Care in Sexual Health Clinic Flashcards
What is the role of the sexual health clinic?
- dx and managment of STIs
- Partner notification
- infection prevention
- genital dermatology
- contraception
- community gynaecology
- menopause
- psychosexual counselling
What are the benefits of partner notification?
- Effective form of case finding
- Cost effective
- Early diagnosis reduces morbidity/mortality
- Reduces incidence of STI in community
What conditions do not require PN? Why?
- warts
- herpes
- vaginal thrush
- bacterial vaginosis
> why: no benefit in asymptomatic case finding —nothing to do about it
not STI (candidiasis and BV)
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
Methods of PN
- PN agreement: Patient, provider referral (anonymously informed) and provisional referral
How to prevent Hep B?
Vaccinations for people with: MSM High prevalence countries Sexual assault Contacts
MSM pts should get which additional vaccinations; apart from Hep B?
- Hep A (rimming; seen in Gay men)
- HPV (<46y.o)
Name PrEP drugs…
- Tenofovir
- Disoproxil
- Emtricitabine
How effective is PrEP rx?
- reduces HIV incidence by 86%
Who is eligible 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
What is HIV PEPSE?
- 3 antiretrovirals
- Start within 72 hours
- 28 days total
- Probably 80% effective
Hep B PEPSE?
HBV vaccine (up to 7 days) Immunoglobulin (vaccine non-responders)
Define rape
Penetration of the vagina, anus or mouth by the penis without consent
When is consent invalidated?
- incapacitated by ALCOHOL or DRUGS
- incarcerated
- violence or threat of violence
Sequelae of rape
- Injuries
-Unwanted pregnancy - STI
-Psychological sequelae common:
>PTSD
>Anxiety/depression
>Psychosexual morbidity
How to manage recent rapes?
- forensic examination (RETAIN bedding, tampons)
- immediate safety
- address INJURIES
- HBV vaccines
- PEPSE (if from a HIGH risk gr.—high prevalence country/ Anal rape)
- STI/ Pregnancy care
Long term management of Rape victims?
- STI screening
- coping abilities assessment
- PTSD
- HBV vaccines
- Practical and psychosocial support
When to test for Syhphilis and HIV ?
- after 12 weeks of exposure
When to test for chlamydia and gonorrohoea?
- 2 weeks
RIsk factors of Gender based Violence?
- HIV
- being female
- disability
- addictions
- pregnancy
