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P69 Improving management of msm patients with repeated rectal infections and syphilis infections
  1. Laura Ellis,
  2. Alison Craig,
  3. Sarah Cowper
  1. Chalmers Centre, Edinburgh, UK


Background/introduction Men who have sex with men (MSM) are at higher risk of acquisition of HIV in relation to risk exposure. Health Advisers (HA) have a key role in recognising the indicators of higher risk1 and reducing this through optimal management.

Aim(s)/objectives Assess documentation of risk reduction discussion and intervention by HAs for MSM with 2 or more episodes of rectal infections in the previous year and /or a diagnosis of syphilis (new or reinfection).

Methods Identified – via the electronic patient record (NASH)- all MSM attending any Clinic (January–June 2014) with 2 or more rectal infections in the previous year and /or diagnosis of syphilis (new or re-infection) Retrospective case note review.

Results N = 19. 15 positive syphilis infections. Four already known HIV positive (One patient received HIV diagnosis at the same time as syphilis). Four repeated rectal infection (all known to be HIV positive). One diagnosed HIV positive between first and second positive rectal infection. Documentation is inconsistent. None had any documentation of referral to a third sector agency or for psychology/ advanced Motivational Interviewing.

Discussion/conclusion Numbers were very small. Lack of documentation does not mean that an intervention or discussion was not carried out. Nonetheless consistent recording aids consultation and demonstrates that all means available, to assist men in reducing risk, have been offered. A risk assessment tool and standards for documentation are being developed in Lothian. HAs are encouraged to consider psychology and advanced behaviour change services early.


  1. Salado-Rasmussen K, Katzenstein TL, Gerstoft J, et al. Risk of HIV or second syphilis infection in Danish men with newly acquired syphilis in the period 2000–2010. Sex Transm Infect. 2013;89:372–376

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