Background/introduction Female sex workers (FSWs) are often considered as a vector for HIV and other sexually transmitted infections entering the general communities. Aim(s)/objectives This study investigated the effectiveness of a resilience-promoting intervention that targets at psychological well-being to facilitate adaptation and safe sexual practices among FSWs which could be an innovative strategy in controlling the spread of these infections. Methods Using resilience framework, this intervention consisted of six-weekly sessions focused on awareness, expression and management of emotions, identifying roles and personal strengths, and effective problem-solving skills. The primary outcome of resilience and reduction of sexual risk behaviour were assessed at baseline, post-intervention and 3-month follow-ups through self-administered questionnaires. Difference of the differences between the two groups and intention-to-treat analysis were adopted in the analysis. Results 127 FSWs were recruited and randomly assigned to the intervention or usual care (control) groups in a multi-centred randomised controlled trial. There were significant differences on the score on resilience, self-esteem and general mental health status between the two groups at post-intervention and 3-month follow-ups. The rate of condom use improved with time but significant difference between groups was only observed at 3-month follow-ups. Regression models showed that, after controlling for marital status and family size, intervention group assignment (OR = 2.95, 95% CI: 1.19-7.35) and self-efficacy (t = 2.48, p < 0.05) was significantly associated with improved resilience scores. Discussion/conclusion The results suggest that the programme was effective in promoting resilience, self-esteem and the mental health status but with less obvious effect on sexual health among FSWs in Hong Kong. Background/introduction BHIVA/BASHH have published guidelines with auditable outcomes for initiation of PEPSE and follow up. Some UK centres have, however, reported missing these targets. Aim(s)/objectives To explore the patient journey from initiation of PEP to completion of follow-up and to identify areas for improvement within our service in supporting patients to take PEP. Methods Each patient commencing or continuing PEP at our clinic between December 2013 and June 2014 was asked to take part in a survey regarding their experience with PEP. The survey included questions about adherence (motivations and barriers), clinic experience and follow up. Results 31 patients took PEP during the study period, 26 patients participated in the study. Reasons for PEP included occupational exposure (n = 6), sexual assault (n = 9), and consensual sex (n = 11). 4 patients (15.3%) reported not completing the 28 day course of PEP. 9 (34.6%) and 8 patients (30.7%) reported late and missing doses respectively. 88.4% of patients experienced side effects from medication, only 43% of patients sought help for this. The most frequent motivation for completing PEP was "fear of H...
insight into the type of information patients most prefer to see in order to enhance patient experience. Aim(s)/objectives To conduct a patient survey of preferences for information provided in sexual health clinic waiting rooms. Methods 133 consecutive patients attending the integrated clinic were asked to complete a simple questionnaire covering the following areas: (1) how much attention is given to the information available; (2) Which types of information are most useful; (3) Preference for pictures, written text or a combination; (4) Importance of information that can be taken away. Results 53% looked at most of the information, 32% only read what looked interesting or relevant while 15% took little notice. Facts about STI's were the most useful (64%), followed by prevention messages (51%), contact details of other organisations/ services (49%), information about local/national campaigns (41%) and boards with specific themes (e.g. Valentine's day, Fresher's Week) (33%). 55% preferred a combination of pictures and text, 41% mainly text and 37% mainly pictures. 74% attached a high importance to information which could be taken away. Discussion/conclusion 85% of patients paid significant attention to the information presented in the waiting room. Patients found factual information about STI's to be most useful followed by prevention messages. There was a clear preference for messages that combined text with pictures. -2015-052126.196 Introduction Trichomonas vaginalis (TV) is the commonest curable STI worldwide. UK prevalence is comparatively lower but TV remains an important cause of genital symptoms. National guidelines recommend NAATs for TV testing due to their high sensitivity. Since 2012 we have utilised Gen-Probe APTIMA TV assays for symptomatic females, males with recurrent urethritis and contacts. Aims Assess the effectiveness of our current TV NAAT testing practice. Methods Retrospective casenote review of patients tested for TV in an inner city sexual health clinic between 01/01/14-31/03/14. Results 961 (882F, 79M) patients were included. Median age was 24 (range 15-67), 445 (46.3%) were White British. 6 (7.6%) of the men were MSM. 28 (2.9%) patients were TV NAAT positive (21F, 7M). 5 of them attended as TV contacts. 11 TVinfected females had positive microscopy. Comparing diagnostic modalities microscopy had inferior sensitivity (=0.524) but excellent specificity (=1) and NPV (=0.986). All TV-positive men were either symptomatic (4) or an asymptomatic contact (3). The TV-positive and TV-negative cohorts were compared: TV incidence was significantly associated with increasing age, Black Caribbean ethnicity and attending as a contact; concurrent STI diagnoses and evident symptoms were not. Conclusion Our data demonstrates the superior sensitivity of NAATs over microscopy. Extending screening to asymptomatic patients is not warranted. We continue to focus TV testing on known at-risk populations.
in clinical practice which are currently not covered by the European guidelines and these need to be reviewed to provide physicians with appropriate guidance. P127 SPECIAL INTEREST CLINIC: A NOVEL GENITOURINARY MEDICINE SERVICE INITIATIVE PROVIDING CONTINUITY OF CARE AND EDUCATIONAL OPPORTUNITIESVian Shafiq*, Jonathan Shaw, Ashish Sukthankar. Manchester Centre for Sexual Health, Manchester, UK 10.1136/sextrans-2015 Introduction External referral to dermatology and psychosexual services from genitourinary medicine (GUM) can cause delays in patient care. To counter this within our service an experienced consultant has established a Special Interest Clinic (SIC) reviewing dermatology, erectile dysfunction and complex GUM cases. Written educational feedback is offered to internal referrers. We reviewed the impact of SIC. Aims To evaluate the service offered by SIC. Methods Data was collated from randomly selected patient records who attended SIC between April 2012 and April 2013. Results A total of 100 records were reviewed. 67 patients were male, 25 of whom were MSM. Patients were ethnically diverse, White British (52) being the most common ethnicity. Median age was 33 years (range 19-70). 12 patients were HIV-infected. Internal referrals predominated (96) and average waiting time from referral was 6.2 weeks (range 0.14-28). Broadly stratifying referrals 40 patients were complex GUM, 35 psychosexual medicine, 25 dermatology. The most prevalent diagnoses were erectile dysfunction (23) and lichen sclerosus (9). 9 patients required skin biopsy, 8 of which were performed within SIC. Ongoing follow up was recommended to 60 patients, of which 43 (71.7%) were retained. 27 patients were discharged after first attendance. 77 referrers requested feedback, all received it. Conclusion Keeping patients within our service provided continuity of care. The availability of formal feedback increases educational opportunities for referrers. We recommend experienced clinicians consider establishing similar SICs in other services. A challenge services will encounter is the lack of specific SHHAPT coding for prevalent SIC diagnoses. P128 MEETING STANDARDS IN MANAGEMENT OF SEXUAL ASSAULT: ARE WE THERE YET?Sujeevani Munasinghe, Malaki Ramogi*, Noellette L'Esperance. Colchester Hospital University Foundation Trust, Essex, UK 10.1136/sextrans-2015-052126.171Background/introduction Effective management of victims of sexual assault is important to encourage people to report abuse and receive care. BASHH provide guidance on management of sexually assaulted patients. We reviewed case notes of 36 patients who were treated for sexual assault. Aim(s)/objectives. To identify demographic characteristics of sexually assaulted victims attending the clinic. . To understand how we meet the BASHH guidance (2011) in the management of sexual assaults. . To assess the usefulness of locally used template for cases of sexual assault Methods Case notes of 36 patients treated for sexual assault who attended the clinic from January 2013 to March 2014 were rev...
Results There were 408 (98 Gonorrhoea, 310 Chlamydia) detected infections in the 2012 period and 404 (121 Gonorrhoea, 283 Chlamydia) in 2014. Between 2012 and 2014, the rate of detected extra-genital Chlamydia/Gonorrhoea infections increased 4-fold from 18/408, 4.4% to 77/404 19% (P < 0.0001). The rise was seen in both pharyngeal (10/408, 2.45% vs 48/404, 11.8% P < 0.0001) and rectal infections (8/408, 2% vs 40/404, 9.9%, P < 0.0001). Significant rises were seen in MSM in rectal (5/408, 1.2% vs 28/404, 6.9% P < 0.0001) and pharyngeal infection (10/408, 2.5% vs 21/404, 5.2%, P = 0.02) and for women in rectal (3/408, 0.7% vs 12/404, 3% P < 0.02) and pharyngeal infection (0/408, 0% vs 20/404, 5%, P < 0.0001). In these patients, rates of extra-genital self-swabbing rose from 0% (0/24) to 58.5% (141/241), P < 0.0001. In separate samples of consecutive un-infected patients having extra-genital swabs, self-swabbing rose from 0% (0/100) to 90% (90/100) P < 0.0001. Conclusion The introduction of routine self -taken extra-genital swabs has led to a large rise in detected extra-genital Chlamydia and/or Gonorrhoea infection, especially for MSM and women. The rise in rates of extra-genital self-swabbing shows that this is acceptable and effective. Introduction BASHH, GMC, RCP and FSRH provide guidance stating that a chaperone should be offered for intimate examinations and the name of the chaperone should be documented. Record keeping is often found to be suboptimal in litigation. Our proformas have prompts for both offer and name of chaperone. Aim/objectives To audit our documentation of chaperone offer (including name) for intimate examinations. Methods 20% case notes for new episodes seen by doctors May-July 2014 were randomly selected and reviewed. Gender of doctor and patient were recorded. Results 208 case notes were examined. 114 patients were examined (61 not examined; 33 inadequate documentation). 96/114 (84.2%) had the offer of a chaperone documented; 18 (15.8%) did not. Of the 96 where the chaperone was documented as offered, 89 (93%) had the chaperone's name documented; 7 (7%) did not. In 64 cases, doctor and patient were the same gender, and in 50 cases they were opposite gender -chaperone offer was documented in 87.5% and 80% respectively (p = 0.278, student's 2 tailed t-test). Discussion Chaperones for intimate examinations reassure and protect both doctors and patients. With the GMC dealing with just under 30 allegations in 2014 recording of this is potentially pivotal. Despite prompts, only 78% had both offer and name documented. It was concerning that in 33 cases it was not clear as to whether or not an examination had occurred. The results ran counter to expectations with offer of a chaperone higher when patient and doctor were the same gender although this was non-significant. P134 CHAPERONES FOR INTIMATE EXAMINATIONS IN A GENITOURINARY MEDICINE CLINIC: AUDIT OF DOCUMENTATION
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