significant difference between figures for homosexuals (48/98, 49%) and for heterosexuals (17/29, 58%). Our findings are similar to those of the prepenicillin era, but the question, Why are so few contacts infected? remains unanswered.
A questionnaire-based cross-sectional study was conducted in order to determine how frequently patients attending a genitourinary (GU) medicine clinic use the Internet to diagnose their own symptoms, and to assess the accuracy of their diagnosis. Out of 223 symptomatic patients attending a GU clinic, 101 (45.3%) looked up their symptoms on the Internet. The age difference between those who looked up their symptoms and those who did not was not statistically significant (P = 0.77). Twenty (19.8%) out of 101 patients diagnosed their own symptoms, and 14 (13.9%) patients made the correct diagnosis. Ninety-one (90.1%) patients used the Google((R)) search engine as the starting point for their search. Although the Internet plays an important role in providing health information, the variable quality of health information available limits its use as a diagnostic tool by patients.
We aimed to evaluate the acceptability of self-collected tampon samples for the screening of female sex workers for sexually transmitted infections. We recruited 65 sex workers, and 63 agreed to provide tampon samples. The tampon samples were processed by realtime polymerase chain reaction (PCR) targeting Neisseria gonorrhoeae and Chlamydia trachomatis. Urethral and endocervical swabs were also obtained from 61 of 63 participants and tested using culture (N. gonorrhoeae) and the BD ProbeTec strand displacement amplification (SDA) (C. trachomatis) assay. Tampon sampling was preferred by 95% of the women and all favoured being tested away from genitourinary medicine clinics; the most common reasons cited were avoidance of embarrassment (40%) and convenience (30%). Besides near-universal acceptability of tampon sampling, the tampon sampling-PCR approach described in this study appeared to have enhanced sensitivity compared with conventional testing, suggesting the possibility of a residual hidden burden of N. gonorrhoeae and/or C. trachomatis genital infections in UK female sex workers.
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