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Whistlestop Tour goes to press just in time for us to reflect on the outcome of a Judicial Review on the role of England's National Health Services in commissioning PREP (Pre-Exposure Prophylaxis for HIV prevention). Many countries have already implemented PREP following a series of impressive trial results around the world. A ruling that NHS England has the power to fund PREP is a welcome outcome to the advocates, clinicians and organisations responsible for this review. However there is a long way to go before implementation, and much more to learn about what it will take to make this game-changing intervention as effective as possible at population level.
By the time this issue lands on your doormat, holidaymakers will be returning home, and perhaps considering a visit to your clinic. We recently published an Australian study on seasonal variation in STIs,1 and this month's issue follows this up with interesting data on travel and sexual behaviour. The National Sexual Attitudes and Lifestyles (Natsal-3) team report here on Brits' propensity to engage in new sexual partnerships while abroad.2 Natsal is a renowned and well resourced study whose third wave3 provides an excellent resource for questionnaires and surveys which is extensively used by clinicians in the UK and abroad. A wide range of their publications can be accessed at natsal.ac.uk. We are delighted to see their prestigious work accompanied by a study of international backpackers, undertaken by a British medical student,4 Christopher Lewis, publishing his research in the journal. Do read the accompanying editorial by Matteeli5 and also check out the related podcast at sti.bmj.com.
We have previously considered the sometimes murky history of chlamydia point of care tests and how they come to be used and established in the market, with useful summaries by Jain and Ison6 and Brook et al.7 This month we have something rather different – an editorial by Julius Schacter which reflects on the need for clinicians to maintain a critical and sceptical eye when faced with claims for a new test.8 This editorial reflects on the worryingly poor performance of the BioChekSwab test in Rwanda, described by De Baetselier9 Testing is the theme of several other papers including a comparison of urine vs penile swabs for HPV.10
In the age of the HPV vaccine, there is now a plethora of surveys on HPV testing now summarised in a systematic review which describes dramatic variation in knowledge among European adolescents.11 Van Klaveren et al explore another question relevant to European young people – the extent to which chlamydia testing can be targeted.12 Again from Natsal-3, Prah et al compare same-sex behaviours behaviour in men in a probability sample with community samples. Elsewhere Wilkinson et al present an interesting evaluation of HIV home sampling,13 Kamali compares HIV incidence in rural vs fishing populations in Kenya Prah14 and Reed describes violence to sex workers in Andhra Pradesh.15
Last but not least, our clinical readers can assess their digital readiness in Menon-Johansson's “How To Do It”,16 read Clinical Round-Up17 and speculate on novel causes of pelvic infection.18 Enjoy!
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Competing interests None.
Provenance and peer review Commissioned; Not peer reviewed.