Sexual health Flashcards
What are some STI’s?
Chlamydia
Gonorrhea
Pelvic Inflammatory Disease (PID)
Non Specific Urethritis (NSU)
Epididymorchitis
Genital warts
Genital herpes
Trichomonas vaginalis
Syphilis
HIV
Hepatitis B & C
What are some non- STIs?
Candidiasis
Bacterial vaginosis
Genital dermatoses
E.g. Lichen sclerosis, Balanitis
Vulval conditions
E.g. Vulvodynia, Vestibulitis
What are some important points to remember about sexual health?
Confidentiality & non-judgemental attitude to encourage attendance
Open access
Accurate diagnosis & effective treatment (preferably on the day of presentation)
Screen for concomitant infections – often asymptomatic
Free treatment – single dose & oral preferred
Contact tracing
How do we take a good sexual health history?
History of presenting complaint
Past GU history
Past general medical/surgical history
Drugs (any antibiotics in last month)
Sexual history – last 3-12 months
Last sexual intercourse
Regular/casual partner
Male/female
Condom use
Type of SI
Focused history for women and men
Females
Menstrual history
Pregnancy history
Contraception
Cervical cytology history
Males
When last voided urine
What to remember for a genital examination?
Privacy
Dignity
Chaperone
Explanation
Both sexes
Genital skin
Inguinal nodes
Pubic hair
What do we check for a women during a genital examination?
Vulva
Perineum
Vagina
Cervix
Bimanual pelvic examination
Possibly anus & oropharynx
What do we look for in a genital examination in men?
Penis
Scrotum
Urethral meatus
Anus & oropharynx in MSMs
How do we do asymptomatic screening for gay men?
MSM (Men who have Sex with Men)
First void urine for Chlamydia/Gonorrhoea NAAT
Pharyngeal swab for Chlamydia/Gonorrhoea NAAT (may be self taken)
Rectal swab for Chlamydia/Gonorrhoea NAAT (may be self taken)
Bld for STS, HIV, Hep B (& Hep C if indicated)
How do we do asymptomatic screening for women and men?
Female
Self taken Vulvo-vaginal swab for Gonorrhoea/Chlamydia NAAT (Nucleic Acid Amplification Test)
Bld for STS + HIV
Heterosexual male
First void urine for Chlamydia/Gonorrhoea NAAT
Bld test for STS + HIV
What are some symptomatic presentations of a female?
Vaginal discharge
Vulval discomfort/soreness, itching or pain
Superficial dyspaerunia
Pelvic pain/deep dyspaerunia
Vulval lumps
Vulval ulcers
Inter-menstrual bleeding
Post-coital bleeding
What are some symptomatic presentations of a male?
Pain/burning during micturition
Pain/discomfort in the urethra
Urethral discharge
Genital ulcers, sores, or blisters
Genital lumps
Rash on penis or genital area
Testicular pain/swelling
How do we do symptomatic screening for a female?
Vulvo-vaginal swab for Gonorrhoea + Chlamydia NAAT
High vaginal swab (wet & dry slides) for
Bacterial Vaginosis (BV)
Trichomonas Vaginalis (TV)
Candida
Cervical swab for slide + Gonorrhoea culture
Dipstick urinalysis (If has dysuria)
Bld for STS + HIV
What is symptomatic screening for males?
Heterosexual male
Urethral swab for slide + Gonorrhoea culture
First void urine for Gonorrhoea + Chlamydia NAAT
Dipstick urinalysis (If has dysuria)
Bld for STS + HIV
MSM
Test as for asymptomatic MSM
+ urethral and rectal slides
+ urethral, rectal, pharyngeal culture plates
Who are screened for Hep B?
Men who have Sex with Men (MSM)
Commercial Sex Workers (CSW) and their sexual partners
IVDUs (current or past), and their sexual partners
People from high risk areas and their sexual partners
Africa, Asia, Eastern Europe
Aim to vaccinate them if non-immune
