Pub Date : 2023-11-01DOI: 10.1136/spcare-2023-hunc.4
Amara Nwosu, Sarah Stanley, Marie-Claire Mulcahy, Rachel Morris, Stephen Mason, Amjad Fayoumi, Laura Chapman
Background
Grief is a natural process, in which many people will cope with help from their friends and family. However, many people will need professional help (Aoun, Breen, Howting, et al. PloS one. 2015;10(3):e0121101). Good bereavement care is important to ensure that people get the support they need when they are grieving (Pattison, White, Lone. J Intensive Care Soc. 2020; 1751143720928898). Digital tools can potentially provide support for bereaved people, however, this has not been extensively studied. In computer systems design, ‘use-cases’ describe individual event steps a user needs to navigate to complete an action or goal on a digital system (Clausen, Apel, Dorchain, et al. Energy Inform. 2018; 1(1):273–283). Well-designed use-cases can improve the efficacy and effectiveness of the developed system (Cockburn. Writing effective use cases. 2001). Use-cases for digital bereavement support have not been established, therefore, there is potential that their use could facilitate development of digital bereavement services.
Aims
We aim to develop ‘use-cases’ to describe the ‘event steps’ needed to design a digital service to provide three tiers of bereavement support, based on recommendations of the UK National Institute for Health and Care Excellence (NICE).
Methods
We will review national UK relevant policy on palliative care bereavement services, and we will conduct semi-structured interviews with key stakeholders, to inform the development of infographic ‘use-cases’, which will support future development of digital bereavement services.
Results
In the short term, this work will inform how palliative care services can best use existing digital systems to support bereavement care. In the medium to long term, this work will support the development, and evaluation, of new digital models of care, which will provide support for bereaved people.
Conclusion
This study will lead to the development of digital bereavement services. Future studies can utilise the ‘use case’ method to improve the evidence base for digital health studies in palliative care.
{"title":"O-04 Development of ‘use-cases’ for a digital palliative care bereavement service","authors":"Amara Nwosu, Sarah Stanley, Marie-Claire Mulcahy, Rachel Morris, Stephen Mason, Amjad Fayoumi, Laura Chapman","doi":"10.1136/spcare-2023-hunc.4","DOIUrl":"https://doi.org/10.1136/spcare-2023-hunc.4","url":null,"abstract":"<h3>Background</h3> Grief is a natural process, in which many people will cope with help from their friends and family. However, many people will need professional help (Aoun, Breen, Howting, et al. PloS one. 2015;10(3):e0121101). Good bereavement care is important to ensure that people get the support they need when they are grieving (Pattison, White, Lone. J Intensive Care Soc. 2020; 1751143720928898). Digital tools can potentially provide support for bereaved people, however, this has not been extensively studied. In computer systems design, ‘use-cases’ describe individual event steps a user needs to navigate to complete an action or goal on a digital system (Clausen, Apel, Dorchain, et al. Energy Inform. 2018; 1(1):273–283). Well-designed use-cases can improve the efficacy and effectiveness of the developed system (Cockburn. Writing effective use cases. 2001). Use-cases for digital bereavement support have not been established, therefore, there is potential that their use could facilitate development of digital bereavement services. <h3>Aims</h3> We aim to develop ‘use-cases’ to describe the ‘event steps’ needed to design a digital service to provide three tiers of bereavement support, based on recommendations of the UK National Institute for Health and Care Excellence (NICE). <h3>Methods</h3> We will review national UK relevant policy on palliative care bereavement services, and we will conduct semi-structured interviews with key stakeholders, to inform the development of infographic ‘use-cases’, which will support future development of digital bereavement services. <h3>Results</h3> In the short term, this work will inform how palliative care services can best use existing digital systems to support bereavement care. In the medium to long term, this work will support the development, and evaluation, of new digital models of care, which will provide support for bereaved people. <h3>Conclusion</h3> This study will lead to the development of digital bereavement services. Future studies can utilise the ‘use case’ method to improve the evidence base for digital health studies in palliative care.","PeriodicalId":19619,"journal":{"name":"Oral Presentations - Late-Breaking Proffered Abstracts","volume":"47 2","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135327578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-01DOI: 10.1136/spcare-2023-hunc.14
Christina Faull, Helen Cullinan, Jackie McBlain, Zoebia Islam, Vijay Umrao
Background
Our research has found that young people may have a pivotal role in helping their family navigate unfamiliar systems and many act as interpreters but often feel excluded from any discussion of the impact of serious illness and death in their family. People in diverse ethnic communities often have little understanding about palliative care and hospices and consequently experience inequity of access to services and outcomes in end of life.
Aims
We wanted to open up the conversation with young people about dying, including the concept of palliative care and what a hospice does.
Methods
Two hour workshops were conducted in partnership with a community youth worker and a visual artist. Recruitment focussed in areas of Leicester and Loughborough with low white British population density. Participants shared and developed visual representation of their thoughts in response to ‘why does dying matter to me?’
Findings
Forty-nine 13–25 year olds attended 9 workshops held in schools, the hospice and youth education project venues. The art they produced was of great diversity and focus including images of nature, fantasy, coffins, monuments, time and religion. Participants used vibrant colours to contrast with the black of death. Most students completed the evaluation form indicating they found the workshop useful and enjoyable. For some the workshop gave them more understanding of a hospice, and empowered them to voice their opinions and think more about life and death. The artwork, developed into pieces of a jigsaw, was pieced together and displayed at a public celebratory launch in Dying Matters Week 2023.
Conclusions
Art-based workshops are a useful way to engage with young people and empower them to discuss their experiences and thoughts about dying and potentially enable a great community dialogue and understanding of access to hospice care.
{"title":"O-14 Piecing it together: workshops exploring why dying matters with young, ethnically diverse people","authors":"Christina Faull, Helen Cullinan, Jackie McBlain, Zoebia Islam, Vijay Umrao","doi":"10.1136/spcare-2023-hunc.14","DOIUrl":"https://doi.org/10.1136/spcare-2023-hunc.14","url":null,"abstract":"<h3>Background</h3> Our research has found that young people may have a pivotal role in helping their family navigate unfamiliar systems and many act as interpreters but often feel excluded from any discussion of the impact of serious illness and death in their family. People in diverse ethnic communities often have little understanding about palliative care and hospices and consequently experience inequity of access to services and outcomes in end of life. <h3>Aims</h3> We wanted to open up the conversation with young people about dying, including the concept of palliative care and what a hospice does. <h3>Methods</h3> Two hour workshops were conducted in partnership with a community youth worker and a visual artist. Recruitment focussed in areas of Leicester and Loughborough with low white British population density. Participants shared and developed visual representation of their thoughts in response to ‘why does dying matter to me?’ <h3>Findings</h3> Forty-nine 13–25 year olds attended 9 workshops held in schools, the hospice and youth education project venues. The art they produced was of great diversity and focus including images of nature, fantasy, coffins, monuments, time and religion. Participants used vibrant colours to contrast with the black of death. Most students completed the evaluation form indicating they found the workshop useful and enjoyable. For some the workshop gave them more understanding of a hospice, and empowered them to voice their opinions and think more about life and death. The artwork, developed into pieces of a jigsaw, was pieced together and displayed at a public celebratory launch in Dying Matters Week 2023. <h3>Conclusions</h3> Art-based workshops are a useful way to engage with young people and empower them to discuss their experiences and thoughts about dying and potentially enable a great community dialogue and understanding of access to hospice care.","PeriodicalId":19619,"journal":{"name":"Oral Presentations - Late-Breaking Proffered Abstracts","volume":"79 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135325692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-01DOI: 10.1136/spcare-2023-hunc.13
Andrea Bruun, Leon Jordan, David Jeffrey, Richard Keagan-Bull, Amanda Cresswell, Jo Giles, Sarah Gibson, Rebecca Anderson-Kittow, Irene Tuffrey-Wijne
Background
Reviews and inquiries into end of life care for people with learning disabilities consistently recommend that services involve them in end of life care planning. However, there is limited evidence on how to do this.
Aims
To co-produce a toolkit of end of life care planning approaches and resources that are welcomed by and are useful for people with learning disabilities, and workable within adult social care services.
Methods
(a) A scoping review of existing resources and (b) focus groups with key stakeholder groups, including people with learning disabilities, family carers, support staff, learning disabilities service managers, professionals working in learning disabilities and/or palliative care and policy makers (n=55); these informed (c) Six Experience-Based Co-Design workshops including representatives from these stakeholder groups and researchers with and without learning disabilities. Workshops included agreeing on key principles and preferred approaches, assessing existing resources and developing new resources to fill identified gaps.
Results
(a) A shortlist of 21 resources included 9 accessible resources to be used with people with learning disabilities. However, most resources were not underpinned by empirical evidence. (b) Stakeholders identified 4 distinct parts of end of life care planning: talking about dying; what matters to me; planning for illness; and after-death/funeral planning. This affected views on when end of life care planning should start, with who, and why. (c) The co-design groups created a preliminary end of life care planning toolkit with separate resources for ‘illness planning’ and ‘funeral planning’, consisting of conversation pictures, pictorial choice cards and staff guidance. These will be trialled within learning disabilities services in autumn 2023.
Conclusion
The active involvement of stakeholders, including 24 people with learning disabilities, was crucial to developing sensitive, appropriate and useful end of life care planning resources and guidance.
{"title":"O-13 Co-producing a toolkit of approaches and resources for end-of-life care planning with people with learning disabilities","authors":"Andrea Bruun, Leon Jordan, David Jeffrey, Richard Keagan-Bull, Amanda Cresswell, Jo Giles, Sarah Gibson, Rebecca Anderson-Kittow, Irene Tuffrey-Wijne","doi":"10.1136/spcare-2023-hunc.13","DOIUrl":"https://doi.org/10.1136/spcare-2023-hunc.13","url":null,"abstract":"<h3>Background</h3> Reviews and inquiries into end of life care for people with learning disabilities consistently recommend that services involve them in end of life care planning. However, there is limited evidence on how to do this. <h3>Aims</h3> To co-produce a toolkit of end of life care planning approaches and resources that are welcomed by and are useful for people with learning disabilities, and workable within adult social care services. <h3>Methods</h3> (a) A scoping review of existing resources and (b) focus groups with key stakeholder groups, including people with learning disabilities, family carers, support staff, learning disabilities service managers, professionals working in learning disabilities and/or palliative care and policy makers (n=55); these informed (c) Six Experience-Based Co-Design workshops including representatives from these stakeholder groups and researchers with and without learning disabilities. Workshops included agreeing on key principles and preferred approaches, assessing existing resources and developing new resources to fill identified gaps. <h3>Results</h3> (a) A shortlist of 21 resources included 9 accessible resources to be used with people with learning disabilities. However, most resources were not underpinned by empirical evidence. (b) Stakeholders identified 4 distinct parts of end of life care planning: talking about dying; what matters to me; planning for illness; and after-death/funeral planning. This affected views on when end of life care planning should start, with who, and why. (c) The co-design groups created a preliminary end of life care planning toolkit with separate resources for ‘illness planning’ and ‘funeral planning’, consisting of conversation pictures, pictorial choice cards and staff guidance. These will be trialled within learning disabilities services in autumn 2023. <h3>Conclusion</h3> The active involvement of stakeholders, including 24 people with learning disabilities, was crucial to developing sensitive, appropriate and useful end of life care planning resources and guidance.","PeriodicalId":19619,"journal":{"name":"Oral Presentations - Late-Breaking Proffered Abstracts","volume":"33 2","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135326309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-01DOI: 10.1136/sextrans-bashh-2023.39
Chloe McColgan, Jane Hosking, Efejiro Ashano, John White, Prita Banerjee
Introduction
Anorectal sexually transmitted infections in women is an understudied area, with variable rates of infection reported in studies. Rectal infections are usually asymptomatic and carry the risk of onward transmission. Although women are offered rectal swabs in clinic if they report anal sex, there is variable offer of rectal swabs for women via home-based testing in the UK. SHUK is the online postal self-sampling service (OPSS) provider for our service, and we offer women rectal swabs for triple-site testing if they report anal sex.
Aim
To assess the effectiveness of offering women rectal swabs via OPSS and compare this to clinic-based testing in terms of detection rates of rectal chlamydia (CT), gonorrhoea (GC), and isolated, single-site rectal infections.
Methods
We conducted a retrospective analysis of clinic- and home-based testing data to identify women who tested positive for rectal CT/GC between April 1- December 31, 2022.
Results
The return rate of OPSS was 71.4%, with a processing rate of 98%.
Discussion
Detection rates for rectal chlamydia and gonorrhoea in women via OPSS were lower than clinic-based testing (4.1% vs 8.3%, p=0.002), likely due to higher rates of asymptomatic service users. OPSS identified low rates of isolated, single-site rectal infection (0.8% vs 2.6%; p=0.005). Based on these results, unselected triple-site testing offers minimal detection advantage in our OPSS population. Targeted testing might yield higher detection rates, but implementation may be dependent on individual service cost pressures.
妇女肛肠性传播感染是一个研究不足的领域，研究报告的感染率各不相同。直肠感染通常是无症状的，并且有继续传播的风险。尽管在诊所里，如果女性报告肛交，就会被提供直肠拭子，但在英国，通过家庭测试，对女性提供直肠拭子的机会是可变的。香港邮政是我们服务的网上邮政自我抽样服务(OPSS)提供商，如果女性报告肛交，我们会为她们提供直肠拭子进行三点检测。目的评估通过OPSS提供女性直肠拭子的有效性，并将其与基于临床的直肠衣原体(CT)、淋病(GC)和孤立的单部位直肠感染的检出率进行比较。方法回顾性分析了2022年4月1日至12月31日期间临床和家庭检测数据，以确定直肠CT/GC检测阳性的女性。结果OPSS的回收率为71.4%，处理率为98%。通过OPSS检测女性直肠衣原体和淋病的检出率低于临床检测(4.1%对8.3%，p=0.002)，可能是由于无症状服务使用者的检出率较高。OPSS发现孤立的、单部位直肠感染的发生率较低(0.8% vs 2.6%;p = 0.005)。基于这些结果，未选择的三位点检测在我们的OPSS人群中提供了最小的检测优势。有针对性的测试可能产生更高的检测率，但实施可能取决于个别服务的成本压力。
{"title":"UG3 A service evaluation comparing online-based testing to clinic-based testing for rectal chlamydia and gonorrhoea in women","authors":"Chloe McColgan, Jane Hosking, Efejiro Ashano, John White, Prita Banerjee","doi":"10.1136/sextrans-bashh-2023.39","DOIUrl":"https://doi.org/10.1136/sextrans-bashh-2023.39","url":null,"abstract":"<h3>Introduction</h3> Anorectal sexually transmitted infections in women is an understudied area, with variable rates of infection reported in studies. Rectal infections are usually asymptomatic and carry the risk of onward transmission. Although women are offered rectal swabs in clinic if they report anal sex, there is variable offer of rectal swabs for women via home-based testing in the UK. SHUK is the online postal self-sampling service (OPSS) provider for our service, and we offer women rectal swabs for triple-site testing if they report anal sex. <h3>Aim</h3> To assess the effectiveness of offering women rectal swabs via OPSS and compare this to clinic-based testing in terms of detection rates of rectal chlamydia (CT), gonorrhoea (GC), and isolated, single-site rectal infections. <h3>Methods</h3> We conducted a retrospective analysis of clinic- and home-based testing data to identify women who tested positive for rectal CT/GC between April 1- December 31, 2022. <h3>Results</h3> The return rate of OPSS was 71.4%, with a processing rate of 98%. <h3>Discussion</h3> Detection rates for rectal chlamydia and gonorrhoea in women via OPSS were lower than clinic-based testing (4.1% vs 8.3%, p=0.002), likely due to higher rates of asymptomatic service users. OPSS identified low rates of isolated, single-site rectal infection (0.8% vs 2.6%; p=0.005). Based on these results, unselected triple-site testing offers minimal detection advantage in our OPSS population. Targeted testing might yield higher detection rates, but implementation may be dependent on individual service cost pressures.","PeriodicalId":19619,"journal":{"name":"Oral Presentations - Late-Breaking Proffered Abstracts","volume":"66 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136169356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Neisseria gonorrhoeae (NG) infection in the pharynx is more difficult to treat than infections at other sites. Persistent NG infection may develop antimicrobial resistance by genetic exchange of resistance determinants with commensal Neisseria species in the pharynx. Using data between 2012–2020 from the Gonococcal Resistance to Antimicrobials Surveillance Programme (GRASP), we investigated the association between anatomical site of infection and reduced susceptibility or resistance to therapeutically relevant antimicrobials among NG positive individuals attending sexual health services in England and Wales.
Methods
Multivariate logistic regression was used to investigate the association between site of infection (pharyngeal vs genital, pharyngeal vs rectal) and resistance (R) or reduced susceptibility (RS) to azithromycin (R at minimum inhibitory concentration (MIC)>0.5 mg/L), ceftriaxone (RS at both MIC>0.015 mg/L and MIC>0.03 mg/L), cefixime (RS at MIC>0.06 mg/L; R at MIC>0.125 mg/L) and ciprofloxacin (R at MIC>0.06 mg/L) among GBMSM and heterosexual women.
Results
In total, 10,275 NG isolates were included; 8,402 (82%) were from GBMSM and 1,873 (18%) from heterosexual women. Pharyngeal isolates comprised 13% of isolates from GBMSM and 6% from heterosexual women. Among GBMSM, pharyngeal infections were significantly associated with RS to ceftriaxone (MIC>0.03 mg/L) compared to both genital (aOR: 1.76, p=0.009) and rectal infections (aOR: 2.15, p<0.001). Among heterosexual women, pharyngeal infections were associated with RS to ceftriaxone (MIC>0.015 mg/L) (aOR: 1.93, p=0.03) and RS to cefixime (aOR: 2.49, p=0.03) compared to genital infections. No other associations were found.
Discussion
Ceftriaxone resistance remains rare in the UK and undetected through GRASP. However pharyngeal isolates from both GBMSM and heterosexual women were more likely to have RS to ceftriaxone than isolates from other sites. These findings emphasise the importance of extra-genital testing, access to susceptibility testing and test-of-cure to prevent the possibility of widespread treatment failures.
{"title":"O07 Reduced susceptibility of pharyngeal<i>Neisseria gonorrhoeae</i>infections to current recommended therapeutics in England and Wales using national surveillance data (GRASP)","authors":"Suzy Sun, Ayda Haile Redai, Katie Thorley, Zdravko Ivanov, Michaela Day, Rachel Pitt, Katy Sinka, Hamish Mohammed, Michelle Cole, Helen Fifer","doi":"10.1136/sextrans-bashh-2023.7","DOIUrl":"https://doi.org/10.1136/sextrans-bashh-2023.7","url":null,"abstract":"<h3>Background</h3> <i>Neisseria gonorrhoeae</i> (NG) infection in the pharynx is more difficult to treat than infections at other sites. Persistent NG infection may develop antimicrobial resistance by genetic exchange of resistance determinants with commensal <i>Neisseria</i> species in the pharynx. Using data between 2012–2020 from the Gonococcal Resistance to Antimicrobials Surveillance Programme (GRASP), we investigated the association between anatomical site of infection and reduced susceptibility or resistance to therapeutically relevant antimicrobials among NG positive individuals attending sexual health services in England and Wales. <h3>Methods</h3> Multivariate logistic regression was used to investigate the association between site of infection (pharyngeal vs genital, pharyngeal vs rectal) and resistance (R) or reduced susceptibility (RS) to azithromycin (R at minimum inhibitory concentration (MIC)>0.5 mg/L), ceftriaxone (RS at both MIC>0.015 mg/L and MIC>0.03 mg/L), cefixime (RS at MIC>0.06 mg/L; R at MIC>0.125 mg/L) and ciprofloxacin (R at MIC>0.06 mg/L) among GBMSM and heterosexual women. <h3>Results</h3> In total, 10,275 NG isolates were included; 8,402 (82%) were from GBMSM and 1,873 (18%) from heterosexual women. Pharyngeal isolates comprised 13% of isolates from GBMSM and 6% from heterosexual women. Among GBMSM, pharyngeal infections were significantly associated with RS to ceftriaxone (MIC>0.03 mg/L) compared to both genital (aOR: 1.76, p=0.009) and rectal infections (aOR: 2.15, p<0.001). Among heterosexual women, pharyngeal infections were associated with RS to ceftriaxone (MIC>0.015 mg/L) (aOR: 1.93, p=0.03) and RS to cefixime (aOR: 2.49, p=0.03) compared to genital infections. No other associations were found. <h3>Discussion</h3> Ceftriaxone resistance remains rare in the UK and undetected through GRASP. However pharyngeal isolates from both GBMSM and heterosexual women were more likely to have RS to ceftriaxone than isolates from other sites. These findings emphasise the importance of extra-genital testing, access to susceptibility testing and test-of-cure to prevent the possibility of widespread treatment failures.","PeriodicalId":19619,"journal":{"name":"Oral Presentations - Late-Breaking Proffered Abstracts","volume":"2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136169656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-01DOI: 10.1136/sextrans-bashh-2023.37
Moradeyo Olaitan, Emma Harding-Esch, Suneeta Soni
Introduction
Online pharmacies are an easily accessible method of procuring treatments for Sexually Transmitted Infections (STIs). We aimed to determine whether treatments sold by online pharmacies in the United Kingdom adhere to national guidelines set by the British Association for Sexual Health and HIV (BASHH) with respect to treatment.
Methods
Using findings from a previous similar study (2017) and Google search engine results (October 2022), a list of pharmacies offering treatments for Herpes simplex Virus (HSV), Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), Trichomonas vaginalis (TV), Non-gonococcal urethritis (NGU) and Mycoplasma genitalium (Mgen), was compiled. Treatments offered were recorded and compared to BASHH guidelines.
Results
24 pharmacies were identified, two of which were excluded. All but one (95%) of the pharmacies required completion of an online consultation form before treatment could be bought. The one not requiring a consultation offered treatment for CT, HSV and MG. Despite 17 pharmacies (77.7%) asking if the individual had been diagnosed with a particular STI, submission of proof of diagnosis was only required by one (4.2%). All pharmacies included written information about the infections for which they offered treatment, although this was of variable quality. Partner notification, as well as partner testing, was recommended by many pharmacies, but guideline adherence was variable within- and between-pharmacies.
Discussion
Compared with the 2017 study, a similar number of online pharmacies is available. Apparent improvements in practice were observed for CT from 88% of pharmacies in 2017 to 100% of pharmacies in our study complying with BASHH guidelines, but numbers are too small for statistical comparison. Poor online prescribing practice for NG, likely because first-line treatment requires an intramuscular injection, is a concern. The non-requirement for proof of diagnosis is problematic and threatens antibiotic stewardship principles. National regulation of, and direct communication with, online pharmacies may help reduce discrepancies with national treatment recommendations.
{"title":"UG1 How well are online sexually transmitted infection treatment providers doing? Measuring the performance of online treatment providers against BASHH national guidelines","authors":"Moradeyo Olaitan, Emma Harding-Esch, Suneeta Soni","doi":"10.1136/sextrans-bashh-2023.37","DOIUrl":"https://doi.org/10.1136/sextrans-bashh-2023.37","url":null,"abstract":"<h3>Introduction</h3> Online pharmacies are an easily accessible method of procuring treatments for Sexually Transmitted Infections (STIs). We aimed to determine whether treatments sold by online pharmacies in the United Kingdom adhere to national guidelines set by the British Association for Sexual Health and HIV (BASHH) with respect to treatment. <h3>Methods</h3> Using findings from a previous similar study (2017) and Google search engine results (October 2022), a list of pharmacies offering treatments for Herpes simplex Virus (HSV), <i>Chlamydia trachomatis</i> (CT), <i>Neisseria gonorrhoeae</i> (NG), <i>Trichomonas vaginalis</i> (TV), Non-gonococcal urethritis (NGU) and <i>Mycoplasma genitalium</i> (Mgen), was compiled. Treatments offered were recorded and compared to BASHH guidelines. <h3>Results</h3> 24 pharmacies were identified, two of which were excluded. All but one (95%) of the pharmacies required completion of an online consultation form before treatment could be bought. The one not requiring a consultation offered treatment for CT, HSV and MG. Despite 17 pharmacies (77.7%) asking if the individual had been diagnosed with a particular STI, submission of proof of diagnosis was only required by one (4.2%). All pharmacies included written information about the infections for which they offered treatment, although this was of variable quality. Partner notification, as well as partner testing, was recommended by many pharmacies, but guideline adherence was variable within- and between-pharmacies. <h3>Discussion</h3> Compared with the 2017 study, a similar number of online pharmacies is available. Apparent improvements in practice were observed for CT from 88% of pharmacies in 2017 to 100% of pharmacies in our study complying with BASHH guidelines, but numbers are too small for statistical comparison. Poor online prescribing practice for NG, likely because first-line treatment requires an intramuscular injection, is a concern. The non-requirement for proof of diagnosis is problematic and threatens antibiotic stewardship principles. National regulation of, and direct communication with, online pharmacies may help reduce discrepancies with national treatment recommendations.","PeriodicalId":19619,"journal":{"name":"Oral Presentations - Late-Breaking Proffered Abstracts","volume":"57 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136169659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-01DOI: 10.1136/sextrans-bashh-2023.1
Alexandra David, Soazig Clifton, Jo Gibbs, Dee Menezes, Julie Riddell, Malachi Willis, Raquel Bosó Pérez, Pam Sonnenberg, Catherine H Mercer, Kirstin Mitchell, Nigel Field
Introduction
Evidence shows that people identifying as a sexual minority experience worse health compared to heterosexual people. We estimated health inequalities by sexual identity in the first year of the COVID-19 pandemic in the general British population.
Methods
Our analysis included 6,016 sexually-experienced participants (18–59 years) participating in Natsal-COVID, a quasi-representative webpanel survey conducted 1-year following Britain’s first lockdown. We report age-adjusted odds ratios (aOR) and age and relationship status-adjusted ORs (aAOR) for general, mental, and sexual health outcomes among sexual minorities compared to their heterosexual-identifying counterparts.
Results
Altogether, 96.2% participants identified as heterosexual, 1.8% as gay/lesbian, 1.4% as bisexual, and 0.7% as other. Sexual minorities were more likely to report their general health as ‘bad/very bad’. There were differences by subgroups; sexual minority women (aOR:2.5, 95% CI 1.5–3.7) and bisexual participants (aOR:2.6, 1.6–4.1) had the highest odds of reporting poor general health. Sexual minority participants were more likely to report poor mental health, with bisexual participants most like to screen positive for anxiety (GAD-2) (aOR:2.3, 1.7–3.0) and depression (PHQ-2) (aOR:1.7, 1.3–2.2), while gay/lesbian participants were most likely to report ‘always/often’ feeling lonely (aOR:1.5, 1.1–2.2).
Sexual minority men (aAOR
1.7, 1.2–2.3), gay/lesbian (aAOR:1.4, 1.1–1.9) and bisexual participants (aAOR:1.6, 1.1–2.1) had highest odds of reporting dissatisfaction with their sex life. Sexual minority men (aAOR:4.1, 2.6–6.4) were more likely to report successfully accessing STI services, and twice as likely to report having tried but failed to access STI services (aAOR:2.1, 1.1–3.9), both in the past year.
Discussion
These data, from a national general population survey, suggest that in the year following Britain’s first lockdown, sexual minorities experienced worse health than heterosexual-identifying people, and among men, an unmet need for STI services. Whether these findings reflect existing inequalities or were exacerbated by the pandemic is unknown, but mitigation is needed.
{"title":"O01 The health and wellbeing of people reporting a minority sexual identity during the first year of the COVID-19 pandemic in Britain: natsal-COVID wave 2","authors":"Alexandra David, Soazig Clifton, Jo Gibbs, Dee Menezes, Julie Riddell, Malachi Willis, Raquel Bosó Pérez, Pam Sonnenberg, Catherine H Mercer, Kirstin Mitchell, Nigel Field","doi":"10.1136/sextrans-bashh-2023.1","DOIUrl":"https://doi.org/10.1136/sextrans-bashh-2023.1","url":null,"abstract":"<h3>Introduction</h3> Evidence shows that people identifying as a sexual minority experience worse health compared to heterosexual people. We estimated health inequalities by sexual identity in the first year of the COVID-19 pandemic in the general British population. <h3>Methods</h3> Our analysis included 6,016 sexually-experienced participants (18–59 years) participating in Natsal-COVID, a quasi-representative webpanel survey conducted 1-year following Britain’s first lockdown. We report age-adjusted odds ratios (aOR) and age and relationship status-adjusted ORs (aAOR) for general, mental, and sexual health outcomes among sexual minorities compared to their heterosexual-identifying counterparts. <h3>Results</h3> Altogether, 96.2% participants identified as heterosexual, 1.8% as gay/lesbian, 1.4% as bisexual, and 0.7% as other. Sexual minorities were more likely to report their general health as ‘bad/very bad’. There were differences by subgroups; sexual minority women (aOR:2.5, 95% CI 1.5–3.7) and bisexual participants (aOR:2.6, 1.6–4.1) had the highest odds of reporting poor general health. Sexual minority participants were more likely to report poor mental health, with bisexual participants most like to screen positive for anxiety (GAD-2) (aOR:2.3, 1.7–3.0) and depression (PHQ-2) (aOR:1.7, 1.3–2.2), while gay/lesbian participants were most likely to report ‘always/often’ feeling lonely (aOR:1.5, 1.1–2.2). <h3>Sexual minority men (aAOR</h3> 1.7, 1.2–2.3), gay/lesbian (aAOR:1.4, 1.1–1.9) and bisexual participants (aAOR:1.6, 1.1–2.1) had highest odds of reporting dissatisfaction with their sex life. Sexual minority men (aAOR:4.1, 2.6–6.4) were more likely to report successfully accessing STI services, and twice as likely to report having tried but failed to access STI services (aAOR:2.1, 1.1–3.9), both in the past year. <h3>Discussion</h3> These data, from a national general population survey, suggest that in the year following Britain’s first lockdown, sexual minorities experienced worse health than heterosexual-identifying people, and among men, an unmet need for STI services. Whether these findings reflect existing inequalities or were exacerbated by the pandemic is unknown, but mitigation is needed.","PeriodicalId":19619,"journal":{"name":"Oral Presentations - Late-Breaking Proffered Abstracts","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136170327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-01DOI: 10.1136/sextrans-bashh-2023.33
Nova Eifert, Daniel Richardson, Justine Orme
Introduction
Sexual health clinics have experienced an increase in sexually transmitted infection (STI) rates and a greater complexity of patients. There is a clear need to address the underlying issues that keep patients within cycles of behaviour which negatively impacts on their sexual health.
Method
We established a counselling service within our clinic for patients who may: present with repeat STIs; display patterns of sexual risk; sex influenced by alcohol or chems use; difficulties in negotiating the sex they want because of issues such as consent, control or coercion. The service began in April 2022, led by a psychotherapist/Health Adviser. Patients receive up to 12-weeks of therapy, and the service is open to all genders/over 18s. Patients seen in general sexual health clinic are assessed by clinicians and referred if they meet the criteria and are motivated to seek therapy.
Results
So far, 7 patients have completed 12 weeks and 6 are currently in the programme. Patients range from age 24–55 and include men who have sex with men, trans-female, bisexual and heterosexual women. The initial 7 patients disclosed at least one ACE (Adverse Childhood Event). 5/7 experienced sexual assault and violence, 4/7 childhood sexual abuse, 2/7 parental neglect, 2/7 parental physical and mental abuse, 1/7 parental separation. All patients experienced domestic violence from parents, siblings or partners. Common themes include internalised homophobia, internalised misogyny, self-loathing and self-blame for their historic abuse and on-going struggles. The service aims to work through these issues to facilitate positive change within our patients leading to enhanced sexual and emotional well-being.
Discussion
We have identified significant levels of ACEs and domestic violence experienced by patients accessing our sexual health counselling service. More work is needed to understand and develop effective interventions for people experiencing poor sexual health from ACEs and domestic violence.
{"title":"N02 Integrating an in-house counselling service within a sexual health service highlights the association with adverse childhood experiences, domestic violence and poor sexual health","authors":"Nova Eifert, Daniel Richardson, Justine Orme","doi":"10.1136/sextrans-bashh-2023.33","DOIUrl":"https://doi.org/10.1136/sextrans-bashh-2023.33","url":null,"abstract":"<h3>Introduction</h3> Sexual health clinics have experienced an increase in sexually transmitted infection (STI) rates and a greater complexity of patients. There is a clear need to address the underlying issues that keep patients within cycles of behaviour which negatively impacts on their sexual health. <h3>Method</h3> We established a counselling service within our clinic for patients who may: present with repeat STIs; display patterns of sexual risk; sex influenced by alcohol or chems use; difficulties in negotiating the sex they want because of issues such as consent, control or coercion. The service began in April 2022, led by a psychotherapist/Health Adviser. Patients receive up to 12-weeks of therapy, and the service is open to all genders/over 18s. Patients seen in general sexual health clinic are assessed by clinicians and referred if they meet the criteria and are motivated to seek therapy. <h3>Results</h3> So far, 7 patients have completed 12 weeks and 6 are currently in the programme. Patients range from age 24–55 and include men who have sex with men, trans-female, bisexual and heterosexual women. The initial 7 patients disclosed at least one ACE (Adverse Childhood Event). 5/7 experienced sexual assault and violence, 4/7 childhood sexual abuse, 2/7 parental neglect, 2/7 parental physical and mental abuse, 1/7 parental separation. All patients experienced domestic violence from parents, siblings or partners. Common themes include internalised homophobia, internalised misogyny, self-loathing and self-blame for their historic abuse and on-going struggles. The service aims to work through these issues to facilitate positive change within our patients leading to enhanced sexual and emotional well-being. <h3>Discussion</h3> We have identified significant levels of ACEs and domestic violence experienced by patients accessing our sexual health counselling service. More work is needed to understand and develop effective interventions for people experiencing poor sexual health from ACEs and domestic violence.","PeriodicalId":19619,"journal":{"name":"Oral Presentations - Late-Breaking Proffered Abstracts","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136170507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-01DOI: 10.1136/sextrans-bashh-2023.24
Stuart Amos-Gibbs, Adrian Martins, Abi Degg, Paula Baraitser, Elena Ardines
Introduction
HIV tests on small blood samples complete the first stage only of the usual 3 stage HIV testing confirmatory algorithm. For this reason, false positive rates are high. Quantitative reactive values could support counselling when giving these results. We looked at reactive values for confirmed/unconfirmed positives to guide use of reactivity rates in results notification.
Methods
We analysed routinely collected data from all HIV self-sampling tests completed within SH:24 during 2022 including reactivity value and the outcome of confirmatory testing. Standard practice for notifying users is 6 contact attempts using 3 different means of communication. The results of confirmatory testing are obtained from the user or the service attended.
Results
257,143 HIV tests were done in 2022 of which 966 (0.4%) were reactive. The results of confirmatory testing were available in 818 (84.68%) and 141 reactives were confirmed positive of which 85 were new diagnoses. Reactivity values ranged from 1.0 - 2713. The positive predictive value (PPV) for all reactives 0.17 and the PPV for reactives over 30 was 0.9.
Discussion
Self-testing is an important source of new HIV diagnoses. While some confirmed positives had reactivity value less than 30, a reactive value over 30 is an important factor in counselling those with self-sampling test results.
{"title":"O24 Quantitative reactive values to support HIV result notifications on small blood volumes from self-sampling test kits","authors":"Stuart Amos-Gibbs, Adrian Martins, Abi Degg, Paula Baraitser, Elena Ardines","doi":"10.1136/sextrans-bashh-2023.24","DOIUrl":"https://doi.org/10.1136/sextrans-bashh-2023.24","url":null,"abstract":"<h3>Introduction</h3> HIV tests on small blood samples complete the first stage only of the usual 3 stage HIV testing confirmatory algorithm. For this reason, false positive rates are high. Quantitative reactive values could support counselling when giving these results. We looked at reactive values for confirmed/unconfirmed positives to guide use of reactivity rates in results notification. <h3>Methods</h3> We analysed routinely collected data from all HIV self-sampling tests completed within SH:24 during 2022 including reactivity value and the outcome of confirmatory testing. Standard practice for notifying users is 6 contact attempts using 3 different means of communication. The results of confirmatory testing are obtained from the user or the service attended. <h3>Results</h3> 257,143 HIV tests were done in 2022 of which 966 (0.4%) were reactive. The results of confirmatory testing were available in 818 (84.68%) and 141 reactives were confirmed positive of which 85 were new diagnoses. Reactivity values ranged from 1.0 - 2713. The positive predictive value (PPV) for all reactives 0.17 and the PPV for reactives over 30 was 0.9. <h3>Discussion</h3> Self-testing is an important source of new HIV diagnoses. While some confirmed positives had reactivity value less than 30, a reactive value over 30 is an important factor in counselling those with self-sampling test results.","PeriodicalId":19619,"journal":{"name":"Oral Presentations - Late-Breaking Proffered Abstracts","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136170118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-01DOI: 10.1136/sextrans-bashh-2023.29
Freddy Green, Hannah Charles, Helen Fifer, Hamish Mohammed, John Saunders, Erna Buitendam, Deborah Shaw, Norah O’Brien, Katy Sinka
Introduction
Syphilis diagnoses in England continue to rise with distinct but interlinked epidemics among gay, bisexual and other men who have sex with men (GBMSM) and heterosexuals. We aim to understand changes in the distribution of diagnoses by stage over time that may indicate shifts in epidemiology.
Methods
Data on syphilis diagnoses and testing between 2012 and 2021 were obtained from GUMCAD STI Surveillance System. Syphilis stages were defined as infectious syphilis (primary, secondary or early latent) or non-infectious syphilis (late latent). Diagnoses coded as complications relating to untreated syphilis were excluded. Test positivity was defined as all syphilis diagnoses divided by all syphilis tests. We compared trends in the annual distribution of syphilis diagnoses by stage among GBMSM and heterosexuals, the number of tests and test positivity.
Results
The proportion of syphilis diagnoses that were infectious among heterosexuals increased from 38.6% in 2012 to 59.8% in 2021 (Table 1). Testing increased among heterosexuals between 2012 and 2019 (888,341 to 1,152,445), before decreasing to 813,606 in 2021. Test positivity increased from 0.22% in 2012 to 0.28% in 2021. Among GBMSM, the proportion of diagnoses that were infectious remained stable between 2012 and 2021 (mean of 86.9%). The proportion of diagnoses that were early latent increased from 24% in 2012 to 37% in 2021 (Figure 1), whilst the proportion that were primary and secondary decreased. Testing increased from 83,053 in 2012 to 256,795 in 2021.
Discussion
The proportional increase in infectious syphilis diagnoses among heterosexuals indicates that infections are being diagnosed at an earlier stage. This trend could be due to changing testing behaviour or given the increase in test positivity and proportion of symptomatic diagnoses, an increase in recent transmission. Further work is needed to assess the impact of HIV pre-exposure prophylaxis (PrEP) on testing frequency among GBMSM and how that may impact transmission.
{"title":"O29 Characterising the increase in syphilis in England between 2012 and 2021 by stage of infection at diagnosis","authors":"Freddy Green, Hannah Charles, Helen Fifer, Hamish Mohammed, John Saunders, Erna Buitendam, Deborah Shaw, Norah O’Brien, Katy Sinka","doi":"10.1136/sextrans-bashh-2023.29","DOIUrl":"https://doi.org/10.1136/sextrans-bashh-2023.29","url":null,"abstract":"<h3>Introduction</h3> Syphilis diagnoses in England continue to rise with distinct but interlinked epidemics among gay, bisexual and other men who have sex with men (GBMSM) and heterosexuals. We aim to understand changes in the distribution of diagnoses by stage over time that may indicate shifts in epidemiology. <h3>Methods</h3> Data on syphilis diagnoses and testing between 2012 and 2021 were obtained from GUMCAD STI Surveillance System. Syphilis stages were defined as infectious syphilis (primary, secondary or early latent) or non-infectious syphilis (late latent). Diagnoses coded as complications relating to untreated syphilis were excluded. Test positivity was defined as all syphilis diagnoses divided by all syphilis tests. We compared trends in the annual distribution of syphilis diagnoses by stage among GBMSM and heterosexuals, the number of tests and test positivity. <h3>Results</h3> The proportion of syphilis diagnoses that were infectious among heterosexuals increased from 38.6% in 2012 to 59.8% in 2021 (Table 1). Testing increased among heterosexuals between 2012 and 2019 (888,341 to 1,152,445), before decreasing to 813,606 in 2021. Test positivity increased from 0.22% in 2012 to 0.28% in 2021. Among GBMSM, the proportion of diagnoses that were infectious remained stable between 2012 and 2021 (mean of 86.9%). The proportion of diagnoses that were early latent increased from 24% in 2012 to 37% in 2021 (Figure 1), whilst the proportion that were primary and secondary decreased. Testing increased from 83,053 in 2012 to 256,795 in 2021. <h3>Discussion</h3> The proportional increase in infectious syphilis diagnoses among heterosexuals indicates that infections are being diagnosed at an earlier stage. This trend could be due to changing testing behaviour or given the increase in test positivity and proportion of symptomatic diagnoses, an increase in recent transmission. Further work is needed to assess the impact of HIV pre-exposure prophylaxis (PrEP) on testing frequency among GBMSM and how that may impact transmission.","PeriodicalId":19619,"journal":{"name":"Oral Presentations - Late-Breaking Proffered Abstracts","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136170798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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