Improving sexual health services for people at most risk of HIV infection

Pre-exposure prophylaxis for HIV (PrEP) is a medicine for HIV negative people that, when taken as instructed, can reduce the risk of acquiring HIV. Previous research has shown it’s safe and effective in reducing the risk of HIV infection. PrEP isn’t available in England on the NHS but can be bought online. NHS England is funding a large-scale PrEP trial, called IMPACT. Bristol’s Unity Sexual Health clinic is a centre in the trial.

We don’t know how those at most risk of HIV infection feel about PrEP, or if they’re able to access it. We also don’t know whether taking PrEP will influence attitudes to unprotected sex, so it’s important that people taking it have regular health checks, including tests for sexual infections. People using PrEP are encouraged to attend sexual health checks every three months. Now PrEP is available through the IMPACT trial and online, people may be coming to Unity Sexual Health who haven’t come before.

Challenges with PrEP include trying to engage the right people in sexual health services, while opportunities include driving down rates of sexual infections by testing the right people more frequently. So this study is called CHOP: Challenges and Opportunities of PrEP.

Project aims

We want to find out if PrEP being more readily available changes how people test for sexually transmitted infections.

We will focus on the patients attending the Unity clinic who are most at risk of HIV infection: men who have sex with men (MSM) and trans people who have sex with men (TPSM). We will look at patterns of how these groups test for sexually transmitted infections, using anonymised patient records.

These patients will be invited to complete a questionnaire exploring their motivation for attending the clinic, sexual behaviour and attitudes to PrEP, and they will be asked how they would like to be offered tests for sexual infections in the future. Some patients will also be interviewed to explore these ideas in more detail.

Anticipated impacts

This study aims to improve sexual health services for people at most risk of HIV infection.

Lead collaborators

  • Dr Jane Nicholls, North Bristol NHS Trust
  • Dr Lindsey Harryman, Unity Sexual Health
  • Nathan Speare, Unity Sexual Health

CLAHRC West staff

Jo Kesten

Dr Joanna Kesten

Partners on this project

North Bristol NHS Trust

North Bristol NHS Trust is one of the largest teaching trusts in the country and serves the population of Bristol, South Gloucestershire and North Somerset. Their internationally renowned specialist areas include neurosciences, renal, orthopaedics, major trauma, urology, plastic surgery and neo-natal intensive care.

University Hospitals Bristol NHS Foundation Trust

University Hospitals Bristol NHS Foundation Trust is a dynamic group of hospitals in the heart of Bristol, with over 100 clinical services across nine sites. They offer care to the people of Bristol and the South West, and have an international reputation for cardiac surgery, paediatric services, oncology and bone marrow transplantation and are the largest centre for medical training and research in the South West.