Accessing Care in the Sexual Health Clinic

Question 1

How are sexual attitudes and practices changing?

Answer 1

• Prevalence of same sex partners increased in women but not men
• Frequency of sex decreased (long term couples)

Question 2

Why may patients NOT present to a sexual health clinic?

Answer 2

• worried about stigma/being judged

- worried about lack of confidentiality

Question 3

What are the roles of a sexual health clinic?

Answer 3

• Diagnosis and management of STIs
• Partner notification
• Infection prevention
• Genital dermatology
• Contraception
• Community gynaecology
• Menopause
• Psychosexual counselling

Question 4

Partner notification is voluntary. TRUE/FALSE?

Answer 4

TRUE

Question 5

How long is the “look back” period for partner notification in chlamydia and gonnorhoea?

Answer 5

CHLAMYDIA
Symptomatic Male = 4 weeks
Any other infection = 6 months

GONNORHOEA
Symptomatic male = 2 weeks
Any other infection = 3 months

Question 6

How long is the “look back” period in syphilis infection for partner notification?

Answer 6

If PRIMARY = 90 days (3 months)

If SECONDARY = 2 years

Question 7

Why is partner notification not required for Genital Warts or Herpes?

Answer 7

No treatment is given if patient is asymptomatic

Question 8

Why is partner notification not required for Vaginal thrush or Bacterial vaginosis?

Answer 8

These are not transmitted sexually

Question 9

How are other sexually transmitted infections prevented in patients diagnosed with HIV?

Answer 9

Vaccinations

• Hep A/B
• HPV

Question 10

What drugs are in PrEP and when can it be taken?

Answer 10

• Combination of Tenofovir / emtricitabine
• Daily or event-based dosing (before sex)
• High risk patients

Question 11

What is PEP in relation to Hep B exposure?

Answer 11

Person can be given Hep B vaccine up to 7 days after exposure
(if people don’t respond to the vaccine they can be given immunoglobulins)

Question 12

What PEP is given after exposure to HIV?

Answer 12

3 anti-retrovirals

• start up to 72 hrs after
• take for 28 days

Question 13

How is rape defined by the law?

Answer 13

Penetration of the vagina, anus or mouth by the penis without consent

Question 14

When is consent to sex invalidated?

Answer 14

If person is:

• Incapacitated by alcohol or drugs
• Incarcerated
• Violence or threat of violence

Question 15

The perpetrator in a case of rape is usually known to the victim. TRUE/FALSE?

Answer 15

TRUE

Question 16

What are the sequelae of rape?

Answer 16

• Injuries
• Unwanted pregnancy
• STI
  Psychological:
• PTSD
• Anxiety/depression
• Psychosexual morbidity

Question 17

If a rape is recent, what tests and treatment would you offer?

Answer 17

• Consider forensic examination
• Check immediate safety
• Tend to Injuries
• HBV vaccination
• Consider PEP
• STI/pregnancy care

Question 18

What is involved in the medium-long term management of patients who have been raped?

Answer 18

• Screening for STIs
• Assessment of coping abilities (PTSD - ask specifically)
• HBV vaccines if indicated
• Practical and psychosocial support

Question 19

Who is most commonly affected by gender based violence?

Answer 19

Usually towards women/children

Usually by men

Question 20

Give examples of gender-based violence

Answer 20

Domestic abuse
Rape and sexual assault
Childhood sexual abuse
Commercial sexual exploitation
Stalking/harassment
Harmful traditional practices (eg. breast ironing)

Question 21

What is the main risk factor for gender based violence?

Answer 21

female sex

Question 22

What other factors can increase a person’s vulnerability with regards to gender based violence?

Answer 22

• Disability
• Pregnancy
• Addictions
• HIV