scholarly journals Pre-Exposure Prophylaxis Counseling in a Community Sexual Health Clinic for Men Who Have Sex with Men in Lisbon, Portugal

2019 ◽  
Vol 32 (6) ◽  
pp. 441 ◽  
Author(s):  
Sofia Ribeiro ◽  
Miguel Rocha
Keyword(s):  
National Health Service ◽  
Health Service ◽  
Sexual Health ◽  
National Health ◽  
Antiretroviral Drugs ◽  
Health Clinic ◽  
Eligibility Criteria ◽  
Sex With Men ◽  
Exposure Prophylaxis

Introduction: Pre-exposure prophylaxis is defined as the use of antiretroviral drugs to prevent HIV acquisition in uninfected individuals. Recognizing the increasing use of informal pre-exposure prophylaxis in Portugal, CheckpointLX, a community clinic targeted to men who have sex with men in Lisbon, Portugal, began offering counselling and follow-up services prior to formal introduction. This study aims to characterize pre-exposure prophylaxis users attending CheckpointLX before formal pre-exposure prophylaxis introduction in Portugal, and those who were referred to pre-exposure prophylaxis in the National Health Service following formal approval of pre-exposure prophylaxis.Material and Methods: Data was collected by peer counsellors between May 2015 and September 2018 and inserted in a database. Medical care followed the European AIDS Clinical Society recommendations for pre-exposure prophylaxis eligibility, initiation and follow-up. For formal pre-exposure prophylaxis, the General-Directorate for Health’s Pre-exposure Prophylaxis guidelines checklist was used.Results: Until the end of May 2018, CheckpointLX had a total of 90 appointments for wild pre-exposure prophylaxis, of which 64 (71%) were first time visits. As for the 380 service users referred to the National Health Service, most were Portuguese (n = 318, 84%), and the mean age was 31 (8.9) years old. Condomless sex in the last six months with partners of unknown HIV status was the most common eligibility criteria (n = 59, 83%).Discussion: Pre-exposure prophylaxis delivery should be complemented with effective information on the importance of immunization and education on safer practices of drug administration, in the scope of broader preventive sexual health care.Conclusion: Much remains to be done in Portugal to ensure that pre-exposure prophylaxis is available to those who need it the most. Offering pre-exposure prophylaxis at community clinics could be a first step.

scholarly journals Pre-exposure prophylaxis in a sexual health clinic for Men who Have Sex with Men in Portugal

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
S Ribeiro ◽  
M Rocha
Keyword(s):  
Sexual Health ◽  
Drug Administration ◽  
Antiretroviral Drugs ◽  
Health Clinic ◽  
Hiv Status ◽  
Eligibility Criteria ◽  
Sexual Health Care ◽  
Condomless Sex ◽  
Exposure Prophylaxis

Abstract Background Pre-exposure prophylaxis (PrEP) is defined as the use of antiretroviral drugs to prevent HIV acquisition in uninfected individuals. Recognizing the increasing use of informal PrEP in Portugal, CheckpointLX, a community clinic targeted for MSM in Lisbon, Portugal, began offering counselling and follow-up services prior to formal introduction. This study aims to characterize PrEP users attending CheckpointLX before formal PrEP introduction in Portugal, and those who were referred to PrEP in the National Health Service (NHS) following formal approval of PrEP. Methods Data was collected by peer counsellors between May 2015 and September 2018 and inserted in a database. Medical care followed EACS recommendations for PrEP eligibility, initiation and follow up. For formal PrEP, the General-Directorate for Health’s PrEP guidelines checklist was used. Results Until the end of May 2018, CheckpointLX had a total of 90 appointments for Wild PrEP, of which 64 (71%) were first time visits. As for the 380 service users referred to the NHS, most were Portuguese (N = 318, 84%), and the mean age was 31 (8.9) years old. Condomless sex in the last six months with partners of unknown HIV status was the most common eligibility criteria (N = 59, 83%). Conclusions PrEP delivery should be complemented with effective information on the importance of immunization and education on safer practices of drug administration, in the scope of broader preventive sexual health care. Much remains to be done in Portugal to ensure that PrEP is available to those who need it the most. Offering PrEP at community clinics could be a first step. Key messages Condomless sex in the last six months with partners of unknown HIV status was the most common eligibility criteria for PrEP. PrEP delivery should be complemented with effective information on the importance of immunization and education on safer practices of drug administration.

scholarly journals Scottish rehabilitation services: eight year follow-up

1993 ◽  
Vol 17 (6) ◽  
pp. 341-344
Author(s):  
Robin G. McCreadie ◽  
Douglas J. Williamson ◽  
Lesley J. Robertson
Keyword(s):  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Mentally Ill ◽  
Support Services ◽  
Psychiatric Rehabilitation ◽  
Rehabilitation Services ◽  
Local Authorities

A survey of Scottish psychiatric rehabilitation and support services, carried out in 1983 (McCreadie et al, 1985), found that although there were wide between-hospital differences, the National Health Service in Scotland was making considerable efforts to provide services for the long-term mentally ill. However, services provided by local authorities were seriously deficient.

scholarly journals Translating the Strengthening and Stretching for Rheumatoid Arthritis of the Hand Programme from clinical trial to clinical practice: An effectiveness–implementation study

Hand Therapy ◽  
2020 ◽  
Vol 25 (3) ◽  
pp. 87-97
Author(s):  
Esther Williamson ◽  
Cynthia Srikesavan ◽  
Jacqueline Thompson ◽  
Eda Tonga ◽  
Lucy Eldridge ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Clinical Trial ◽  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Routine Care ◽  
Service Organizations ◽  
Implementation Study ◽  
Health Service Organizations

Introduction The Strengthening and Stretching for Rheumatoid Arthritis of the Hand programme is a hand exercise programme for people with rheumatoid arthritis. It was clinically effective when delivered during a clinical trial but there was a need to evaluate translation into routine care. Methods We conducted an effectiveness–implementation study. We adapted the trial training into an online format for National Health Service hand therapists. Educational outcomes included confidence and capability to deliver the programme. Implementation outcomes included training reach and adoption. Therapists were invited to collect clinical outcomes. Patients receiving the programme provided data on function (Michigan Hand Questionnaire function scale), pain and grip strength at baseline, treatment discharge and four-month follow-up. Results A total of 790 therapists (188 National Health Service organizations) enrolled in the training; 584/790 (74%) therapists (162 National Health Service organizations) completed the training; 448/790 therapists (145 National Health Service organizations) (57%) evaluated the training and were confident (447/448, 99.8%) and capable (443/448, 99%) to deliver the programme with 85% intending to adopt it (379/448). Follow-up data were provided by 116/448 (26%) therapists. Two-thirds (77/116; 51 National Health Service organizations) reported adopting the programme. One hundred and eighteen patients (15 National Health Service trusts) participated. Patients reported improved function (mean change Michigan Hand Questionnaire scores: 10 (95% CI 6.5–13.6) treatment discharge; 7 (95% CI 3.8–10.2) 4-month follow-up). Grip strength increased 24.5% (left) and 31% (right). Pain was stable. Discussion Online training was an effective way to train therapists with good reach. Clinical outcomes were similar to the clinical trial providing preliminary evidence of successful translation into routine care.

Psychiatric Out-Patients in Plymouth—An Area Service Analysed

1965 ◽  
Vol 111 (470) ◽  
pp. 10-17 ◽  
Author(s):  
Neil Kessel ◽  
Christine Hassall ◽  
Robert Blair ◽  
John M. Gilroy ◽  
Francis Pilkington ◽  
...  
Keyword(s):  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Mental Hospital ◽  
Psychiatric Care ◽  
Community Care ◽  
Psychiatric Patients ◽  
Patient Department

Out-patient services in Britain for psychiatric patients have expanded enormously under the National Health Service. Well over half a million patients are seen at clinics annually. Concomitant with this increase the out-patient department has changed in function. No longer is it principally concerned with providing follow up and support for discharged mental hospital in-patients; instead, because of the greatly increased demand for psychiatric care for less severe disorders and under the influence of the movement for community care it now should play a part not at all subservient to the in-patient department. The clinic, properly run, should be an arena of treatment in its own right.

Fuckbuddy partnerships among men who have sex with men – a marker of sexually transmitted infection risk

2017 ◽  
Vol 29 (1) ◽  
pp. 44-50 ◽  
Author(s):  
Vincent J Cornelisse ◽  
Christopher K Fairley ◽  
Tiffany Phillips ◽  
Sandra Walker ◽  
Eric PF Chow
Keyword(s):  
Sexual Health ◽  
Health Centre ◽  
Romantic Attachment ◽  
Sexual Partners ◽  
Health Clinic ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Hiv Prevention Strategies ◽  
Sex With Men ◽  
Exposure Prophylaxis

‘Fuckbuddies’ are a type of regular sexual partner with whom men have ongoing sexual contact, generally in the absence of romantic attachment. We surveyed 989 men who have sex with men (MSM) at the Melbourne Sexual Health Centre, Australia, with the aim of determining the frequency of ‘fuckbuddy’ partnerships among sexual health clinic attendees and assessing their sexual risk. The majority (60%) of 1139 regular partnerships were described as ‘fuckbuddies’. Most MSM (63%) with a ‘fuckbuddy’ had multiple ‘fuckbuddies’. MSM with ‘fuckbuddies’ were more likely to also have casual sexual partners (odds ratio [OR] 5.7; 95% confidence interval 3.6–8.9) and had more casual sexual partners (median of 4 versus 1, p < 0.001) and more rectal chlamydia (12.4% versus 5.7%; adjusted OR 2.3; p < 0.05) than MSM without ‘fuckbuddies’, and this risk persisted after adjusting for total numbers of sexual partners. Our findings suggest that patients with ‘fuckbuddies’ are at particular risk of sexually transmitted infections. We argue that clinicians should specifically ask about ‘fuckbuddy’ partnerships as part of their risk assessment during patient interviews, as these patients may benefit from HIV prevention strategies such as pre-exposure prophylaxis (PrEP).

Validation of the Security Needs Assessment Profile (SNAP) by a national survey of secure units in England

2012 ◽  
Vol 36 (10) ◽  
pp. 366-371 ◽  
Author(s):  
Steffan Davies ◽  
Mick Collins ◽  
Chris Ashwell
Keyword(s):  
Clinical Practice ◽  
National Health Service ◽  
Health Service ◽  
Needs Assessment ◽  
National Health ◽  
National Survey ◽  
Content Validity ◽  
Security Requirements ◽  
Clinical Implications

Aims and methodThe Security Needs Assessment Profile (SNAP) was developed to provide a detailed description of individual patient's security requirements in the then Trent Region of England. A national survey of secure units was undertaken to examine the content validity of the item structure of SNAP and revise the item definitions to reflect more broadly based clinical practice. A follow-up survey sought views on the usefulness of SNAP in clinical practice.ResultsThirty-five secure units from National Health Service and independent sector providers participated. No new security items were generated. All the item definitions were reviewed, many amended, and a small number revised extensively. Units' security profiles were rated on the original and revised instruments.Clinical implicationsThe revised SNAP has been shown to be generalisable across secure services in England; 92% of respondents agreed or strongly agreed that SNAP would be useful in providing a structured security needs assessment.

scholarly journals HIV Pre-exposure Prophylaxis (PrEP) Uptake and Retention Among Men Who Have Sex with Men in a Community-Based Sexual Health Clinic

2017 ◽  
Vol 22 (4) ◽  
pp. 1096-1099 ◽  
Author(s):  
J. Carlo Hojilla ◽  
David Vlahov ◽  
Pierre-Cedric Crouch ◽  
Carol Dawson-Rose ◽  
Kellie Freeborn ◽  
...  
Keyword(s):  
Sexual Health ◽  
Health Clinic ◽  
Community Based ◽  
Sex With Men ◽  
Exposure Prophylaxis

Follow-up of renal impairment results among attendees taking HIV Pre-Exposure Prophylaxis at a Sydney Sexual Health Clinic

2020 ◽  
Vol 31 (7) ◽  
pp. 689-693
Author(s):  
NB Comninos ◽  
R Foster ◽  
R Varma ◽  
C Bourne
Keyword(s):  
Renal Impairment ◽  
Sexual Health ◽  
Service Provision ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
Health Centre ◽  
Health Clinic ◽  
Immunodeficiency Virus ◽  
Exposure Prophylaxis

Renal monitoring is recommended for Pre-Exposure Prophylaxis (PrEP) users. We aimed to explore follow-up and outcomes among PrEP users with renal impairment (defined as estimated glomerular filtration rate <65 mL/min/1.73 m2) attending Sydney Sexual Health Centre. Time to follow-up was analysed for impairment results over a 12-month period (January–December 2018); 48/2504 (1.9%) tests among 1700 attendees showed impairment. Follow-up occurred in 39/48 (81.3%) impairment results after a median of 42 days. PrEP was ceased in 3/6 cases of non-resolving/persisting impairment, with one case of subsequent human immunodeficiency virus infection. Maintaining engagement and follow-up of those with renal impairment are important aspects of PrEP service provision.

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