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Women who have sex with women (WSW) were reluctant to
attend services due to perceptions of low risk and discrimina-
tion, and valued the choice of a women-only service).
In 2012 a women’s clinic opened, offering a range of sexual
health and contraception services. Staffed by female HCPs and
receptionists, the service has been well received by women. Plans
for a women-only waiting area proved challenging within the
confines of environment and patient activity.
Aim(s)/objectives To assess patient experience of the women’s
clinic, including that of mixed sex versus female only waiting
areas.
Methods An anonymous patient experience questionnaire dis-
tributed 3
rd
–17
th
April 2014. Women were asked their age, sex-
ual orientation, previous experience of services and their views
on accessing integrated contraception and sexual health care.
Data was collated and entered into an excel database.
Results Questionnaires were received from 43 women (36 fully
completed); Majority (n = 21, 50%) 26–35 years. 33 (77%)
WSM, 3 (7%) WSW; 7 (16%) did not answer. 28 (66%) had
accessed other sexual health/ contraception services within 3
years. 3 (6%) preferred female only waiting areas, with 40
(94%) wanting a choice, or stating that they had no strong
feelings.
Discussion Assumptions about acceptability of single-sex waiting
areas did not match the majority of patients’views. WSM and
WSW accessing the service valued the choice of mixed or single
sex waiting areas.
P250 SEXUAL HEALTH INFORMATION AND SERVICES: THE
VIEWS AND EXPERIENCES OF 14 TO 22 YEAR OLDS
1
Babs Evans*,
2
David Armitage.
1
Nudge Associates, London, UK;
2
Tameside Metropolitan
Borough Council, Ashton-Under-Lyne, UK
10.1136/sextrans-2015-052126.292
Background/introduction Young people are not always consulted
about their sexual health information and service needs.
Aim(s)/objectives The authors sought to capture young people’s
views and experiences of sexual health information and services
in a specific geographical area.
Methods An online survey was published on survey monkey
between 4 and 16 December 2014. It was promoted via social
media, youth groups and Lesbian, Gay, Bisexual and Transgender
(LGBT) organisations. 207 responses from young people aged
between 14 and 22 were analysed.
Results 50% of respondents were female. Of 190 stating sexual-
ity, 12% may be gay or bisexual. Only 13% had attended sexual
health classes that met all their sexual health needs. Young peo-
ple reported getting sexual health information from TV pro-
grammes and websites. Young women were more likely to get
information from family members than young men. Most young
people knew where they could get condoms, pregnancy tests
and emergency contraception. 85% did not know about PEP
(Post Exposure Phrophylaxis) for HIV. 30 young women had
talked to a health professional about contraception, most com-
monly the pill and implant. Young people want sexual health
services to be open in the evenings and weekends, the most
common combination was Monday evening, Friday evening, and
Saturday afternoon.
Discussion/conclusion The sexual health information needs of
young people are not being met in education settings. More
information about PEP is needed, especially for young gay and
bisexual men. Sexual health services should have extended open-
ing hours leading up to, during and after weekends.
P251 TREATMENT DILEMMA OF CHLAMYDIA IN PREGNANCY
Jemy Thomas*, CM Bates, T Mathew. Royal Liverpool University Hospital, Liverpool, UK
10.1136/sextrans-2015-052126.293
Background Drug hypersensitivity reactions are immunological
responses to medications. An accurate understanding of the type
of antibiotic hypersensitivity reactions is crucial in the decision
making process of alternative antibiotic usage versus
desensitisation.
Clinical presentation A 25-year old female, twenty-four weeks
pregnant, with dysuria was diagnosed with Chlamydia. She had
asthma, which was treated with inhalers. She gave a history of
reaction to penicillin and an episode of collapse and rash to
erythromycin. Effective treatments for Chlamydia are azithromy-
cin, erythromycin, amoxicillin and doxycycline. The latter is
contraindicated in pregnancy and erythromycin and amoxicillin
were contraindicated because of this patient’s history. There is
small risk of cross reactivity between azithromycin and erythro-
mycin, so a desensitisation protocol was drawn up by the immu-
nologist. The patient was counselled regarding the possibility of
a reaction even to small doses of azithromycin and the possibility
of an anaphylactic reaction needing adrenaline, which could pre-
cipitate preterm labour. She was admitted on the ward and given
azithromycin in titrating doses, which was tolerated well without
any problems. The repeat chlamydia test following treatment
was negative.
Discussion There are limited therapeutic choices for treatment
of various sexually transmitted infections in patients with aller-
gies particularly in pregnancy. These patients will need desensiti-
sation under an immunologist with careful monitoring. If a
patient with a reported allergy is deemed not allergic or if the
allergy is simply an expected side effect, the medical record
should be updated to reflect this change along with educating
the patient.
P252 TILL DEATH DO US PART: MARRIAGE, AFRICAN-BORN
WOMEN AND HIV PREVENTIATION IN THE UNITED
KINGDOM
Tabeth Timba-Emmanuel*, Thilo Kroll, Mary Renfrew. University of Dundee, Dundee, UK
10.1136/sextrans-2015-052126.294
Background/introduction Recent studies from Sub-Saharan
Africa, most especially Southern Africa, reveal a shocking trend
in HIV transmission with married couples recording the biggest
percentage of new infections per annum. Hence the mode of
transmission as far as HIV is concerned has been evolving and
the previously so called ‘low risk’unions are no longer as safe as
previously thought, most especially for women. UK literature
shows that the trend of HIV in Black-African population mirrors
that in Africa. Making of culturally sensitive and therefore effec-
tive policies and interventions for this particular group calls for
a good in-depth understanding and insight into experiences and
strategies that persists and those that newly emerge for married
African-born women when they immigrate into UK.
Abstracts
A98 Sex Transm Infect 2015;91(Suppl 1):A1–A104
group.bmj.com on October 27, 2015 - Published by http://sti.bmj.com/Downloaded from
Aim(s)/objectives The aim of this study was to explore experien-
ces and strategies of married African-born women who are living
in the United Kingdom in prevention of HIV.
Methods Eighteen in-depth Interviews were conducted with
married African-born women who were aged between 25 to
55 years old in three Scottish cities: Aberdeen; Edinburgh; and,
Glasgow.
Results Women’s reports suggest a false sense of security
amongst married women in regard to HIV prevention. Contrary
to the daily exposure to the lived realities of HIV in Africa, HIV
is rarely mentioned in media or discussed by health professio-
nals. Condom use and asking husbands to get HIV tested was
deemed unnecessary and therefore often neglected.
Discussion/conclusion Policies and interventions for HIV pre-
vention amongst married African-born women should transcend
multiple levels: individual-level; couple-level; and, structural-
level.
P253 REGIONAL AUDIT OF TESTING CHILDREN OF HIV
POSITIVE MOTHERS
1
Victoria McArdell*,
2
Katrina Humphreys,
2
Sangeetha Sundaram,
2
Raj Patel,
2
Selvavelu
Samraj.
1
University of Southampton, Southampton, UK;
2
Solent NHS Trust, Southampton,
UK
10.1136/sextrans-2015-052126.295
Background In 2009, the “Don’t forget the children”report rec-
ommended that all new HIV-positive patients attending adult
HIV services should have any children identified, tested and the
information clearly documented. In our clinic, HIV diagnosis in
a child was delayed due to lack of a robust testing protocol
despite regularly engaging with the mother for her care. We
aimed to survey our clinic’s testing practice before and after pub-
lication of this report to assess impact.
Method A retrospective case note review on all HIV positive
women registered at the Solent adult HIV service. The popula-
tion will be divided into 2 groups: (a) pre guidelines (n = 81),
and post guidelines (n = 61). Details of children, their ages,
country of residence, testing status, outcomes and timescales
were recorded.
Results
Pre-guidelines
(2000–2009)
n=81
Post-guidelines
(2010–2014)
n=61
Number of children <18, UK resident, at risk 36 33
Number of children for whom HIV testing
was discussed and documented in maternal
notes
22 (61%) 33 (100%)
Testing initiated by HIV service 10 15
Time scale for children to be tested (range) 3 months –9 years 3 months –3 years
Conclusion Testing of children at risk of HIV has significantly
improved in our service since the publication of “Don’t forget
the Children”. However this audit identified some children who
continue to remain untested or status unconfirmed. We have
implemented a robust protocol to chase up outcomes of children
tested outside of HIV service and to proactively negotiate testing
when parents initially decline consent. Since January 2012,
Southampton has been integrated with 3 other clinics to form
Solent Sexual Health Service. We plan to extend this retrospec-
tive audit to include HIV positive women attending 3 other clin-
ics, which may result in identification and testing of more
children at risk.
P254 SAFEGUARDING CHILDREN IN SEXUAL HEALTH
SERVICES –A GROWING CONCERN
Christine Donohue, Nicola Fearnley, Sophie Brady*. Bradford Teaching Hospitals NHS
Foundation Trust, Bradford, West Yorkshire, UK
10.1136/sextrans-2015-052126.296
Background Additional focus on child sexual exploitation (CSE)
and high profile safeguarding cases within the media has
impacted on workload within sexual health services. Our trust
has established pathways for sharing information about the most
vulnerable children in the form of named nurse (for safeguarding
children) notifications (NNN). These facilitate the triangulation
of information and senior review of cases. Following integration
in 2011 we have emphasised the need for all clinical staff work-
ing across different sites to recognise children at risk and notify
cases.
Aim To quantify the NNN made from our integrated service as
a measure of safeguarding children workload.
Methods Numbers of safeguarding referrals in the form of
NNN initiated by our service over 3 years were obtained from
the NNN database.
Results
Year January–March April–June July–September October–December Total
2012 002 1 3
2013 346 7 20
2014 11 19 18 23 71
10 database entries were undated: 5 closed in 2012; 5 in
2013.
Discussion The workload in managing children at risk has
increased as demonstrated by the large rise in NNN. It is impor-
tant that the additional workload falling upon teams is recog-
nised and particularly the disproportionate burden falling upon
health advisors who may be supporting the young people in
addition to advising colleagues. The marked increase may have
resulted from community staff gaining more experience in recog-
nising the signs of children in need. Further training, supervision
and the use of a standardised proforma across all sites may also
have contributed.
Abstracts
Sex Transm Infect 2015;91(Suppl 1):A1–A104 A99
group.bmj.com on October 27, 2015 - Published by http://sti.bmj.com/Downloaded from
women and hiv preventiation in the united kingdom
Till death do us part: marriage, african-born P252
Tabeth Timba-Emmanuel, Thilo Kroll and Mary Renfrew
doi: 10.1136/sextrans-2015-052126.294
2015 91: A98-A99 Sex Transm Infect
http://sti.bmj.com/content/91/Suppl_1/A98.3
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Topic Articles on similar topics can be found in the following collections
(1318)Reproductive medicine
(738)Condoms (2431)HIV/AIDS (2431)HIV infections
(2431)HIV / AIDS (3083)Drugs: infectious diseases
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