Attending STI clinic Flashcards
Roles of SHC?
Diagnosis and management of STIs Partner notification Infection prevention Genital dermatology Contraception Community gynaecology Menopause Psychosexual counselling
What is partner notification?
Process of informing people who have been in contact with STI
Look-back period depends upon STI
Public health benefit
Voluntary
What is the look back period for chlamydia?
Male urethral; 4 weeks
Any other infection; 6 months
What is the look back period for gonorrhoea?
Male urethral; 2 weeks
Any other; 3 months
What is the look back period for non specific urethritis?
4 weeks
What is the look back period for trichomonas vaginalis?
4 weeks
What is the look back period for epididymitis?
As Ct/GC or if neg, 6 months
What is the look back period for PID?
As CT/GC or if neg, 6 months
What is the look back period for HIV?
4 weeks before neg test or before most likely time of infection
What is the look back period for syphilis?
Primary; 90 days
Secondary; 2 years
Other infections; 3 months before most recent neg test
What is partner notification not required for?
Warts
Herpes
Vaginal thrush
BV
Who gets vaccinated against hep B?
MSM
High prevalence countries
Sexual assault
Contacts
Who get vaccinated against hep A?
MSM; sexually transmitted enteric infection
Who gets vaccinated for HPV?
MSM aged <46
What is included in PrEP?
Tenofovir
Disoproxil/ emtricitabine
How often is PrEP taken?
Daily or event based dosing
By how much will PrEP reduce HIV?
86% in high risk patients
Eligibility for PrEP in Scotland?
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 VL > 50
When can hep B be given after exposure?
HBP vaccine up to 7 days after exposure
Immunoglobulin (vaccine non-responders)
When can HIV PEP be given?
3 antiretrovirals
Within 72 hours
28 days total
What invalidates consent?
Incapacitated by alcohol or drugs
Incarcerated
Violence or threat of violence
What should be performed in recent rapes?
Consider forensic exam Immediate safety Injuries HBV vaccination Consider PEPSE STI/ pregnancy care
Examples of GBV?
Domestic abuse Rape and sexual assault Childhood sexual abuse Commercial sexual exploitation Stalking/ harassment Harmful traditional practices (FGM, breast ironing)
What are risk factors for GBV?
Female sex Disability Pregnancy Addictions HIV
What is the minimum incubation period for chlamydia?
3-5 days; this is how long it takes the organism to complete one life cycle
Symptoms tend to present within 2 weeks post exposure
Who is hepatitis B vaccination recommended to as a pre-exposure prophylaxis?
MSM PWID People who sell sex Sexual contacts of those with HPV People who travel to endemic areas for sex People living with HIV People with chronic HCV Swingers Prisoners
Who is hepatitis B vaccination recommended to as post-exposure prophylaxis?
Within 6 weeks after a high risk exposure such as a sexual assault
Ultra-rapid schedule is recommended as post-exposure prophylaxis
What contraceptive methods are recommended with ARVs?
Intrauterine
Depo (with concern for bone health)
