Accessing Care in the Sexual Health Clinic

Question 1

chlamydia partner notification (PN) look back period?

Answer 1

male urethral = 4 weeks

any other = 6 months

Question 2

gonorrhoea PN period?

Answer 2

male urethral = 2 weeks

any other = 3 months

Question 3

non specific urethritis PN period?

Answer 3

4 weeks

Question 4

trichomonas vaginalis PN period?

Answer 4

4 weeks

Question 5

epididymitis PN period?

Answer 5

same as chlamydia or gonorrhoea

if negative 6 months

Question 6

PID PN period?

Answer 6

same as epididymitis

Question 7

HIV PN period?

Answer 7

4 weeks before negative test or before most likely time of infection

Question 8

syphilis PN period?

Answer 8

primary = 90 days
secondary = 2 years
other infections = 3 months before most recent negative test

Question 9

what infections do not require partner notification?

Answer 9

warts
herpes
- no benefit in asymptomatic case finding
vaginal thrush
bacterial vaginosis
- not STIs

Question 10

high risk groups which would benefit from Hep B vaccine?

Answer 10

MSM
high prevalence countries
sexual assault
contacts

Question 11

who may benefit from Hep A vaccine?

Answer 11

MSM

Question 12

who may benefit from HPV vaccine?

Answer 12

MSM <46
girls 11-13
boys in school also

Question 13

what is PrEP?

Answer 13

pre-exposure prophylaxis
contains
- tenofovir
- disoproxil/emtricitabine
taken daily and reduces HIV incidence by 86%
can be prescribed to high risk patients

Question 14

PrEP eligability?

Answer 14

MSM condomless anal sex with 2+ partners in last year and likely in next 3 months
rectal bacterial STI in last year
partner of someone with HIV with viral load >50

Question 15

what is PEPSE?

Answer 15

medicine taken after exposure
can be for Hep B
- HBV vaccine up to 7 days after
- immunoglobulin (vaccine non-responders)

HIV

• 3 antiretrovirals
• start within 72 hours
• 28 days total treatment
• around 80% effective

Question 16

rape definition?

Answer 16

penetration of vagina, anus or mouth by penis (or anything else) without consent

Question 17

consent is invalidated in which circumstances?

Answer 17

incapacitated by alcohol or drugs

• incarcerated (wont let them leave until after sex)
• violence or threat of violence

Question 18

what is done immediately after rape?

Answer 18

consider forensic examination (must be done before doctors examination)
immediate safety
injuries
HBV vaccine
HIV vaccine
consider PEPSE if perpetrator is in high risk group
STI/pregnancy care

Question 19

medium/long term management after a rape?

Answer 19

screen for STIs
assessment of coping abilities
PTSD
HBV vaccines if indicated
practical and psychosocial support