Sexual risk assessment in general practice: evidence from a New South Wales survey

Sexual Health ◽  
2007 ◽  
Vol 4 (1) ◽  
pp. 1 ◽  
Author(s):  
Asaduzzaman Khan ◽  
David Plummer ◽  
Rafat Hussain ◽  
Victor Minichiello
Keyword(s):  
Risk Assessment ◽  
Sexual Risk ◽  
New South ◽  
New South Wales ◽  
Sexual History ◽  
History Taking ◽  
South Wales ◽  
Sexually Transmissible Infections ◽  
Sexual History Taking ◽  
Sexual Histories

Background: Physicians’ inadequate involvement in sexual risk assessment has the potential to miss many asymptomatic cases. The present study was conducted to explore sexual risk assessment by physicians in clinical practice and to identify barriers in eliciting sexual histories from patients. Methods: A stratified random sample of 15% of general practitioners (GP) from New South Wales was surveyed to assess their management of sexually transmissible infections (STI). In total, 409 GP participated in the survey with a response rate of 45.4%. Results: Although nearly 70% of GP regularly elicited a sexual history from commercial sex workers whose presenting complaint was not an STI, this history taking was much lower (<10%) among GP for patients who were young or heterosexual. About 23% never took a sexual history from Indigenous patients and 19% never elicited this history from lesbian patients. Lack of time was the most commonly cited barrier in sexual history taking (55%), followed by a concern that patients might feel uncomfortable if a sexual history was taken (49%). Other constraints were presence of another person (39%) and physician’s embarrassment (15%). About 19% of GP indicated that further training in sexual history taking could improve their practice. Conclusions: The present study identifies inconsistent involvement by GP in taking sexual histories, which can result in missed opportunities for early detection of many STI. Options for overcoming barriers to taking sexual histories by GP are discussed.

What proportion of sexually transmissible infections and HIV are diagnosed in New South Wales’ public sexual health services compared with other services?

Sexual Health ◽  
2013 ◽  
Vol 10 (2) ◽  
pp. 119 ◽  
Author(s):  
Chris Bourne ◽  
Debbie Allen ◽  
Katherine Brown ◽  
Stephen C. Davies ◽  
Anna McNulty ◽  
...  
Keyword(s):  
Health Services ◽  
Sexual Health ◽  
New South ◽  
New South Wales ◽  
Large Contribution ◽  
Geographical Variations ◽  
South Wales ◽  
Sexually Transmissible Infections ◽  
Geographical Regions ◽  
High Risk Populations

Background: In New South Wales (NSW), publicly funded sexual health services (PFSHSs) target the populations at greatest risk for important sexually transmissible infections (STIs) and so may make a large contribution to the diagnosis of notifiable STIs. We aimed to determine the proportions of STIs diagnosed in PFSHSs and notified to the NSW Ministry of Health in 2009, and describe geographical variations. Methods: The number of notifiable STIs (infectious syphilis, gonorrhoea, HIV and chlamydia) diagnosed in 2009 was obtained for each Area Health Service (AHS) and each PFSHS. The proportion of diagnoses made by PFSHSs was calculated at the state and AHS level according to five geographical regions: inner and outer metropolitan, regional, rural and remote. Results: The overall proportions of diagnoses made by NSW PFSHSs were syphilis, 25%; gonorrhoea, 25%; HIV, 21%; and chlamydia, 14%. Within each zone, the proportions of these STIs were (respectively): (i) inner metropolitan: 32%, 26%, 21% and 13%; (ii) outer metropolitan: 41%, 24%, 43% and 9%; (iii) regional: 62%, 15%, 23% and 10%; (iv) rural: 8%, 29%, <5% and 20%; and (v) remote: <5%, 43%, <5% and 29%. There was considerable variation in proportions of STIs between and within AHSs (<5–100%). Conclusions: NSW PFSHSs contribute a large proportion of diagnoses for syphilis, gonorrhoea and HIV, but less so for chlamydia. Across AHSs and zones, there was considerable variation in the proportions. These data support the role of PFSHS in identifying and managing important STIs in high-risk populations.

scholarly journals Are printed sexually transmissible infection materials for patients appropriate? A physician perspective

Sexual Health ◽  
2008 ◽  
Vol 5 (3) ◽  
pp. 307 ◽  
Author(s):  
Asaduzzaman Khan ◽  
David Plummer
Keyword(s):  
General Practitioners ◽  
New South ◽  
New South Wales ◽  
Postal Survey ◽  
Physician Perspective ◽  
South Wales ◽  
Sexually Transmissible Infections ◽  
Information Materials ◽  
Sexually Transmissible Infection ◽  
Transmissible Infection

The data from a postal survey of 409 general practitioners (GPs) practicing in New South Wales are analysed to explore GPs’ concerns, if any, about available printed information materials on sexually transmissible infections (STI) for patients. Just over half (55%) of GPs considered the materials for patients to be inadequate and/or inappropriate with 18% considering the materials as too technical for many patients and 13% considering the materials mostly out of date. Over a fifth reported that either STI materials were not available in their clinic or they did not know where to get those materials.

Corrigendum to: What proportion of sexually transmissible infections and HIV are diagnosed in New South Wales’ public sexual health services compared with other services?

Sexual Health ◽  
2013 ◽  
Vol 10 (3) ◽  
pp. 290
Author(s):  
Chris Bourne ◽  
Debbie Allen ◽  
Katherine Brown ◽  
Stephen C. Davies ◽  
Anna McNulty ◽  
...  
Keyword(s):  
Health Services ◽  
Sexual Health ◽  
New South ◽  
New South Wales ◽  
Large Contribution ◽  
Geographical Variations ◽  
South Wales ◽  
Sexually Transmissible Infections ◽  
Geographical Regions ◽  
High Risk Populations

Background: In New South Wales (NSW), publicly funded sexual health services (PFSHSs) target the populations at greatest risk for important sexually transmissible infections (STIs) and so may make a large contribution to the diagnosis of notifiable STIs. We aimed to determine the proportions of STIs diagnosed in PFSHSs and notified to the NSW Ministry of Health in 2009, and describe geographical variations. Methods: The number of notifiable STIs (infectious syphilis, gonorrhoea, HIV and chlamydia) diagnosed in 2009 was obtained for each Area Health Service (AHS) and each PFSHS. The proportion of diagnoses made by PFSHSs was calculated at the state and AHS level according to five geographical regions: inner and outer metropolitan, regional, rural and remote. Results: The overall proportions of diagnoses made by NSW PFSHSs were syphilis, 25%; gonorrhoea, 25%; HIV, 21%; and chlamydia, 14%. Within each zone, the proportions of these STIs were (respectively): (i) inner metropolitan: 32%, 26%, 21% and 13%; (ii) outer metropolitan: 41%, 24%, 43% and 9%; (iii) regional: 62%, 15%, 23% and 10%; (iv) rural: 8%, 29%, Conclusions: NSW PFSHSs contribute a large proportion of diagnoses for syphilis, gonorrhoea and HIV, but less so for chlamydia. Across AHSs and zones, there was considerable variation in the proportions. These data support the role of PFSHS in identifying and managing important STIs in high-risk populations.

Chlamydia trachomatis infection in the family planning clinical setting across New South Wales

Sexual Health ◽  
2006 ◽  
Vol 3 (1) ◽  
pp. 15 ◽  
Author(s):  
Deborah J. Bateson ◽  
Edith Weisberg ◽  
Harpreet Lota
Keyword(s):  
Family Planning ◽  
Chlamydia Trachomatis ◽  
New South ◽  
New South Wales ◽  
Oral Contraceptive Pill ◽  
Chlamydia Trachomatis Infection ◽  
The Past ◽  
South Wales ◽  
Sexually Transmissible Infections ◽  
The Family

Background: Following a small pilot study in 2003, a study was set up to determine the prevalence of genital Chlamydia trachomatis infection in young women presenting to Family Planning NSW centres across New South Wales and to evaluate the characteristics of those infected. Methods: A cross-sectional survey of 621 consecutive women aged from 16 to 24 years was carried out over a 3-month period in 2004 at five Family Planning NSW centres. Urine samples were tested for C. trachomatis using the polymerase chain reaction (PCR) method. Women with a positive result were reviewed and treated. Results: Of 925 eligible clients, 621 (67%) were recruited to the study. Chlamydia trachomatis was detected in 35 of the 621 recruits (5.6%, 95% CI 3.8–7.4). The prevalence at the Hunter centre was significantly higher than the combined prevalence at the other four participating centres (9.7% compared with 3.9%; P = 0.008). Two characteristics were identified as independent predictors of infection in this study: ‘reporting a recent change of partner in the past three months’ (crude odds ratio (OR) 3.33, 95% CI 1.67–6.64) and ‘reporting three or more partners in the past year’ (crude OR 3.69, 95% CI 1.83–7.46). Reported condom use, a history of one or more sexually transmissible infections and current combined oral contraceptive pill use were not associated with infection in this study. Conclusions: The prevalence of C. trachomatis infection is sufficiently high to support targeted testing of 16–24-year-old women in the Family Planning NSW setting and informs the development of a national screening strategy.

Changing pattern of sexually transmissible infections and HIV diagnosed in public sexual health services compared with other locations in New South Wales, 2010–14

Sexual Health ◽  
2018 ◽  
Vol 15 (4) ◽  
pp. 366 ◽  
Author(s):  
Christopher Bourne ◽  
Meeyin Lam ◽  
Christine Selvey ◽  
Rebecca Guy ◽  
Denton Callander
Keyword(s):  
Young People ◽  
Sexual Health ◽  
New South ◽  
New South Wales ◽  
People Living With Hiv ◽  
Bisexual Men ◽  
South Wales ◽  
Sexually Transmissible Infections ◽  
Annual Proportion ◽  
Priority Population

Background In Australia, testing and treatment for HIV and other sexually transmissible infections (STIs) is usually managed in general practice, while publicly funded sexual health clinics (PFSHC) attract people at higher risk for infection. The proportion of HIV and STI diagnoses in New South Wales (NSW) occurring in PFSHC stratified by priority population was investigated. Methods: From 2010 to 2014, NSW notification frequencies for chlamydia, gonorrhoea, infectious syphilis, and HIV were compared with the number of diagnoses in PFSHC. The annual proportion of diagnoses at PFSHC was calculated and Wilcoxon rank-sum tests assessed trends. Diagnoses from PFSHC were also organised by priority population, including gay and bisexual men (GBM), people living with HIV, Aboriginal and Torres Strait Islander people, people who use injecting drugs, sex workers and young people. Results: The annual proportion of HIV and STIs diagnosed at PFSHC increased (all P < 0.001): chlamydia from 12% to 15%, gonorrhoea 23% to 38%, infectious syphilis 21% to 40% and HIV 22% to 30%. Overall, the majority of all infections diagnosed at PFSHC were among GBM, with the proportional distribution of chlamydia increasing from 32% to 46% among GBM (P < 0.001) and decreasing among young people (50% to 40%; P < 0.001). There were no other significant changes by population or infection at PFSHC. Conclusions: Increasing proportions of STI and HIV are being diagnosed at NSW PFSHC, mostly among GBM. PFSHC reorientation to priority populations continues to make a large and increasing contribution to STI and HIV control efforts in NSW.

Factors Affecting Sexual History Taking in a Health Center Serving Homeless Persons

2018 ◽  
Vol 28 (9) ◽  
pp. 1395-1405
Author(s):  
Timothy Joseph Sowicz ◽  
Christine K. Bradway
Keyword(s):  
Health Care ◽  
Health Center ◽  
Health Care Providers ◽  
Sexual History ◽  
History Taking ◽  
Care Providers ◽  
Opioid Use ◽  
Factors Affecting ◽  
Sexual History Taking ◽  
Sexual Histories

Low rates of documentation of sexual histories have been reported and research on sexual history taking (SHT) has focused on the content of, barriers to collecting, and interventions to improve documentation of sexual histories. Absent from this literature is an understanding of the contextual factors affecting SHT. To address this gap, a focused ethnography of one health center was conducted. Data were collected through observations of health care encounters and interviews with health care providers (HCPs). No SHT was observed and this was likely influenced by patients’ characteristics, communication between patients and HCPs, the prioritization of patients’ basic needs, and time constraints imposed upon encounters. Given that the health center studied serves patients experiencing homelessness, behavioral health concerns, and opioid use disorder, findings illuminate areas for future inquiry into a patient population affected by social as well as physiologic determinants of health and potentially at high risk for adverse sexual health outcomes.

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