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Improving clinical practice and service delivery
P121 Do guidelines help promote sexual health screening (SHS) and detect sexually transmitted infections (STIs) in older adults with HIV?
  1. A Baugh,
  2. R Taylor,
  3. L Bellingham,
  4. I Ahmed
  1. Nottingham University Hospitals NHS Trust, Nottingham, UK

Abstract

Background Adults over 50 with HIV comprise 20% of the national cohort. BASHH/BHIVA guidelines recommend all patients have a sexual health assessment documented at presentation and 6-monthly, with a full SHS offer annually and outcome documented.

Aims We audited practice against these guidelines, to establish any difference in services offered to over-50s. We also examined rate of STI detection.

Methods 80 case notes were retrospectively audited–40 aged over 50 and 40 aged under 50.

Results Abstract P121 Table 1 Shows the demographics of the groups. Only 75% of over-50s had sexual history documented at presentation compared to 86% of under-50s. 45% of >50s had SHS documented at presentation (Chlamydia, GC and Syphilis), with a further 15% having Syphilis test only. 77% of over-50s had full SHS at baseline. In 24 baseline SHS performed in the over-50s we found 8 STIs: 2 Syphilis, 1 HSV, 1 Hepatitis B, 1 Chlamydia and 3 Gonorrhoea. In the 34 SHS performed in under-50s we found 11 STIs: 1 HPV, 2 Syphilis, 2 HSV, 1 Hepatitis B, 3 Chlamydia and 2 GC. Sexual history documentation in 2010/11 was poor in both groups. In the >50s, only 28% had a documented sexual history. In the under-50s, 35% had documented sexual history. SHS in 2010/11 was offered to 20% of over-50s with 1 declining and in 35% of under-50s with 2 declining. Positivity was low; 1 case of Syphilis in each group.

Abstract P121 Table 1

Demographics of HIV cohort

Conclusion In our sample, fewer over-50s had a sexual history and SHS offer documented at presentation. Screening at presentation identified STIs in both groups. Few patients declined SHS, suggesting patients find it acceptable. There were more STIs in the under-50s group at presentation, correlating to national trends. However, we tested more young patients, possibly explaining this difference. STI rate in 2010/11 was low but didn't differ with age—it is important to perform a sexual history in all patients and offer SHS, so we are developing a proforma to prompt clinicians.

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