How to do it: setting up a PrEP service in an integrated sexual reproductive health service setting.

Pre-exposure prophylaxis for HIV (PrEP) has been shown to reduce transmission of HIV in a number of trials; however, there is limited evidence regarding the optimal way to deliver PrEP through pre-existing UK services, particularly through fully integrated drop-in sexual health service models. PrEP in the form of Truvada was launched in Wales in July 2017. We set up a PrEP service to be delivered via our drop-in integrated sexual reproductive health service.

Audit of a human papillomavirus vaccine programme for men who have sex with men delivered through an Integrated Sexual Reproductive Health service.

Following the Joint Committee on Vaccination and Immunisation statement in November 2015 advising a human papillomavirus (HPV) vaccination programme targeting men who have sex with men (MSM) up to the age of 45 attending Genitourinary medicine and HIV services, we launched a HPV vaccination programme for MSM to be delivered through our Integrated Sexual Reproductive Health drop-in service across Newport and the South East Wales Valleys from 1 August 2016. Over the first 18 months of the vaccination programme 539 of the 693 (77%) eligible MSM who attended clinics where the vaccine was available commenced vaccination. The vaccination programme appears to have fitted in well with our pre-existing sexual health service delivery model and appears popular with MSM attending the service.

Molecular epidemiology of gonorrhoea in Wales (UK).

Objectives: After a trend of increasing incidence of gonorrhoea in the 1990s, by 2004 the incidence was declining in England, but continuing to increase in Wales. This prompted an investigation of the epidemiology of gonorrhoea in Wales to inform future prevention and control measures.

Methods: As an extension to Gonococcal Resistance to Antimicrobials Surveillance Programme, between May 2005 and September 2006, 540 consecutive gonococcal isolates were collected from three microbiology laboratories in South Wales.

The public health response to the re-emergence of syphilis in Wales, UK.

During the 1990s, cases of infectious syphilis were uncommon in Wales. In 2002, an outbreak occurred in a sexual network of men who have sex with men (MSM) attending a sauna. A multidisciplinary outbreak control team was convened to raise awareness of the outbreak among MSM and health professionals, assess the extent of outbreak, and initiate surveillance measures.

Audit of routine rectal swabs for gonorrhoea culture in women.

The British Association for Sexual Health and HIV Guidelines on the Diagnosis and Treatment of Gonorrhoea (GC) in Adults recommends rectal screening only in special circumstances. Our genitourinary medicine clinic undertakes rectal swabs for gonorrhoea culture in all women attending for sexually transmitted infection screening. We undertook this audit to determine the value of our practice.

Audit of a network of sexually transmitted infections centred in South Wales.

The aim of this article is to audit the distribution and frequency of sexually transmitted infections (STIs) within a sexual network centred in South Wales. After diagnosis of a new case of HIV in February 2007, partner notification, HIV and STI testing were undertaken. Those traced were given information regarding safe sex practices and informed they had been in contact with HIV.

Emergence of high-level azithromycin resistance in Neisseria gonorrhoeae in England and Wales.

Objectives: This study aimed to investigate the origin of high-level azithromycin resistance that emerged in isolates of Neisseria gonorrhoeae in England and Wales in 2007, and to establish methods for identifying high-level azithromycin resistance.

Methods: The Gonococcal Resistance to Antimicrobials Surveillance Programme (GRASP) data from 2001-07 were examined for emerging trends in azithromycin susceptibility. Further to the identification of six high-level azithromycin-resistant isolates in GRASP 2007, an additional 102 isolates were selected on the basis of azithromycin susceptibility and geographic origin from the GRASP 2006 and 2007 collections.

Investigation of an HIV transmission cluster centred in South Wales.

Objective: To describe an HIV transmission cluster centred in South Wales by the analysis of partner notification outcomes and demographic characteristics of individuals identified in the sexual network.

Methods: After diagnosis of the index case, HIV testing and partner notification were undertaken by Cardiff Genitourinary Medicine Clinic in collaboration with the local Health Protection Team, National Public Health Service for Wales and Terrence Higgins Trust Cymru. Rapid test and standard venepuncture methods were used for HIV screening and the resulting clinical and behavioural data were analysed.

Risk factors associated with pelvic inflammatory disease.

Objective: To investigate factors associated with pelvic inflammatory disease (PID).

Methods: A case-control study was used to investigate demographic and behavioural factors, and causative agents associated with PID.

Results: A total of 381 participants were recruited: 140 patients, and 105 and 136 controls in tubal ligation and general practice groups, respectively.

Outreach health adviser in a community clinic screening programme improves management of genital chlamydia infection.

Objective: To assess the effectiveness of an outreach health adviser on treatment, partner notification and outcome for clients diagnosed with genital chlamydia (CT) infection at a community young people's clinic.

Methods: From August 1999 to March 2000, a genitourinary medicine (GUM) based health adviser helped to develop testing and undertook outreach management of clients aged under 26 years diagnosed with CT infection. In addition to facilitating referral to GUM, she gave antibiotic treatment based on a GUM derived patient group direction to those not wishing to travel to the GUM clinic.

Comparison of urine, first and second endourethral swabs for PCR based detection of genital Chlamydia trachomatis infection in male patients.

Objectives: To compare endourethral swabs and urine as diagnostic specimens for the detection of genital Chlamydia trachomatis infection using the polymerase chain reaction (PCR), in male patients attending a genitourinary clinic and to assess whether the first endourethral swab used solely for diagnosing gonococcal infection could be used for C trachomatis detection as well.

Methods: Two endourethral swabs were taken from 80 male patients, in whom the likelihood of genital C trachomatis infection was high. The first swab was used for microscopy and culture for Neisseria gonorrhoeae, before being used for C trachomatis detection.