Sexual Health Responsibilities and History

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Questions and Answers

Which method can be used to transmit STDs from an infected mother to her baby?

Pregnancy, childbirth, or breastfeeding (correct)

Use of public swimming pools

Sharing personal items like toothbrushes

Breathing the same air

What sample is preferred for testing chlamydia and gonococcus in females?

Lower vaginal swab (correct)

Throat swab

Upper vaginal swab

First catch urine

What is an appropriate test for men at risk of chlamydia and gonorrhoea?

Rectal swab for chlamydia/gonococcal NAAT (correct)

Blood test for HPV

Saliva test for syphilis

Skin scrape for herpes

Which of the following individuals should be recommended to undergo HIV testing?

Those diagnosed with an STI Signup and view all the answers

What is a critical component of primary care for promoting public health?

HIV screening Signup and view all the answers

Which condition could indicate a need for initial blood tests during differential diagnosis?

Non-genital symptoms from serious STIs Signup and view all the answers

Which statement regarding shared needles is true?

Shared needles can transmit STDs like HIV and hepatitis. Signup and view all the answers

What is the primary focus of healthcare professionals regarding sexual health?

To protect and promote the overall sexual health of patients Signup and view all the answers

Which of the following is NOT a component of taking a sexual health history?

Current job status Signup and view all the answers

What is one way STIs can be transmitted?

Via sexual contact involving bodily fluids Signup and view all the answers

Which statement best describes the duty of care to protect sexual health?

To promote healthy sexuality throughout a person's lifetime Signup and view all the answers

What does dyspareunia refer to in the context of sexual health?

Painful sexual intercourse Signup and view all the answers

What is an important consideration when asking about a patient’s last sexual contact?

Acknowledge the personal nature of the questions Signup and view all the answers

Which demographic factors should be considered when providing sexual health services?

Any personal characteristics including race and sexual orientation Signup and view all the answers

Which type of sexual contact can lead to skin-to-skin transmission of infections?

Contact with infected areas like genital herpes Signup and view all the answers

Study Notes

Duty of Care for Sexual Health

Healthcare professionals have a responsibility to promote and protect sexual health.
Sexual health services should be accessible, affordable, and of high quality for everyone, regardless of background.

Taking a Sexual Health History

Symptoms to look for:
- Pain during urination (dysuria)
- Vaginal or penile discharge
- Itching, soreness, or swelling (including testicular swelling and groin pain)
- Genital skin changes (e.g., blisters, sores, ulcers)
- Painful intercourse (dyspareunia)
- Systemic symptoms (e.g., fever, rashes, joint pain)
- Gynecological history in women (e.g., menstrual cycle, contraception, smear history, pregnancies, miscarriages, terminations)
Last sexual contact:
- Ask about the last sexual encounter, ensuring consent was given.
- Gather information about the partner, including sexual orientation.
- Inquire about the type of sexual activity (oral, anal, vaginal, digital) and if contraception was used.
- Determine the number of partners in the last three months.
Medical and Surgical History:
- Previous STIs
- Abnormal smears
- Drug history (current and previous)
- Current prescription medications
- Allergies
- History of injecting drug use (current or past)
- HIV risk history
- Previous HIV screening

Understanding Sexually Transmitted Infections (STIs)

STIs are infections spread primarily through close sexual contact or intercourse.
Transmission pathways include:
- Sexual Contact: Vaginal, anal, and oral sex can transmit STIs through bodily fluids like semen, vaginal fluids, and blood.
- Skin-to-Skin Contact: Some STIs, like genital herpes and HPV, can spread through direct skin-to-skin contact with an infected area.
- Mother to Baby: Certain STIs can be passed from an infected mother to her baby during pregnancy, childbirth, or breastfeeding.
- Shared Needles: Using shared needles or syringes for drug use, tattoos, or piercings can transmit STIs like HIV and hepatitis.

Differential Diagnosis

Don't assume all genital problems are STI-related.
Consider alternative diagnoses.
Be aware of possible non-genital symptoms of serious STIs.
Consider initial blood tests or specialist referrals.

STI Tests in Community Settings

Female:
- Self-obtained or clinician-obtained lower vaginal swab (SOLVS) for chlamydia and gonorrhea.
- Lower vaginal swabs are preferred even during speculum examinations.
- Serum tests for syphilis and HIV serology.
- Hepatitis B, C, A, and B tests if from an endemic area, partner is from an endemic area, returning traveler, or bisexual partner.
Male:
- First catch urine (20ml) for chlamydia and gonorrhea NAAT.
- Serum tests for syphilis and HIV serology.
- For Gay, Bisexual, and MSM:
  - Throat swab for chlamydia/gonorrhea NAAT.
  - Rectal swab for chlamydia/gonorrhea NAAT.
  - Hepatitis B test (Hep/B/C/Ab).

HIV Screening in Primary Care

HIV Screening is essential for early detection and prevention.
It should be offered and recommended to everyone who hasn't been previously diagnosed with HIV, and who:
- Is diagnosed with, or requests testing for, a sexually transmitted infection.
- Has symptoms that may indicate HIV or HIV is part of the differential diagnosis.
- Is known to be from a country or group with a high rate of HIV.
- Reports sexual contact (either abroad or in the UK) with someone from a country with a high rate of HIV.
- Reports a history of injecting drug use.
- Discloses high-risk sexual practices, for example, "chemsex".
- Is male and discloses that they have sex with men, or has not had an HIV test in the previous year.
- Is a trans woman who has sex with men and has not had an HIV test in the previous year.
- Is a sexual partner of someone known to be HIV positive or someone at high risk of HIV (e.g., female sexual contacts of men who have sex with men).

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Description

This quiz focuses on the duty of care in sexual health and the importance of taking a thorough sexual health history. Participants will learn about key symptoms and factors that healthcare professionals must consider when assessing sexual health. Understanding these elements is essential for providing quality care and ensuring patient safety.