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[This corrects the article DOI: 10.1371/journal.pone.0204793.].

Background In 2009, Sydney Sexual Health Centre implemented a short message service (SMS) reminder system to improve re-screening after chlamydia infection. SMS reminders were sent at 3 months recommending the patient make an appointment for a re-screen. Methods Using a before-and-after study, the authors compared the proportion re-screened within 1–4 months of chlamydia infection in women and heterosexual men who were sent an SMS in January to December 2009 (intervention period) with a 18-month period before the SMS was introduced (before period). The authors used a χ2 test and multivariate regression. Visitors and sex workers were excluded. Results In the intervention period, 141 of 343 (41%) patients were diagnosed with chlamydia and sent the SMS reminder. In the before period, 338 patients were diagnosed as having chlamydia and none received a reminder. The following baseline characteristics were significantly different between those sent the SMS in the intervention period and the before period: new patients (82% vs 72%, p=0.02), aged <25 years (51% vs 33% p<0.01), three or more sexual partners in the last 3 months (31% vs 27%, p<0.01) and anogenital symptoms (52% vs 38%, p<0.01). The proportion re-screened 1–4 months after chlamydia infection was significantly higher in people sent the SMS (30%) than the before period (21%), p=0.04, and after adjusting for baseline differences, the OR was 1.57 (95% CI 1.01 to 2.46). Conclusions SMS reminders increased re-screening in patients diagnosed as having chlamydia at a sexual health clinic. The clinic now plans to introduce electronic prompts to maximise the uptake of the initiative and consider strategies to further increase re-screening.

ObjectivesTo describe, using routine data in selected countries, chlamydia control activities and rates of chlamydia infection, pelvic inflammatory disease (PID), ectopic pregnancy and infertility and to compare trends in chlamydia positivity with rates of PID and ectopic pregnancy.MethodsCross-national comparison including national data from Australia, Denmark, the Netherlands, New Zealand, Sweden and Switzerland. Routine data sources about chlamydia diagnosis and testing and International Classification of Disease-10 coded diagnoses of PID, ectopic pregnancy and infertility in women aged 15–39 years from 1999 to 2008 were described. Trends over time and relevant associations were examined using Poisson regression.ResultsOpportunistic chlamydia testing was recommended in all countries except Switzerland, but target groups differed. Rates of chlamydia testing were highest in New Zealand. Chlamydia positivity was similar in all countries with available data (Denmark, New Zealand and Sweden) and increased over time. Increasing chlamydia positivity rates were associated with decreasing PID rates in Denmark and Sweden and with decreasing ectopic pregnancy rates in Denmark, New Zealand and Sweden. Ectopic pregnancy rates appeared to increase over time in 15–19-year-olds in several countries. Trends in infertility diagnoses were very variable.ConclusionsThe intensity of recommendations about chlamydia control varied between countries but was not consistently related to levels of chlamydia diagnosis or testing. Relationships between levels of chlamydia infection and complication rates between or within countries over time were not straightforward. Development and validation of indicators of chlamydia-related morbidity that can be compared across countries and over time should be pursued.

BackgroundSexual Transmitted infections (STls) are widespread in Pakistan and have not been fully documented. A hospital based prospective study was carried out to determine the incidence and clinical pattern of various types of STls in general population of Larkana division and its surrounding cities.MethodsPatients and methodsThis study was conducted at male STD Clinic in the Department of Dermatology Shaheed Mohtarma Benazir Bhutto Medical University (SMBBMU) hospital Larkana. A total of 4288 cases were seen in this semi urban area. A structured questionnaire presenting the details of syndromic diagnosis was filled during the examination of each patient. For our ease and understanding, these patients were also separated on the basis of clinical and etiological grounds.ResultsAmong 4288 patients, 3947 had the history of extra marital sexual contact and simultaneously had developed clinical signs of STls. Majority of patients had the history of heterosexual contact with different partners. According to syndromic diagnosis: 1930 patients had genital ulcer (including herpes genitals) with or without skin manifestations, 690 had urethral discharge, 431 had genital warts, 349 had lesions other than STls related, 304 had more than one syndrome, 193 had scrotal swelling, 46 had inguinal baboo, 3 were human immunodeficiency virus (HIV) positive and 1 had ophthalmia neonatorium.ConclusionIt is concluded that 5Tls are the growing concern and a public health problem in the central part of 5indh province of this muslim state and syphilis exhibited the highest level of concentration followed by gonorrhea and so on. Community needs to be educated for adopting the safe sex measures to prevent the STls.DisclosureNo significant relationships.

Introduction159,448 chlamydia infections were reported in England (2021), accounting for 51% of STI diagnoses. Online services perform 43% of chlamydia tests. Due to high chlamydia reinfection rates national guidance supports retesting three months post-treatment. We compared chlamydia reinfection rates between e-service users and attendees of three London clinics.MethodsBetween 01/05/2019–01/09/2022, patients diagnosed and treated for chlamydia in clinic were identified via GUMCAD coding and compared to e-service users that received their diagnosis and treatment remotely. Outcomes from repeat chlamydia tests performed between 6weeks-6months post-treatment were collected.Results13736 patients were diagnosed and treated for chlamydia in clinic. Of those 32.4% (4457/13736) retested: 19.7% (876/4457) were positive, 80.3% (3581/4457) negative.30,830 e-service users were diagnosed and treated online. 57.7%, 17803/30830, retested: 9.6% (1716/17803) were positive, 90.4% (16087/17803) negative.Re-infections by demographic characteristics are tabulated. E-service groups with the highest reinfection rates were: <18s 15.9% (38/239), gay/bisexual men 13.5% (599/4451), and Caribbean communities 11.3% (252/2239).Abstract P001 Table 1 SHL re-infected Clinic re-infected Total %/1716 %/876 Female 821 47.8% 89 10.2% Male 880 51.3% 786 89.7% Other 15 0.9% 1 0.1% White British 568 33.1% 212 24.2% Other White 337 19.6% 311 35.5% Caribbean 252 14.7% 37 4.2% African 172 10.0% 29 3.3% White/Black Caribbean 79 4.6% 22 2.5% Other 308 18.0% 265 30.3% Gay/bisexual men 599 34.9% 731 83.4% MSW 280 16.3% 29 3.3% WSM 764 44.5% 73 8.3% Gay/Bisexual women 47 2.7% 8 0.9% Other 26 1.5% 35 4.0% Under 18s 38 2.2% 12 1.4% DiscussionChlamydia retesting rates were significantly higher and reinfection rates significantly lower (p<0.01) amongst e-service users. Barriers to accessing clinic during COVID-19, clinic booking systems diverting asymptomatics online and clinic populations comprising more GBMSM may account for the variance observed. Ease/convenience of online testing, electronic partner notification and e-service retest prompts/reminders could also be responsible.

IntroductionUK sexual health services are shifting online. Uptake of online partner notification and management (OPNM) for sexually transmitted infections (STIs) is low. There is a lack of evidence to guide its development and deployment. This study explored the acceptability of, and barriers and facilitators to, OPNM to inform the optimisation of an eSexual Health Clinic (eSHC).MethodsWe conducted semi-structured qualitative interviews (n=25) with UK sexual health service users recruited from clinics and the community (10/2021–01/2023). Interviews explored experiences of partner notification (PN), barriers to and facilitators of OPNM, and involved a walk-through of an OPNM prototype pathway (Figure 1) using fictional personas/scenarios. We analysed transcripts using thematic analysis.ResultsParticipants were diverse in terms of gender, sexual identity, and disability. Most found OPNM acceptable and described using some online PN methods themselves (e.g., texting). Facilitators included: perception of OPNM as more convenient and less embarrassing than face-to-face/telephone PN; perception of its suitability for use with casual partners; provision of multiple tools for both identifiable and anonymous PN; and facilitation of online partner testing/treatment. Barriers included: perception of OPNM as impersonal and preferences for telling/being told in a more personal way, especially in ongoing relationships; security and privacy concerns; and distrust of online notifications.Abstract O19 Figure 1DiscussionOPNM appears acceptable, but acceptability varied depending on relationship type and communication preferences. In developing an eSHC, consideration should be given to incorporating multiple options for communicating with partners that allow users to identify themselves or remain anonymous, and providing messaging that is personalisable to the relationship and context. Pairing PN with accessible online STI testing/information and treatment, where appropriate, may motivate index patients to engage in PN and efficiently link partners into online management. Building trust with users is key and may be facilitated through NHS branding and security/privacy assurances.

IntroductionOnline contraception services provide a means of broadening contraception access and served as a key component of sexual health care delivery in the COVID response. An STI screening and contraception e-service, collaboratively funded by 30/33 London local authorities, assesses medical suitability of service users and provides up to 12 months of contraceptive pill/patch/ring, dispatched to home by post or to a community pharmacy for user collection. Examining the uptake of services is pivotal to delivering services which do not exacerbate health inequities. We provide a quantitative description of users of this e-contraception service spanning sixteen London boroughs in 2022 and their chosen mode of routine contraception dispensing.MethodsWe conducted a retrospective analysis of individual users of the e-contraception service requesting routine contraception between January 2022 and December 2022, stratifying by chosen mode of dispensing, age, ethnicity and indices of multiple deprivation (IMD).Results25540 routine contraception orders were fulfilled in 2022, with 51% of service users being aged 25–34. 35% of all users opted for pharmacy dispensing of contraception rather than postal (9017/25540). All ethnicities were more likely to opt for postal dispatch except for those of Bangladeshi background. Of those choosing pharmacy collection those of a Caribbean background formed the largest group amongst those from racially minoritised backgrounds (n=1420). When comparing choice amongst orders from African service users, pharmacy collection was 1.5% higher (9.9% vs 11.4%) than postal delivery, and for those from most affluent IMDs, most opted for pharmacy collection.DiscussionOver one third of online contraception service users choose face-to-face pharmacy dispensing rather than postal dispatch. Those of Bangladeshi background are more likely to opt for pharmacy dispensing. A deeper understanding of this preference through mixed method research is crucial in shaping equitable services for all.