Project title: Exploring perspectives on provision and accessibility of Pre-exposure prophylaxis (PrEP) in North England and the West Midlands.
Principal Investigator Professor Marie Claire Van Hout
Team: Professor Vivian Hope; Mr Jim McVeigh: Mrs Jennifer Germain
Site: Public Health Institute, Liverpool John Moores University, Liverpool
The United Kingdom (UK) has a concentrated HIV epidemic, with an estimated 101,200 people living with HIV in 2015. A decrease in diagnoses among men who have sex with men (MSM), the group most affected by HIV transmission, has recently been observed, and is probably due to increased frequency of testing (3 monthly) among those at greatest risk and rapid treatment for those testing positive.
Pre-exposure prophylaxis (PrEP) is an evidence based biomedical HIV prevention strategy which involves HIV negative individuals taking antiretroviral drugs to reduce probability of infection if exposed. The UK PROUD study found PrEP reduced HIV infection risk by 86% among MSM. PrEP is available on the NHS in Wales and Scotland. In October 2017, the IMPACT trial commenced in England, with PrEP being rolled out to 10,000 eligible people.
The project will explore and describe MSM and health professional perspectives on PrEP using qualitative interviews in three Northern cities (Liverpool, Manchester, Sheffield) and one city in the West Midlands (Birmingham) where PrEP is available through the IMPACT trial. Interviews with a purposive sample of participants (8-12 MSM and 4-8 health professionals per city) will focus on: PrEP awareness and sources of information including eligibility, compliance, drug interaction and online sourcing; impact of PrEP on HIV testing patterns, hepatitis C, sexual risk and other sexually transmitted infections; and on issues related to accessing PrEP and optimal service provision
The project is timely given the current IMPACT trial in England, with results informing policy, practice and professional training.
Infection by Chlamydia trachomatis the commonest bacterial sexually transmitted infection in the UK and can result in long term complications such as pelvic inflammatory disease and infertility in women.
Once treatment is given to the patient and their partner(s) a test of cure is recommended. However when this should be done is unclear. A similar question hangs over another common sexually transmitted bacterial infection, gonorrhoea.
Dr Gabriel Schembri and his colleagues in Manchester in collaboration with researchers in London have completed a study, part co-funded by STIRF (in conjunction with BASHH) in an effort to answer these questions:
STIRF-015: Testing for chlamydia and gonorrhoea: persistence of a positive test result after successful treatment.
The study has now finished and was presented at the British Association for sexual Health and HIV (BASHH) meeting in Oxford (July 2016) and won the prize for the best oral presentation.
The investigators showed that the site of infection may have an effect on time to clearance of infection, with pharyngeal gonorrhoea infections and vaginal chlamydia infections taking longer to clear than other sites.
The results of this study will help guide clinicians to the timing for tests of cure.
A workshop on philosophical aspects of sexual health is being held at
Seminar Room 3.28, New Business School, Manchester Metropolitan University Manchester, United Kingdom
The workshop is run by Dr Phil Hutchinson and was part funded by a research grant from Sexually Transmitted Infections Research Foundation (STIRF). Project STIRF-026
Workshop 1: The Problem of Selection Bias in Biomedical & Public Health Research. Wednesday September 16
Workshop 2: Shame, Stigma and HIV. Thursday September 17
Venue: Seminar Room 3.28, New Business School, Manchester Metropolitan University, Manchester, UK
Mandatory registration: contact: email@example.com
Further information can be obtained from Phil Hutchinson firstname.lastname@example.org
In this year’s funding round we received six applications. After sending them for external peer review by experts, the Scientific Committee approved two projects for funding in 2013 which was submitted to the Trustees.
Project 1: Chlamydia trachomatisis the most common sexually transmitted infection effecting young people in the UK. It infects one in ten of all women aged 15-25 and can cause serious long term complications such as pelvic inflammatory disease and infertility. According to the Health Protection Agency in 2011 in England and Wales 147,594 infections were diagnosed in 15 to 24 year olds.
Recent evidence for emergence of resistance to the commonly used antibotics used in eradicating chlamydia is very worrying. We are delighted to fund Emma Hathorn as part of a multi-centre study to evaluate the incidence of chlamydia resistance in people attending a clinic for sexually transmitted infections.
Antimicrobial resistance in Chlamydia trachomatis: is it a reality? STIRF-022
Project 2: There is increasing focus on involving patients and what they perceive are their actual needs when delivering clinical services in the NHS. This is particularly important in the fast developing field of HIV where new management strategies and new treatments take place within the background of shrinking funding. These clearly call for new ways of delivering these services more efficiently as well as more effectively. It is with this in mind that STIRF decided to fund the nurse-led project by Lucy Land that is taking steps to objectively define these priorities as seen from the HIV-infected patients perspective.
Development of a weighting scale to evaluate the relative importance of items in a validated HIV patient satisfaction questionnaire. STIRF-020
This study aims to refine a questionnaire they developed and validated with the help of HIV-infected patients to find issues that are more important and therefore need to be prioritised in development of HIV services.
Thanks to all the researchers who submitted and to the reviewers who gave their valuable time for free.
A STIRF funded project (STIRF-012) has been completed successfully. Professor Jonathan Ross, Consultant in HIV medicine at University Hospital Birmingham and Lucy Land, Reader in Nursing at Birmingham City University have developed a questionnaire that will give patients attending an HIV clinic the opportunity to feedback their experiences of care.
A systematic review of the medical literature provided background information on what factors were important to patients attending a HIV clinic. Current users of the service were then involved in verifying this information and added their views about the issues that were important to them. For example being afforded respect, dignity and autonomy, together with an expectation of expert medical care were considered essential to a good service.
A draft questionnaire was constructed to include questions around these issues as well as others that were relevant and important to patients with HIV. This draft was tested with a group of patients and refined further. The final questionnaire was piloted on 100 clinic patients and showed that the feedback from the questionnaire could provide an accurate reflection of patients’ experiences. In the future, an annual survey using this questionnaire will be conducted and the data will be used to measure the quality of care and inform improvements in HIV clinic services.
The research had been submitted for publication
An assessment of patients’ satisfaction with their HIV care
Project STIRF 012
People with HIV are living longer, healthier lives due to advances in treatments. Their healthcare needs, therefore, have changed and doctors and nurses need to have the knowledge and skills to meet those needs. The project funded by STIRF aims to find out what patients attending an HIV outpatient clinic want from the service and how well it is provided. The team started out by trying to find out whether there was an established way of measuring HIV patients satisfaction with there care and if a questionnaire already existed that could be used. Some of questionnaires which had been used in the past did not seem to be relevant to the patients today.
Since then the team have held focus groups with patients to ask them what questions they would like included and what would motivate them to fill in a questionnaire. Once the questionnaire has been tested on a small group of people, a larger survey will be conducted and the results analysed, to find out how happy HIV patients are with their outpatient service and what they would like to see changed. We hope to find the right tools so that a listening exercise can be turned into an effective plan of action.