Quality statement 5: Repeat testing for sexually transmitted infections

Quality statement

Men who have sex with men have repeat testing every 3 months if they are at increased risk of sexually transmitted infections.

Rationale

Regular repeat testing for sexually transmitted infections (STIs) for men who have sex with men and who are at increased risk of STIs will ensure that diagnosis is made as soon as possible and further transmission of STIs can be avoided.

Quality measures

Structure

a) Evidence of local arrangements to provide STI repeat testing every 3 months for men who have sex with men and are at increased risk of STIs.

Data source: Local data collection, such as service protocols.

b) Evidence of local arrangements to encourage men who have sex with men to have repeat STI tests every 3 months if they are at increased risk of STIs.

Data source: Local data collection, such as health promotion leaflets and materials.

Process

a) Proportion of men who have sex with men and are at increased risk of STIs who were sent a reminder to have repeat testing for STIs within the past 3 months.

Numerator – the number in the denominator who were sent a reminder to have repeat testing for STIs within the past 3 months.

Denominator – the number of men who have sex with men and are at increased risk of STIs.

Data source: Local data collection, such as an audit of patient health records.

b) Proportion of men who have sex with men and are at increased risk of STIs who were tested for STIs within the past 3 months.

Numerator – the number in the denominator who were tested for STIs within the past 3 months.

Denominator – the number of men who have sex with men and are at increased risk of STIs.

Data source: Local data collection, such as an audit of patient health records.

Outcome

a) Coverage of testing for STIs: proportion of people attending the service who are tested for STIs.

Data source: Local data collection, for example, the proportion of young people screened for chlamydia and HIV testing coverage are collected as part of Public Health England's Sexual and reproductive health profiles.

b) New STI diagnoses (excluding chlamydia in people aged under 25) per 100,000 people aged 15 to 64.

Data source: These data are collected as part of Public Health England's Sexual and reproductive health profiles.

c) Chlamydia detection rate per 100,000 people aged 15 to 24.

Data source: These data are collected as part of Public Health England's Sexual and reproductive health profiles.

What the quality statement means for different audiences

Service providers (such as primary care services, genitourinary medicine clinics, community sexual health services and online sexual health services) offer men who have sex with men repeat STI testing every 3 months if they are at increased risk of STIs. Service providers ensure men are signposted to an alternative service for repeat testing if necessary. They ensure that recall reminders are sent every 3 months to improve re-attendance rates.

Healthcare professionals (such as GPs, practice nurses and sexual health consultants) offer men who have sex with men repeat appointments for STI testing every 3 months if they are at increased risk of STIs. If their service does not provide repeat testing, healthcare professionals should signpost the person to an alternative service.

Commissioners (clinical commissioning groups, local authorities and NHS England) ensure that they commission services that arrange repeat appointments for STI testing every 3 months for men who have sex with men and are at increased risk of STIs. This could include online sexual health services.

Men who have sex with men and who have a high risk of getting an STI are offered testing for STIs every 3 months.

Source guidance

British Association of Sexual Health and HIV (2016) United Kingdom national guideline on the sexual health care of men who have sex with men, recommendations on STI and HIV testing

Definitions of terms used in this quality statement

Men who have sex with men and are at increased risk of sexually transmitted infections

Men who have sex with men, who have:

  • condomless anal intercourse with partner(s) of unknown or serodiscordant HIV status over last 12 months

  • over 10 sexual partners, over last 12 months

  • drug use (such as methamphetamine, mephedrone, inhaled nitrites, gamma-butyrolactone (GBL), ketamine, and other novel psychoactive substances) during sex over last six months

  • multiple or anonymous partners since last tested

  • any condomless sexual contact (oral, genital or anal) with a new partner since last tested.

[Adapted from the British Association of Sexual Health and HIV guideline on United Kingdom national guideline on the sexual health care of men who have sex with men, recommendations on STI and HIV testing]