Access of non-specialist sexual health services by men who have sex with men: do they differ from those attending specialist services?

Sex Transm Infect. 2018 Feb;94(1):72-74. doi: 10.1136/sextrans-2016-052755. Epub 2016 Nov 25.

Abstract

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.

Keywords: GAY MEN; HIV TESTING; SERVICE DELIVERY; SEXUAL HEALTH; SURVEILLANCE.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • England / epidemiology
  • Gonorrhea / epidemiology
  • HIV Infections / epidemiology
  • Health Services / statistics & numerical data*
  • Health Services Accessibility*
  • Herpes Genitalis / epidemiology
  • Humans
  • Male
  • Mass Screening
  • Middle Aged
  • Prevalence
  • Risk Factors
  • Sexual Health / statistics & numerical data
  • Sexual and Gender Minorities / statistics & numerical data*
  • Sexually Transmitted Diseases / epidemiology*
  • Specialization*
  • Young Adult