Attending the Sexual Health Clinic

Question 1

How is confidentiality managed in the sexual health clinic?

Answer 1

Tests are sent with anonymous number = not visible to GP

Fraser guidelines used for young people

Question 2

What are the roles of the sexual health clinic?

Answer 2

Diagnosis and management of STIs, partner notification, infection prevention, genital dermatology, contraception, community gynaecology, menopause, psychosexual counselling

Question 3

What is partner notification?

Answer 3

Process of informing people who have been in contact with an STI = look back period depends on STI, voluntary process

Question 4

What are the benefits of partner notification?

Answer 4

Effective form of case finding, cost effective, early diagnosis reduces morbidity, reduces STI incidence in community

Question 5

What is the look back period for chlamydia?

Answer 5

2 weeks for male urethral

3 months for any other infection

Question 6

What is the look back period for gonorrhoea?

Answer 6

4 weeks for male urethral

6 months for any other infection

Question 7

What is the look back period for non-specific urethritis and trichomonas vaginalis?

Answer 7

4 weeks

Question 8

What is the look back period for epididymitis and PID?

Answer 8

Same as CT/GC or 6 months if negative

Question 9

What is the look back period for HIV?

Answer 9

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

Question 10

What is the look back period for syphilis?

Answer 10

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

Question 11

What are some STIs that don’t require contact tracing?

Answer 11

Warts, herpes, vaginal thrush, bacterial vaginosis

Question 12

What is the partner notification process?

Answer 12

PN agreement = patient, provider or provisional referral

Follow up

Question 13

What are some methods of infection prevention?

Answer 13

Vaccination, pre-exposure prophylaxis (PrEP), post exposure prophylaxis (PEPSE)

Question 14

What are some vaccinations that exist for STIs?

Answer 14

Hep A = male/male sex
HPV = male/male sex age <46
Hep B = male/male sex, sexual assault, contacts, high prevalence countries

Question 15

What is pre-exposure prophylaxis (PrEP)?

Answer 15

Medicine taken before exposure to reduce risk of infection = tenofovir, disoproxil, emtriatabine

Question 16

How is pre-exposure prophylaxis given?

Answer 16

Either taken daily or event based dosing in high risk individuals

Question 17

What are the eligibility criteria for pre-exposure prophylaxis?

Answer 17

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

Question 18

What is post-exposure prophylaxis (PEPSE)?

Answer 18

Medicine taken after exposure to reduce risk of infection

Question 19

What are some STIs that post-exposure prophylaxis be taken for?

Answer 19

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

Question 20

What is one definition of rape?

Answer 20

Penetration of vagina, anus or mouth by penis without consent

Question 21

What are some examples of when consent becomes invalidated?

Answer 21

Incapacitated by alcohol/drugs, incarcerated, violence or threat of violence

Question 22

What are some features of rape?

Answer 22

Common = 5% women reported serious sexual assault after age 16
Perpetrator usually known to victim

Question 23

What are some common sequelae of rape?

Answer 23

Injuries, unwanted pregnancy, STI, PTSD, anxiety and depression

Question 24

How are recent rapes managed?

Answer 24

Consider forensic examination, immediate safety, injuries, HBV vaccination, consider PEPSE, STI/pregnancy care

Question 25

How are rapes managed after a medium/long time since the event occurred?

Answer 25

STI screening, assessment of coping abilities, PTSD, HBV vaccine if indicated, practical and psychosocial support

Question 26

What are some examples of gender based violence?

Answer 26

Domestic abuse, rape, childhood sexual abuse, commercial sexual exploitation, stalking

Question 27

Who tends to suffer from gender based violence?

Answer 27

Usually towards women and children = usually carried out by men

Question 28

What are the risk factors for gender based violence?

Answer 28

Female gender, disability, pregnancy, addictions, HIV