Attending the Sexual Health Clinic Flashcards
How is confidentiality managed in the sexual health clinic?
Tests are sent with anonymous number = not visible to GP
Fraser guidelines used for young people
What are the roles of the sexual health clinic?
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 an STI = look back period depends on STI, voluntary process
What are the benefits of partner notification?
Effective form of case finding, cost effective, early diagnosis reduces morbidity, reduces STI incidence in community
What is the look back period for chlamydia?
2 weeks for male urethral
3 months for any other infection
What is the look back period for gonorrhoea?
4 weeks for male urethral
6 months for any other infection
What is the look back period for non-specific urethritis and trichomonas vaginalis?
4 weeks
What is the look back period for epididymitis and PID?
Same as CT/GC or 6 months if negative
What is the look back period for HIV?
4 weeks before negative test or before most likely time of infection
What is the look back period for syphilis?
90 days for primary syphilis
2 years for secondary syphilis
3 months before most recent negative test for other infections
What are some STIs that don’t require contact tracing?
Warts, herpes, vaginal thrush, bacterial vaginosis
What is the partner notification process?
PN agreement = patient, provider or provisional referral
Follow up
What are some methods of infection prevention?
Vaccination, pre-exposure prophylaxis (PrEP), post exposure prophylaxis (PEPSE)
What are some vaccinations that exist for STIs?
Hep A = male/male sex
HPV = male/male sex age <46
Hep B = male/male sex, sexual assault, contacts, high prevalence countries
What is pre-exposure prophylaxis (PrEP)?
Medicine taken before exposure to reduce risk of infection = tenofovir, disoproxil, emtriatabine
How is pre-exposure prophylaxis given?
Either taken daily or event based dosing in high risk individuals
What are the eligibility criteria for pre-exposure prophylaxis?
Male/male condomless anal sex with >=2 partners in last year and likely to in next 3 months
Rectal bacteria STI in last year
Partner of someone with HIV viral load >50
What is post-exposure prophylaxis (PEPSE)?
Medicine taken after exposure to reduce risk of infection
What are some STIs that post-exposure prophylaxis be taken for?
Hep B = HBV vaccine up to 7 days post-exposure, immunoglobulin for vaccine non-responders
HIV = 3 antiretrovirals, start within 72hrs, lasts 28 days, about 80% effective
What is one definition of rape?
Penetration of vagina, anus or mouth by penis without consent
What are some examples of when consent becomes invalidated?
Incapacitated by alcohol/drugs, incarcerated, violence or threat of violence
What are some features of rape?
Common = 5% women reported serious sexual assault after age 16
Perpetrator usually known to victim
What are some common sequelae of rape?
Injuries, unwanted pregnancy, STI, PTSD, anxiety and depression
How are recent rapes managed?
Consider forensic examination, immediate safety, injuries, HBV vaccination, consider PEPSE, STI/pregnancy care
How are rapes managed after a medium/long time since the event occurred?
STI screening, assessment of coping abilities, PTSD, HBV vaccine if indicated, practical and psychosocial support
What are some examples of gender based violence?
Domestic abuse, rape, childhood sexual abuse, commercial sexual exploitation, stalking
Who tends to suffer from gender based violence?
Usually towards women and children = usually carried out by men
What are the risk factors for gender based violence?
Female gender, disability, pregnancy, addictions, HIV
