Background Saunas have traditionally been where MSM participate in risky sexual activities, contracting high numbers of sexually transmitted infections (STIs) and have been ideal targets for sexual health outreach work. There has however been a recent trend towards private “Chem-Sex “parties arranged through social media. Is sexual health outreach work in the saunas still justified, particularly in these financially pressured times?

Aim Comparison of outreach services in a large urban centre in 2011 and 2013.

Methods Retrospective case-note review of patients who accessed outreach services July–December 2011 and 2013.

Results In 2011, 98 case notes were reviewed. The rate of infection was 28.2%.

In 2013, 89 case notes were reviewed. The overall rate of infection fell to 14.6%. However, 46% had never attended our GUM clinic and among these the infection rate was 22%. The comparative rate in MSM attending clinic was 8.7%. Of those new to our services 19% had never attended any GU service and of these 82% had never tested for HIV.

Conclusion Our outreach team tested a significant number of patients with a high burden of infection who had never accessed services. However, the team is taken from conventional clinics; due to staff shortages in the clinic, patients are turned away. A balance needs to be found between financial constraints and reducing infection in hard-to-reach populations. Collaboration with voluntary organisations and saunas will be the key to our success. We are currently setting up a Chem-Sex clinic to target evolving at risk populations.