Is the recall of men who have sex with men (MSM) diagnosed as having bacterial sexually transmitted infections (STIs) for re-screening a feasible and effective strategy?
- 1Department of Genitourinary Medicine, Mortimer Market Centre, Camden Provider Services, Central North and West London Foundation Trust, London, UK
- 2Research Department of Infection and Population Sciences, University College London Medical School, London, UK
- Correspondence to Dr Derval Harte, Bristol Sexual Health Services, Central Health Clinic, Tower Hill, Bristol BS2 0JD, UK;
Contributors DH was involved in the planning of the evaluation, monitored and involved in the collection of data, cleaned and statistically analysed the data, and drafted and revised the paper. DM was involved in developing and implementing the original recall strategy and revised the draft paper. JJ managed the daily operation of the recall strategy in terms of identifying eligible MSM and recalling them and collected and recorded data for the evaluation. PB was involved in developing and implementing the original recall strategy, planning and supervising the evaluation and revised the draft paper.
- Accepted 31 August 2011
- Published Online First 28 September 2011
Objectives To assess the feasibility and outcomes of recalling men who have sex with men (MSM) diagnosed as having a bacterial sexually transmitted infection (STI) for re-screening.
Methods This evaluation was conducted from December 2008 for a 9-month period. MSM diagnosed as having a bacterial STI in that period were offered recall for re-screening 3 months after their diagnosis. Re-screening rates and infection incidence were calculated. Differences in baseline characteristics by re-screening status and factors predictive of infection at re-screening were assessed using the Mann–Whitney test, χ2 test and logistic regression.
Results Of the 337 MSM diagnosed as having a bacterial STI, 301 were offered recall. Of these, 206 (68.4%) re-screened after 3 months, 30 (10%) declined and the remainder did not re-attend despite giving verbal consent. Compared with those not re-screening, those re-screening were less likely to be HIV positive (p=0.001), but there was no difference in baseline risk behaviours. There were 15 diagnoses of bacterial STIs at re-screening (29 per 100 person-year follow-up (pyfu); 95% CI 14.3 to 43.7) and five new HIV diagnoses of whom three had a negative test at baseline, one tested negative 6 months earlier and one never tested. Among those testing at both time points, the HIV incidence was 8.3 per 100 pyfu (95% CI 0.0 to 17.7).
Conclusions This evaluation demonstrates a ‘recall for re-screening’ strategy is feasible in terms of high re-screening rates and incidence of new infections diagnosed. Experimental evidence is needed to assess cost-effectiveness and whether it achieves its aim of reducing transmission of STIs and HIV.
- sexually transmitted infections
Funding Camden Primary Care Trust was the funder of all services at Mortimer Market Centre. They provided extra funding for this new service strategy to be rolled out in the service. This extra funding was used to cover employ an extra health advisor to run the service.
Competing interests None.
Ethics approval Ethics approval was not deemed to be required by the local research and development department as this was an evaluation of a service delivery.
Provenance and peer review Not commissioned; externally peer reviewed.