title: Access of non-specialist sexual health services by men who have sex with men: do they differ from those attending specialist services?
abstract: Men who have sex with men (MSM) bear a disproportionate burden of STIs. While routine STI surveillance data suggest MSM regularly access specialist genitourinary medicine (GUM) clinics for their sexual healthcare, the extent to which MSM attend non-specialist sexual health services (SHSs) is unclear.
  
  
  
  We used data from the GUM Clinic Activity Data Set (GUMCADv2), the national STI surveillance system, to compare the characteristics, service usage and STI outcomes of MSM accessing specialist and non-specialist (non-GUM) SHSs in England in 2014. Pearson's χ2, Student's t-test and logistic regression analysis were used.
  
  
  
  Where sexual orientation was recorded (92%), 11% (4552/41 597) of non-GUM attendances were among MSM compared with 28% (280 466/999 331) of GUM attendances (p<0.001). Compared with those attending GUM services, MSM attending non-GUM services were younger (mean age: 30.2 years vs 37.7 years; p<0.001) and were more likely to be of mixed ethnicity (4.9% vs 3.5%; p<0.001), to have had a full sexual health screen (chlamydia, gonorrhoea, syphilis and HIV tests) (48.0% vs 37.0%; p<0.001) and to be diagnosed with chlamydia (7.4% vs 4.1%; p<0.001) and gonorrhoea (8.5% vs 6.5%: p<0.001). MSM attending non-GUM services had slightly lower HIV test uptake (87.0% vs 95.0%; p=0.157) and were less likely to be diagnosed with HIV (0.5% vs 0.8%; p=0.019), compared with those attending GUM clinics.
  
  
  
  Non-specialist SHSs play an important role in the care of MSM and should ensure services meet their needs.
authors.affiliation: Public Health England, London, UK.
authors.forename: Helen
authors.identifier: 0000-0001-9664-5003
authors.initials: H
authors.lastname: Mebrahtu
authors.affiliation: Public Health England, London, UK.
authors.forename: Martina
authors.initials: M
authors.lastname: Furegato
authors.affiliation: Public Health England, London, UK.
authors.forename: Bersabeh
authors.identifier: 0000-0003-2890-862X
authors.initials: B
authors.lastname: Sile
authors.affiliation: Public Health England, London, UK.
authors.forename: John
authors.initials: J
authors.lastname: Were
authors.affiliation: Public Health England, London, UK.
authors.forename: Hamish
authors.identifier: 0000-0002-2060-7286
authors.initials: H
authors.lastname: Mohammed
authors.affiliation: Public Health England, London, UK.
authors.forename: Gwenda
authors.initials: G
authors.lastname: Hughes
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004739:England / Q000453:epidemiology; D006069:Gonorrhea / Q000453:epidemiology; D015658:HIV Infections / Q000453:epidemiology; D006296:Health Services / Q000706:statistics & numerical data*; D006297:Health Services Accessibility; D006558:Herpes Genitalis / Q000453:epidemiology; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D000074384:Sexual Health / Q000706:statistics & numerical data; D000072339:Sexual and Gender Minorities / Q000706:statistics & numerical data*; D012749:Sexually Transmitted Diseases / Q000453:epidemiology*; D013038:Specialization; D055815:Young Adult
keywords: GAY MEN; HIV TESTING; SERVICE DELIVERY; SEXUAL HEALTH; SURVEILLANCE