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O037 Predicting STI risk among people attending sexual health services: Development of a triage tool targeting behavioural interventions among young people
  1. Carina King1,
  2. Cath Mercer1,
  3. Martina Furegato2,
  4. Hamish Mohammed2,
  5. Andrew Copas1,
  6. Maryam Shahmanesh1,
  7. Richard Gilson1,
  8. Gwenda Hughes2
  1. 1Research Department of Infection and Population Health, University College London, London, UK
  2. 2Department of HIV & STIs, Centre for Infectious Disease Surveillance & Control, Public Health England, London, UK

Abstract

Background/introduction There are very limited resources for delivering sexual health promotion within sexual health services (SHS).

Aim(s)/objectives Santé, a feasibility study for a trial of sexual risk reduction interventions, is developing a triage tool embedded within the electronic patient record to target interventions by risk score among young people (16–25 years) attending SHS.

Methods We used GUMCADv2, the national mandatory STI surveillance dataset (2013–2014 – Model 1), and the GUMCADv3 pilot (July-October 2015 – Model 2). Predictive logistic regressions for acute STI diagnosis were run. Model 1 only considered demographic and clinical variables; Model 2 also included enhanced behavioural data (number of partners, new partners, and condom use in the past 3 months).

Results 936,251 and 619 patient-episodes were included in Models 1 and 2 respectively, of which 11% and 4% involved an STI diagnosis. In Model 1, predicted risk of STI diagnosis ranged between 1–47% (pseudo-R2: 1.9%). Referring the riskiest (highest decile) patients to more intensive interventions gives a sensitivity and specificity of 70% and 45%, respectively, and a positive predictive value (PPV) of 13% for STI diagnosis. In Model 2 the predicted risk of STI was 0–53% (pseudo-R2: 23%), and referring the riskiest patients demonstrated an improved sensitivity (76%), specificity (87%) and PPV (25%).

Discussion/conclusion Routinely collected surveillance data can be used to triage young people for targeted risk-reduction interventions, but this is more robust if behavioural data are taken into account. Addition of behavioural data to routine STI surveillance (GUMCADv3) is a powerful way to target sexual health promotion.

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