Transgender people attending a Sydney sexual health service over a 16-year period

Sexual Health ◽  
2007 ◽  
Vol 4 (3) ◽  
pp. 189 ◽  
Author(s):  
Victoria L. Hounsfield ◽  
Eleanor Freedman ◽  
Anna McNulty ◽  
Christopher Bourne
Keyword(s):  
Health Service ◽  
Sexual Health ◽  
Sex Work ◽  
Health Centre ◽  
Health Clinic ◽  
Risk Behaviours ◽  
Retrospective Case ◽  
Transgender People ◽  
Sexual Health Service ◽  
Sexually Transmissible Infections

Background: Previous studies have concluded that transgender people are a marginalised and stigmatised group, with high rates of sexually transmissible infections (STI), sex work, injecting drug use and multiple sexual partners. To our knowledge, this is the first study in Australia to focus on the sexual behaviour and sexual health needs of transgender people attending an urban sexual health clinic. Methods: A retrospective case note review was undertaken of the transgender attendees of the Sydney Sexual Health Centre between 1990 and 2006. Demographics, gender characteristics, risk behaviours, sexual health morbidity, psychosocial information and other significant features of the transgender population were assessed. Results: Forty clients were identified as transgender, of whom 36 (90%) were male-to-female and four (10%) were female-to-male. Seventeen (43%) had a history of sex work, 16 (40%) had injected drugs, 14 (35%) had had unprotected anal or vaginal sex in the past 3 months. Twenty (50%) clients had histories of a STI, including three (7.5%) that were HIV positive, and two were co-infected with hepatitis C. Genital warts and chlamydia were the most common diagnoses made during the study period. Physical examination was inadequately documented in 53% of first visits. Psychosocial morbidity was common. Conclusions: Transgender clients presented infrequently at this clinic. Although half reported few risks, the other half reported multiple risk behaviours and had most STI. These findings suggest that there needs to be improved sexual health service for transgender clients at our clinic.

Triage in a public outpatient sexual health clinic

Sexual Health ◽  
2006 ◽  
Vol 3 (2) ◽  
pp. 87 ◽  
Author(s):  
Vickie Knight ◽  
Anna McNulty
Keyword(s):  
Sexual Health ◽  
Waiting Times ◽  
Health Centre ◽  
Wait Time ◽  
Health Clinic ◽  
Average Wait Time ◽  
Survey Tool ◽  
Time Flow ◽  
Sexually Transmissible Infections ◽  
Nurse Triage

Background:The increasing prevalence of sexually transmissible infections in Australia, coupled with a NSW Health Department requirement to target services to those most in need, has led many services to investigate patient triage as a way of better using scarce resources.2 In October 1997, a Triage Nurse position was trialled that aimed to facilitate the optimal flow of patients through the Sydney Sexual Health Centre (SSHC) clinic in an efficient and patient-focussed manner. A pre and post implementation time-flow study was conducted to analyse the effect. A staff survey was also completed to ascertain staff acceptance of the Nurse Triage system. Methods:A time-flow data survey tool was developed and placed in the medical record of every person attending the SSHC in one month in 1997 and again in 1999. The staff survey was an 11-item likert scale questionnaire administered to all centre staff. Data were analysed and average visit and waiting times were generated. Results:When comparing 1997 with 1999 data, the main results of note were that the length of consultation had been stable or decreased, the average wait time had remained stable or decreased and the wait time in the medical and nursing unbooked clinic had decreased. The average wait time for the unbooked clinic had decreased from ~24 minutes in 1997 to ~12 minutes in 1999. Conclusions:Since the introduction of Nurse Triage, the average overall waiting times for those who attend without an appointment has halved and the wait to see a doctor and a nurse has decreased. The majority of staff felt that the triage process had improved patient flow.

scholarly journals Sexually transmitted infection diagnoses and access to a sexual health service before and after the national lockdown for COVID-19 in Melbourne, Australia

2020 ◽  
Author(s):  
Eric P F Chow ◽  
Jane S Hocking ◽  
Jason J Ong ◽  
Tiffany R Phillips ◽  
Christopher K Fairey
Keyword(s):  
Health Service ◽  
Sexual Health ◽  
Sexually Transmitted Infection ◽  
Health Centre ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Sexual Health Service ◽  
Before And After ◽  
Clinical Conditions ◽  
The Impact

Abstract Background We aimed to examine the impact of lockdown on sexually transmitted infection (STI) diagnoses and access to a public sexual health service in the COVID-19 pandemic in Melbourne, Australia. Methods The operating hours of Melbourne Sexual Health Centre (MSHC) remained the same during the lockdown. We examined the number of consultations and STI at MSHC between January and June 2020 and stratified the data into pre-lockdown (3-February to 22-March), lockdown (23-March to 10-May) and post-lockdown (11-May to 28-June) with seven weeks in each period. Incidence rate ratio (IRR) and its 95% confidence intervals (CI) were estimated using Poisson regression models. Results The total number of consultations dropped from 7,818 in pre-lockdown to 4,652 during lockdown (IRR=0.60;95%CI:0.57-0.62) but increased to 5,347 in the post-lockdown period (IRR=1.15;95%CI:1.11-1.20). There was a 68% reduction in asymptomatic screening during lockdown (IRR=0.32; 95%CI:0.30-0.35) but it gradually increased in the post-lockdown period (IRR=1.59;95%CI:1.46-1.74). STI with milder symptoms showed a marked reduction, including non-gonococcal urethritis (IRR=0.60;95%CI:0.51-0.72), and candidiasis (IRR=0.61;95%CI:0.49-0.76) during lockdown compared with pre-lockdown. STI with more marked symptoms did not change significantly, including pelvic inflammatory disease (IRR=0.95;95%CI:0.61-1.47) and infectious syphilis (IRR=1.14;95%CI:0.73-1.77). There was no significant change in STI diagnoses in post-lockdown compared to lockdown. Conclusions The public appeared to be prioritising their attendance for sexual health services based on the urgency of their clinical conditions. This suggests that the effectiveness of clinical services in detecting, treating and preventing onward transmission of important symptomatic conditions is being mainly preserved despite large falls in absolute numbers of attendees.

scholarly journals P105 A bespoke sexual health service for transgender people is highly acceptable and meets the broader health needs of this population

2016 ◽  
Vol 92 (Suppl 1) ◽  
pp. A55.3-A56
Author(s):  
Bethan Machado ◽  
Kate Nambiar ◽  
Tamara Woodroffe ◽  
Alison Parnell ◽  
Daniel Richardson
Keyword(s):  
Health Service ◽  
Sexual Health ◽  
Health Needs ◽  
Transgender People ◽  
Sexual Health Service

scholarly journals Do gay and bisexual men who conceal their same-sex behavior prefer different kinds of health services? Findings across four cities to inform client-centered HIV prevention in China

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Rong Fu ◽  
Bryan A. Kutner ◽  
Yumeng Wu ◽  
Lu Xie ◽  
Siyan Meng ◽  
...  
Keyword(s):  
Health Service ◽  
Health Services ◽  
Sexual Health ◽  
Health Clinic ◽  
Sex Behavior ◽  
Bisexual Men ◽  
Same Sex ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Sexual Health Service

Abstract Background In China, addressing disparities in the HIV epidemic among men who have sex with men (MSM) requires targeted efforts to increase their engagement and retention in prevention. In an effort to advance MSM-friendly HIV services within China, and informed by community-based partnerships, we tested whether MSM who have ever versus never disclosed their same-sex behavior to healthcare providers (HCP) differ in sociodemographic and behavioral characteristics as well as the qualities of sexual health services each group would prefer to access. Methods We conducted a cross-sectional survey among HIV-negative MSM who went to MSM-focused voluntary counseling and testing clinics in four cities in China. The survey was anonymous and collected information on sociodemographic characteristics, testing behaviors, sexual-health related behavior, and sexual health service model preferences. Results Of 357 respondents, 68.1% participants had ever disclosed same-sex behavior to HCPs when seeking advice for sexual health. Younger age (aOR = 1.04; 95% CI: 1.01-1.08), and worry of HIV acquisition (aOR = 1.39; 95% CI: 1.05–1.84) were associated with higher odds of past disclosure. The availability of comprehensive sexual health services was one of the most valued characteristics of the ideal sexual health clinic. Those who ever disclosed and never disclosed differed significantly in their ranking of the importance of three out of ten dimensions: sexual health counseling services available (M = 3.99 vs. M = 3.65, p = .002), gay identity support available (M = 3.91 vs. M = 3.62, p = .016) and clinic collaborates with a gay CBO (M = 3.81 vs. M = 3.56, p = .036). Conclusions Our hypothesis that MSM who had disclosed versus never disclosed same-sex behavior would differ in the value they placed on different dimensions of sexual health service was partially borne out. As health authorities in China decide on implementation models for pre-exposure prophylaxis (PrEP) delivery and specifically within which institutions to integrate PrEP services, the preferences of target populations should be considered to develop comprehensive, patient-centric and LGBT-friendly services.

Prevalence of other sexually transmissible infections in patients with newly diagnosed anogenital warts in a sexual health clinic

Sexual Health ◽  
2010 ◽  
Vol 7 (1) ◽  
pp. 55 ◽  
Author(s):  
Elizabeth A. Sturgiss ◽  
Fengyi Jin ◽  
Sarah J. Martin ◽  
Andrew Grulich ◽  
Francis J. Bowden
Keyword(s):  
Human Papillomavirus ◽  
Sexual Health ◽  
Health Centre ◽  
Health Clinic ◽  
Newly Diagnosed ◽  
Anogenital Warts ◽  
Human Papillomavirus Vaccination ◽  
Anogenital Wart ◽  
Screening Programs ◽  
Sexually Transmissible Infections

Background: Anogenital warts are a common initial presentation to the Canberra Sexual Health Centre. It is anticipated that the introduction of human papillomavirus vaccination will reduce the incidence of anogenital warts. The present study determines the prevalence of other sexually transmissible infections in patients newly diagnosed with warts who may not have presented for screening without the impetus of a genital lump. Methods: The prevalence of other sexually transmissible infections in new patients presenting to the Canberra Sexual Health Centre diagnosed with anogenital warts was determined from a retrospective clinical audit from 2002 to 2007. Results: A total of 1015 new patients were diagnosed with anogenital warts. Of this total cohort, 53 (5.2%) were found to be co-infected with either chlamydia and/or gonorrhoea. Only 13.2% of co-infected patients reported symptoms other than genital lumps. Of co-infected patients 11.3% reported contact with a partner with chlamydia and/or gonorrhoea. Not all patients were screened for other sexually transmissible infections: 762 (75.1%) were screened for chlamydia and 576 (56.7%) were screened for gonorrhoea. Of those tested, 6.8% of men and 6.9% of women were positive for chlamydia highlighting the importance of offering full sexually transmissible infection screening in those newly diagnosed with anogenital warts. Chlamydia was more common in younger patients who reported a higher number of sexual partners. Conclusions: It is anticipated that human papillomavirus vaccination will lead to a decline in anogenital wart incidence as well as other human papillomavirus associated disease. Although one opportunity for testing for other sexually transmissible infections may be lost in this population, the decrease in anogenital warts will leave clinicians with more time to pursue other screening programs. Education and screening campaigns should continue to focus on the asymptomatic nature of the majority of sexually transmissible infections.

scholarly journals Evolution of a pre-exposure prophylaxis (PrEP) service in a community-located sexual health clinic: concise report of the PrEPxpress

Sexual Health ◽  
2018 ◽  
Vol 15 (6) ◽  
pp. 598 ◽  
Author(s):  
Nicolo Girometti ◽  
Sheena McCormack ◽  
Emma Devitt ◽  
Keerti Gedela ◽  
Nneka Nwokolo ◽  
...  
Keyword(s):  
Sexual Health ◽  
Good Clinical Practice ◽  
Health Clinic ◽  
Nurse Prescribing ◽  
Concise Report ◽  
Sexual Health Service ◽  
Sexually Transmissible Infections ◽  
The Uk ◽  
Exposure Prophylaxis

Screening and treatment of sexually transmissible infections, including HIV, are free in the UK nations; pre-exposure prophylaxis (PrEP) became free in England in October 2017 through the PrEP Impact trial. Doctor-led PrEP clinics started at 56 Dean Street in September 2015, with the drug purchased privately at full price. The service was expanded to other staff to support initiation and monitoring of increasing numbers of attendees purchasing PrEP from online pharmacies. Nonetheless, when the clinic was given a target of 1700 for the PrEP Impact trial, it was clear this could not be achieved in a timely manner through 56 Dean Street alone. To prepare for the trial, all staff with HIV testing competencies were trained in good clinical practice and trial-specific procedures, and a patient group directive was approved to facilitate nurse prescribing and dispensing. Electronic pro formas to capture eligibility for starting or continuing PrEP were adapted for the Dean Street Express clinic, with some information collected directly from service users using touch screens. These interventions, together with an update to the 2016 information leaflet developed by the community, enabled enrolment and follow-up of 1700 participants in 4 months. PrEP advice and monitoring were easily accommodated in the 56 Dean Street sexual health service, but did require additional training and approval for nurse prescribing and dispensing drug in order to achieve the target, which still fell short of the demand.

Trichomonas vaginalis infection among women in a low prevalence setting

Sexual Health ◽  
2011 ◽  
Vol 8 (1) ◽  
pp. 65 ◽  
Author(s):  
Ruby N. N. Uddin ◽  
Nathan Ryder ◽  
Anna M. McNulty ◽  
Lynne Wray ◽  
Basil Donovan
Keyword(s):  
Sexual Health ◽  
Trichomonas Vaginalis ◽  
Health Centre ◽  
Health Clinic ◽  
Access To Health Services ◽  
Health Seeking ◽  
Retrospective Case ◽  
Access To Health ◽  
Data Collection Instrument ◽  
Low Prevalence

Objectives: Trichomonas vaginalis has become rare in Australian cities but remains endemic in some remote regions. We describe the prevalence and associations of infection among women attending an urban Australian sexual health clinic. Methods: A retrospective case control study was conducted with women diagnosed with T. vaginalis at Sydney Sexual Health Centre between January 1992 and December 2006. Proforma medical records for all women were reviewed to extract demographic, behavioural and diagnostic variables using a predefined data collection instrument. Results: Over the 15-year period, 123 cases of T. vaginalis were diagnosed, with a prevalence of 0.40%. Factors independently associated with infection were older age, vaginitis symptoms (adjusted odds ratio (AOR) 6.47; 95% confidence interval (CI), 3.29–12.7), sex with a partner from outside Australia (AOR 2.33; 95% CI, 1.18–4.62), a concurrent (AOR 3.65; 95% CI, 1.23–10.8) or past (AOR 2.67; 95% CI, 1.28–5.57) sexually transmissible infection, injecting drugs (AOR 7.27; 95% CI, 1.43–36.8), and never having had a Papanicolaou smear (AOR 7.22; 95% CI, 2.81–18.9). Conclusions: T. vaginalis infection was rare in women attending our urban clinic. Rarity, combined with an association with sex outside Australia, points to imported infections accounting for a large proportion of T. vaginalis infections in an urban population. The association with never having had cervical cancer screening, along with injecting drug use, likely reflects an increased prevalence in those with reduced access to health services or poor health seeking behaviours.

Low yield of anogenital examination among asymptomatic clients of an urban sexual health clinic

Sexual Health ◽  
2011 ◽  
Vol 8 (1) ◽  
pp. 90 ◽  
Author(s):  
Jun Yong Ma ◽  
Nathan Ryder ◽  
Lynne Wray ◽  
Anna McNulty
Keyword(s):  
Sexual Health ◽  
Physical Examination ◽  
Diagnostic Yield ◽  
Health Centre ◽  
Cross Sectional Study ◽  
Health Clinic ◽  
Cross Sectional ◽  
Heterosexual Women ◽  
Sexually Transmissible Infections ◽  
Sexual Health Clinics

Background: The use of self-collected specimens to test for sexually transmissible infections (STI) has reduced the opportunity for physical examination. Physical examination has been found to be of limited value in asymptomatic heterosexual women and men; however, prior studies have excluded higher risk populations. We performed a retrospective cross-sectional study to determine the diagnostic yield of physical examination among all clients attending our sexual health service. Methods: The Sydney Sexual Health Centre database was used to identify asymptomatic clients attending for the first time between January and June 2009. Demographic and behavioural data were extracted from the database for all clients. Medical records were then manually reviewed to determine the number and nature of diagnoses related to the examination and whether this varied by sex and sex of sexual partners. Results: Of the 590 clients included, 450 (76%) received anogenital examinations. Ten (2.2%; 95% confidence interval 1.1–4.1%) STI were found, including four cases of cervicitis, four of anogenital warts and two of molluscum. Nineteen (4.2%) other non-STI conditions were detected, mostly in heterosexual women and men who have sex with men (MSM). Conclusion: Physical examination of asymptomatic clients attending our sexual health clinic was of limited value, even among higher risk individuals such as MSM. Sexual health clinics should direct resources currently used to examine clients towards increasing the STI testing rate.

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