{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,6]],"date-time":"2026-09-06T17:45:36Z","timestamp":1788716736800,"version":"build-2803163510"},"reference-count":40,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T00:00:00Z","timestamp":1767830400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T00:00:00Z","timestamp":1767830400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"The National Institute for Health and Care Research Health Protection Research Unit"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Int J STD AIDS"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Sexual health service (SHS) delivery in England shifted substantially with rapid expansion of online services during the COVID-19 pandemic. While digital services may improve reach, limited data exist on unmet need for in-person SHS in England, especially among men and gender-diverse individuals who have sex with men, key populations disproportionately affected by sexual health inequalities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analysed data from \u201cReducing inequalities in Sexual Health\u201d (RiiSH) 2024 (Nov\/Dec 2024), an online survey of UK-resident men and gender-diverse individuals having sex with men. We assessed in-person SHS access and unmet need (tried but failed to access a SHS in-person) over the past year. Bivariate and multivariable logistic regression was used to examine associations with unmet need.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 2404 participants living in England (median age 45\u00a0years, 88% White, 95% cisgender), 86% had ever accessed in-person SHS and 59% in the past year. Of those who tried to access in-person care in the past year, 12% (95% CI: 11%\u201314%) experienced unmet need, especially Outside London (15% vs 8% in London). Common barriers included unavailable (50%) or inconvenient (41%) appointment times. In adjusted multivariable analysis, unmet need continued to be lower among participants living in London (aOR: 0.64 [95% CI: 0.44\u20130.92]), those financially comfortable (aOR: 0.69 [0.49\u20130.97]), and those reporting \u22651 marker(s) of sexual risk (e.g. HIV-PrEP use in the last year and\/or in the last 3\u20134 months, the report of a bacterial STI diagnosis, engaging in chemsex, having had \u226510 male physical sex partners; aOR: 0.14 [0.10\u20130.20]). Unmet need was higher among participants with limiting long-term physical health conditions (aOR: 1.61 [1.12\u20132.30]) and those who reported ever using online postal self-sampling services for STI testing (OPSS) (aOR: 1.50 [1.07\u20132.09]).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Despite high SHS engagement, one-in-eight reported unmet need for in-person SHS. Local service delivery guided by joint strategic needs assessments could help address unmet need for SHS.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/09564624251413004","type":"journal-article","created":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T17:06:06Z","timestamp":1767891966000},"page":"538-547","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["The waiting room: Unmet sexual health service needs among men and gender-diverse individuals having sex with men in England, findings from an online, cross-sectional community survey in 2024"],"prefix":"10.1177","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1900-8892","authenticated-orcid":false,"given":"Dana","family":"Ogaz","sequence":"first","affiliation":[{"name":"UK Health Security Agency"},{"name":"The National Institute for Health and Care Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in Partnership with the UK Health Security Agency, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dolores","family":"Mullen","sequence":"additional","affiliation":[{"name":"UK Health Security Agency"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-9292-1379","authenticated-orcid":false,"given":"George","family":"Baldry","sequence":"additional","affiliation":[{"name":"UK Health Security Agency"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danielle","family":"Jayes","sequence":"additional","affiliation":[{"name":"UK Health Security Agency"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dawn","family":"Phillips","sequence":"additional","affiliation":[{"name":"UK Health Security Agency"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine M","family":"Lowndes","sequence":"additional","affiliation":[{"name":"UK Health Security Agency"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Reid","sequence":"additional","affiliation":[{"name":"The National Institute for Health and Care Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in Partnership with the UK Health Security Agency, London, UK"},{"name":"University College London"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jordan","family":"Charlesworth","sequence":"additional","affiliation":[{"name":"UK Health Security Agency"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erna","family":"Buitendam","sequence":"additional","affiliation":[{"name":"UK Health Security Agency"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Phillips","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gwenda","family":"Hughes","sequence":"additional","affiliation":[{"name":"London School of Hygiene and Tropical Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine H","family":"Mercer","sequence":"additional","affiliation":[{"name":"The National Institute for Health and Care Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in Partnership with the UK Health Security Agency, London, UK"},{"name":"University College London"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3020-9916","authenticated-orcid":false,"given":"John","family":"Saunders","sequence":"additional","affiliation":[{"name":"UK Health Security Agency"},{"name":"The National Institute for Health and Care Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in Partnership with the UK Health Security Agency, London, UK"},{"name":"University College London"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kate","family":"Folkard","sequence":"additional","affiliation":[{"name":"UK Health Security Agency"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katy","family":"Sinka","sequence":"additional","affiliation":[{"name":"UK Health Security Agency"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hamish","family":"Mohammed","sequence":"additional","affiliation":[{"name":"UK Health Security Agency"},{"name":"The National Institute for Health and Care Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in Partnership with the UK Health Security Agency, London, UK"},{"name":"University College London"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,1,8]]},"reference":[{"key":"e_1_3_8_2_2","unstructured":"British Association for Sexual Health and HIV (BASHH). 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