Colin Fitzpatrick

Brighton and Sussex University Hospitals NHS Trust | BSUH · Claude Nicol Centre (Sexual Health) and Lawson Unit (HIV)

Objective. Hepatitis B is sexually transmitted among men who have sex with men (MSM) and has previously been endemic in some populations of MSM. Presence of anti-hepatitis B core (anti-HBc) determines previous or ongoing infection. We aimed to establish the prevalence and associations of anti-HBc in our clinic population of MSM. Method. A cross-sec...

Three cases of a blip in HIV viral load following SARS-CoV-2 vaccines, ESCRH Congress 2022 Poster

Objective: We aimed to evaluate the usability and acceptability of a co-designed mobile health (mHealth) application (PrEP-EmERGE) within a digital health pathway to support HIV pre-exposure prophylaxis (PrEP). Methods: This was a cross-sectional study to evaluate the usability and acceptability of the PrEP-EmERGE app. Data were collected via an...

Background: In order to provide safe, high-quality hospital care, it is essential that doctors are optimally deployed. Digital platforms for rostering doctors improves both the quality of hospital care and the wellbeing of doctors. We evaluated the usability and acceptability of the HealthRota© e-rostering system. Methods: We circulated an elect...

Sexually transmitted proctitis is associated with HIV transmission in men who have sex with men (MSM) and transgender women (TGW).In our clinic-based, cross-sectional study from Brighton UK, 152 MSM/ TGW attended with a proctitis between January and May 2021 (gonorrhoea=69, chlamydia=74, herpes simplex virus=3, syphilis=1, Mycoplasma genitalium=0,...

Hepatitis A is a sexually transmitted enteric infection in men who have sex with men (MSM). HIV pre-exposure prophylaxis (PrEP) has increased opportunities for sexual health interventions in MSM. 588 (372 in 2019, 216 in 2021) MSM attended for the first time in the study periods. MSM were significantly more likely to be screened for Hepatitis A sus...

Introduction The incidence of syphilis has increased significantly in the last 2 decades predominantly amongst men who have sex with men (MSM) and people living with HIV(PLWH). Some studies have suggested that syphilis is associated with transient HIV viral load(HIV VL) rebound in patients taking effective antiretroviral therapy(ART).Aims and Metho...

Background Hepatitis A virus(HAV) is a sexually transmitted enteric infection in MSM. 70% vaccination levels in MSM is required to achieve adequate herd immunity. Access to PrEP has driven increased numbers of MSM to sexual health clinics for other sexual health interventions including hepatitis A testing/vaccination.Aims & Method We aimed to deter...

Background ‘PrEP-EmERGE’ is a co-designed digital health innovation that supports HIV-PrEP users via a novel digital-health pathway and mobile-health application. Method A cross sectional study using a mixed-methods approach evaluating the usability and acceptability of the PrEP-EmERGE app. Data were collected via an online survey sent to all acti...

Introduction Estimates of HIV prevalence amongst gender minorities are determined exclusively from scarce data for transgender women (TGW) who, globally, are disproportionately affected by HIV.¹ Data for transgender men (TGM) and non-binary individuals (NBI) are extremely limited. Transgender people are often identified as an underserved group for...

Objectives: Chemsex has been reported among men who have sex with men (MSM) living with HIV. There have been concerns about potentially harmful drug-drug interactions between chemsex drugs and antiretroviral therapy (ritonavir and cobicistat). We aimed to describe the prevalence and patterns of chemsex users in our HIV clinic population and to eva...

Anal examination and proctoscopy are important skills needed to facilitate the diagnoses of STIs and cancer. Clinician (25 doctors/15 nurses) confidence was higher for anal examination versus proctoscopy (median Likert scores 4/5 vs 5/5, P ≤ 0.05) and higher in doctors compared with nurses (median Likert scores 5/5 vs 4/5, P < 0.008, 4/5 vs 2/5, P...

Objectives: HIV pre-exposure prophylaxis (PrEP) is now available in the UK, however some MSM continue to use HIV post exposure prophylaxis following sexual exposure(PEPSE) and are not using PrEP. It is important to characterise MSM having condomless anal sex who are not using PrEP. Methods: In a cross-sectional analysis, we compared the character...

We examined the impact of Covid-19 restrictions on the wellbeing and access to care among people living with HIV (PLWH) in the UK. A cross-sectional anonymous online survey was circulated to PLWH attending care at three HIV services in Sussex. The questionnaire covered key themes: socio-demographic characteristics; changes in physical and mental he...

Objectives Rates of HIV, syphilis and gonorrhoea have increased over the past 20 years in men who have sex with men (MSM). Contact tracing strategies have increased the number of MSM attending clinics as sexual contacts. Understanding the outcomes of contact tracing could inform future public health policies to reduce the burden of STIs in MSM. Me...

Rates of Neisseria gonorrhoea including antimicrobial resistant gonorrhoea are increasing particularly in men who have sex with men (MSM) ¹⁻⁴ As a consequence of contact tracing, increasing numbers of patients are presenting as sexual contacts of gonorrhoea.⁵⁻⁸ Understanding the clinical characteristics of MSM who present as contacts of gonorrhoea,...

Background HIV post-exposure prophylaxis following sexual exposure (PEPSE) and pre-exposure prophylaxis (PrEP) are used by people at sexual risk of HIV acquisition including men who have sex with men (MSM). Owing to the high risk of HIV seroconversion due to on-going risk behaviours, it is becoming commonplace for HIV-negative MSM requiring PEPSE (...

Background Simultaneous testing for both Gonorrhoea and Chlamydia using dual nucleic acid amplification tests (NAAT) has increased pharyngeal Chlamydia testing in MSM. There has been increasing interest in pharyngeal Gonorrhoea due to emerging Gonorrhoea antimicrobial resistance but less is understood about the characteristics of pharyngeal Chlamyd...

Hepatitis A is an important sexually transmitted enteric infection in MSM and an effective vaccination is available. It has been estimated that 70% of MSM need to be immune to hepatitis A in order to provide adequate herd immunity. In the UK, hepatitis A transmission in MSM is associated with high risk behaviours such as anonymous sex, multiple sex...

Background HIV-1 transmitted drug resistance (TDR) is associated with sexually transmitted infections (STIs) and sexual clusters including MSM and non-MSM. TDR can lead to antiretroviral failure, and therefore UK guidelines recommend TDR testing in all new HIV patients. Subtype B is most common in urbanised western populations however is decreasing...

Lymphogranuloma venereum (LGV) is a sub-type of Chlamydia trachomatis and is associated with proctitis. LGV proctitis is associated with recreational drug use particularly chemsex, HIV, hepatitis C, and other sexually transmitted infection transmission. The presenting symptoms of LGV proctitis are not well characterised. We aimed to describe the re...

Shigella outbreaks in MSM are associated with sexual networks involving transmission of other sexually transmitted infections (STIs), geosocial app use for meeting sexual partners and chemsex. There is increasing antimicrobial resistance (AMR) in Shigella amongst MSM. We aimed to describe cases and patterns of AMR amongst MSM with Shigella between...

Background Rates of infectious syphilis has significantly increased in men who have sex with men (MSM). Recent data has shown that primary syphilis does not always present with painless genital lesions. Our aim was to describe the clinical characteristics, serological response and management of primary syphilis in HIV-positive and negative MSM. Me...

Partner notification strategies have increased the number of MSM attending sexually transmitted infection (STI) clinics as sexual contacts of syphilis. Current guidelines suggest testing and consideration of presumptive antimicrobial treatment. Syphilis treatment with benzathine penicillin; requires clinic resources, is painful and is associated wi...

Background Rectal Neisseria gonorrhoea is an important sexually transmitted infection in men who have sex with men (MSM). The past decade has seen and increasing rates of rectal gonorrhoea and antimicrobial resistant (AMR) gonorrhoea associated with recreational drug use, geo-spacial mobile phone dating apps and HIV risk reduction strategies includ...

Rates of Neisseria gonorrhoea in MSM continue to increase in Europe.1 Antimicrobial resistance (AMR) in gonorrhoea is increasing and surveillance relies on the taking and sensitivity of gonorrhoea culture specimens.2,3 It has been estimated that between 16‐50% of MSM with rectal gonorrhoea have ano‐rectal symptoms; therefore most MSM with rectal go...

Persistence of HIV through integration into host DNA in CD4⁺ T cells presents a major barrier to virus eradication. Viral integration may be curtailed when CD8⁺ T cells are triggered to kill infected CD4⁺ T cells through recognition of histocompatibility leukocyte antigen (HLA) class I-bound peptides derived from incoming virions. However, this has...

HIV post-exposure prophylaxis following sexual exposure (PEPSE) and pre-exposure prophylaxis (PrEP) are used by people at sexual risk of HIV acquisition, including men who have sex with men (MSM) [1]. MSM who are prescribed PEPSE have a 2.5-to 5-fold increase in HIV acquisition in the months after PEPSE compared with MSM not requiring PEPSE [2]. Ow...

Unlike pharyngeal Neisseria gonorrhoeae, less is known about pharyngeal Chlamydia trachomatis in men who have sex with men (MSM). We reviewed cases of pharyngeal chlamydia in MSM from January to December 2019. The overall prevalence of pharyngeal chlamydia was 75/6613 (1.13%; 95% confidence interval (CI) = 0.9–1.14). The median number of sexual par...

ABSTRACT Objectives There has been a significant increase in syphilis in men who have sex with men (MSM) in the UK over the past 20 years. Partner notification strategies have increased the number of MSM attending STI clinics as sexual contacts of syphilis. Current guidelines suggest testing and consideration of presumptive antimicrobial treatment....

Within the UK, the majority of hepatitis A occurs in high risk groups such as men who have sex with men (MSM). It has been estimated that 70% of MSM need immunity to provide adequate herd immunity. We aimed to estimate the proportion of hepatitis A susceptibility in MSM throughout a 10-year period (2010-2019), and explore associated demographic fac...

HIV-1 transmitted drug resistance (TDR) is associated with transmission in men who have sex with men (MSM), non MSM clusters, sexually transmitted infections (STIs) and can lead to antiretroviral failure. UK guidelines recommend performing TDR testing in all newly-diagnosed people living with HIV. We audited performance of TDR in our large tertiary...

The characteristics and serological responses of primary syphilis are not completely understood. We aimed to describe the characteristics, the serological responses and presumptive treatment of primary syphilis in HIV-positive and-negative men who have sex with men (MSM). We conducted a retrospective review of microbiological and demographic inform...

We aim to identify associations that may help support strategies to increase job satisfaction and reduce unscheduled time off work for nurses. Given current concerns regarding nursing workforce and retention, it is vital we identify strategies and factors which maintain job satisfaction, support staff retention and reduce unscheduled time off work....

Within the healthcare domain, commercial-sector terminology such as 'client', 'customer' and 'user' are replacing the previously acceptable collective noun, 'patient'. Is the term we use important to the individuals accessing our services? A paper survey collected the responses of 581 individuals attending the service between August and October 201...

We read with interest the recent report by Mwasakifwa and colleagues demonstrating that presence of mucopurulent ano-rectal discharge on clinical examination was associated with identification of a sexually transmitted organism by NAAT testing in men who have sex with men (MSM) with symptomatic proctitis.1 We also showed that sexually transmitted p...

Background: Antiretroviral therapy (ART) cannot cure HIV infection because of a persistent reservoir of latently infected cells. Approaches that force HIV transcription from these cells, making them susceptible to killing-termed kick and kill regimens-have been explored as a strategy towards an HIV cure. RIVER is the first randomised trial to dete...

Up to 4.7% of adult men have experienced attempted non-consensual sexual contact in Britain. 1 Male sexual assault is frequently under-reported and the consequences include physical harm, anxiety, depression, substance misuse, suicidal ideation and suicide. Drug-facilitated sexual assault involves many types of pharmacological agents including alco...

Men who have sex with men (MSM) with symptomatic secondary syphilis present with characteristic symptoms of rash, fever and lymphadenopathy; due to delays in microbiology results and some patients failing to return for treatment, empirical treatment is sometimes offered. We reviewed all patients presenting with secondary syphilis diagnosed on the b...

Background: Named nurses can be defined as a nurse who has overall responsibility for the care of a patient, and are generally responsible for identifying patient needs, care planning and coordination of care. Locally in Brighton (UK), a named nurse is assigned to each newly diagnosed HIV patient at their first appointment and will continue to prov...

Named nurses can be defined as a nurse who will identify as having overall responsibility for the care of a patient, and are generally responsible for identifying patient needs, care planning and coordination of care. In Brighton, a named nurse is assigned to each newly diagnosed HIV patient at their first appointment and will continue to provide...

There are an estimated 15,000 PrEP users in the UK.1 PrEP users are a self-selected group of individuals who identify as high risk of HIV acquisition. Locally in Brighton (UK) we have a large MSM population, and high rates of STIs. Between October 2017 to October 2018 we identified HIV negative MSM who attended our weekly MSM clinic, divided them...

Given current nursing shortages, poor retention rates and high unscheduled time-off work, it is important that we identify strategies and factors which maintain job satisfaction and reduce unscheduled time off work. An online anonymous survey of nurses was distributed via social media and email between March – April 2019 In this pilot online surv...

Up to 4.7% of adult men have experienced attempted non-consensual sexual contact in Britain.1 Male sexual assault is frequently underreported and the consequences include physical harm, anxiety, depression, substance misuse, suicidal ideation and suicide. Drug facilitated sexual assault involves many types of pharmacological agents including alcoho...

Background: Demographic data show an increasingly aging HIV population worldwide. Recent concerns over dolutegravir-related neuropsychiatric toxicity have emerged, particularly amongst older HIV patients. We describe the pharmacokinetics (PK) of dolutegravir (DTG) 50mg once daily in people living with HIV (PLWH) aged 60 and older. Additionally, to...