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Access of non-specialist sexual health services by men who have sex with men: do they differ from those attending specialist services?
  1. Helen Mebrahtu,
  2. Martina Furegato,
  3. Bersabeh Sile,
  4. John Were,
  5. Hamish Mohammed,
  6. Gwenda Hughes
  1. Public Health England, London, UK
  1. Correspondence to Helen Mebrahtu, Public Health England, 61 Colindale Avenue, London NW9 5EQ, UK; helen_mebrahtu{at}


Objectives Men who have sex with men (MSM) bear a disproportionate burden of STIs. While routine STI surveillance data suggest MSM regularly access specialist genitourinary medicine (GUM) clinics for their sexual healthcare, the extent to which MSM attend non-specialist sexual health services (SHSs) is unclear.

Methods We used data from the GUM Clinic Activity Data Set (GUMCADv2), the national STI surveillance system, to compare the characteristics, service usage and STI outcomes of MSM accessing specialist and non-specialist (non-GUM) SHSs in England in 2014. Pearson's χ2, Student's t-test and logistic regression analysis were used.

Results Where sexual orientation was recorded (92%), 11% (4552/41 597) of non-GUM attendances were among MSM compared with 28% (280 466/999 331) of GUM attendances (p<0.001). Compared with those attending GUM services, MSM attending non-GUM services were younger (mean age: 30.2 years vs 37.7 years; p<0.001) and were more likely to be of mixed ethnicity (4.9% vs 3.5%; p<0.001), to have had a full sexual health screen (chlamydia, gonorrhoea, syphilis and HIV tests) (48.0% vs 37.0%; p<0.001) and to be diagnosed with chlamydia (7.4% vs 4.1%; p<0.001) and gonorrhoea (8.5% vs 6.5%: p<0.001). MSM attending non-GUM services had slightly lower HIV test uptake (87.0% vs 95.0%; p=0.157) and were less likely to be diagnosed with HIV (0.5% vs 0.8%; p=0.019), compared with those attending GUM clinics.

Conclusions Non-specialist SHSs play an important role in the care of MSM and should ensure services meet their needs.


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  • Handling editor Jackie A Cassell

  • Contributors GH and HMo conceived the analysis and agreed the data analysis plan with HMe. HMe performed the analysis and prepared the first draft with the assistance of BS, JW and MF. All authors read and critically reviewed the manuscript and helped in developing the final version for publication.

  • Competing interests None declared.

  • Ethics approval GUMCADv2 is a routine public health surveillance activity, therefore no specific consent was required from the patients whose data were used in this analysis. PHE has permission to handle data obtained by GUMCADv2 under section 251 of the UK National Health Service Act of 2006 (previously section 60 of the Health and Social Care Act of 2001), which was renewed annually by the ethics and confidentiality committee of the National Information Governance Board until 2013. Since then, the power of approval of public health surveillance activity has been granted directly to PHE.

  • Provenance and peer review Not commissioned; externally peer reviewed.