P137 The effect of a dedicated syphilis clinic on syphilis management outcomes

Abstract

Background Training for medical students in the UK now incorporates formalised training in sexual health and HIV. While research has assessed knowledge and skills in medical graduates around sexual history taking, this has been largely approached from a quantitative paradigm rather than students own experience It was decided by the author to carry out a qualitative study to inform content and delivery of the current sexual and HIV module. Aim To explore the experiences of fourth year medical students in their learning of sexual history taking. Methods Semi-structured interviews were undertaken with six fourth year medical students. Framework analysis was used to identify emerging categories and themes from the data. Results Four distinct categories were acknowledged: prior experience, classroom based learning, clinic based learning, and future confidence. Themes identified included patient and student embarrassment, acquisition of key phrases, the use of proformas and patient consent. Factors influencing the learning of sexual history taking were often interwoven and stemmed from both the classroom and clinical setting. One common expectation was that another healthcare professional would take over while being observed with a patient. The issue regarding confidence appeared to be intrinsically built up from the start of their overall training. Students recommended that classroom based scenarios should include non-genito-urinary medicine settings. Student confidence was improved by the recognition that classroom teaching matched the clinical consultations, with no preference to designation of the health care professional teaching. Conclusion Acknowledgement of the influences experienced by medical students while undertaking classroom and clinic based learning of sexual history taking provides useful guidance for future curriculum development. Background Hepatitis C is a major cause of liver disease, cirrhosis and liver cancer but is increasingly amenable to treatment. Sexual health services often have unique access to test patients within risk groups. Aim To assess the role of sexual health services in diagnosis and initial assessment of Hepatitis C (HCV). Method Patients diagnosed with HCV at a large inner city sexual health service from 1 July 2009 to 30 June 2011 were identified along with a control group of negative patients. Results 4430 HCV tests were performed on 3395 patients. 53 (1.56%) were HCV antibody positive of which 26 (49%) were PCR positive with a detectable viral load. Where genotyping was performed the majority were 3A (50%), 1A (22%) or 1B (22%). The most common reasons for testing were intravenous drug use (64%), men who have sex with men (15%) and sexual intercourse with a known IVDU (9%). 27 patients were referred to HCV services of which only 18 (67%) attended. The main reasons documented for testing within the control group were related to the patient's country of origin (32%), country of origin of a sexual partner (24%) or for men who have sex with men (19%). 34 countries were given as p...