To manage the rising demand on sexual health services in the UK, many clinics have introduced asymptomatic screening pathways for heterosexuals, which omit examination. In men who have sex with men however the screening of extragenital sites poses additional challenges. This study aimed to establish whether omitting examination of asymptomatic men who have sex with men would lead to clinically significant diagnoses being missed. The notes of all men who have sex with men who attended a UK level 3 sexual health clinic between 1 July 2011 and 30 June 2012 were retrospectively reviewed. Exclusion criteria included HIV-positive patients attending for HIV-related care, attendances for follow-up consultations not requiring a full sexual health screen, symptomatic patients, contacts of sexually transmitted infections and patients requesting an examination or a repeat prescription of a regularly used medication. In all, 920 consultations occurred during 12 months, of which 893 were reviewed; 476 (53.3%) consultations would have been eligible for screening on an asymptomatic pathway and, of these, 21 (4.4%) had abnormalities found at examination. Findings included genital warts, minor dermatological conditions and three cases of minor asymptomatic urological conditions. There were no clinically significant findings on examination of asymptomatic men who have sex with men requiring treatment, indicating that examination in this cohort may be of little benefit.

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Conclusion We propose that with good interagency and MDT working, an efficient and effective ART delivery service is feasible, with patient and hospital benefits. Collaborative approaches between the delivery service and HIV MDT should be established and regularly evaluated with patient input. Identifying a key contact person for the delivery service is important to ensure continuity of communication, together with a local contractual service level agreement to ensure clear terms of reference and accountability. Results of a qualitative patient survey evaluating the delivery service are imminent. Do Patients Have ConfiDenCe in traineD non P2.145Background The BRAVO trial is an ongoing study designed to determine whether bi-monthly home-screening and treatment for asymptomatic bacterial vaginosis (BV) reduces risk of urogenital chlamydia and gonorrhoea infections in young women. Return rate of self-collected swabs is a critical element of home testing interventions. We conducted this preliminary analysis to determine the swab return rate and to assess its association with age, race, or recruitment setting. Methods Participants, recruited from 10 clinics in 5 cities, were asked to mail self-collected vaginal swabs to the research team every 2 months for one year. For each evaluable participant, we determined the number of kits returned (of 6 total) and compared the proportion of women that returned all 6 kits according to age, race, and recruitment setting. Results Data were available for 756 participants who were primarily non-Hispanic Blacks (76%), with median age 21 (range: 17-25 years), and mostly recruited from STD clinics (82%). Nearly all women (89%) returned at least one swab; 59% returned all 6 kits; 14% returned 5, 16% returned 1-4, and 11% returned none. Complete swab return rate (all 6) was greater among women aged 23-25 than those aged 17-22 (67% vs. 56%, p < 0.01) and varied among the 5 recruitment cities (range 42%-66%, p = 0.02). Return rates were not significantly associated with race and Hispanic ethnicity, or with recruitment from STD clinics vs. other settings (58% vs. 66%, p = 0.10). Conclusions The majority of study participants collected and submitted all six home-screening kits, and 73% completed at least five. Adolescent women aged 22 and younger had a lower return rate than women aged 23-25, although the complete return rate was still over 50%. Therefore, frequent home-screening for BV and STIs is feasible in clinical trial settings and could likely be implemented as part of clinical care and STD prevention programmes.