"Disappointed in the level of care"

Dear Medical Student,

Thank you for your feedback regarding your recent experience with our service. I’m sorry to hear that you felt dismissed and unsupported during your appointment, and I appreciate the opportunity to respond to your concerns.

We recognise and commend your proactive approach to sexual health. It is entirely appropriate to seek testing based on your individual circumstances, and we regret that you felt judged or discouraged from doing so.

To clarify, NHS Ayrshire & Arran provides sexual health services through Sexual Health Ayrshire (SHAYR), and our current approach to testing and care includes:

Routine Testing: Individuals on PrEP are typically offered testing every 3 months, including STI screening and kidney function monitoring.

Symptom-Free Testing: Patients without symptoms can book a sexual health check online.

Symptomatic or High-Risk Exposure: If someone believes they’ve been exposed to an STI or is at higher risk—such as through recent unprotected sex, new partners, or group sex—they should still be eligible for testing, even if it falls within the 3-month window.

Emergency Situations: Immediate appointments are available for potential HIV exposure (PEP), sexual assault, or condom failure.

LGBTQ+ Inclusive Services: We are committed to providing inclusive, respectful care for gay, bisexual, and other men who have sex with men (GBMSM), including tailored advice and testing.

It’s important to note that HIV PrEP patients are considered our highest-risk group. By definition, they are eligible for PrEP because they have frequent or multiple sexual partners. As such, they are always within the window periods for STIs. These are approximately:

2 weeks for chlamydia and gonorrhoea

45 days for HIV

6 weeks for syphilis

The 3-monthly testing schedule is designed to detect asymptomatic infections at an early stage and provide reassurance. While we understand the desire for more frequent testing, this schedule is part of our clinical process and is applied consistently across our services. We could not feasibly offer full screening after every new sexual encounter, even for our highest-risk patients.

That said, we do advise our PrEP users to contact us directly for an appointment if they develop symptoms or are contact traced between their routine 3-monthly tests. These appointments are not available via online booking, which is how we suspect this appointment may have been made. Unfortunately, the online booking system does not cover all services we provide—such as PrEP reviews, symptomatic assessments, coil removals, or menopause care—and this can sometimes lead to expectations not being met.

We acknowledge that the rationale for your care plan was not clearly communicated and that your concerns did not feel heard. While the clinical decision aligned with our current process, we recognize that the interaction could have been approached with greater empathy and clarity. Your feedback will be shared with the team to support ongoing training and service improvement.

If you would like to discuss this further or provide additional details, please don’t hesitate to contact us directly or submit further feedback through the SHAYR website.

Kind regards

Attica Wheeler