Sexual health and contraception

2014 ◽  
pp. 733-780
Author(s):  
Chantal Simon ◽  
Hazel Everitt ◽  
Françoise van Dorp ◽  
Matt Burkes
Keyword(s):  
Sexual Health ◽  
Hiv Infection ◽  
Vaginal Discharge ◽  
Hormonal Contraception ◽  
Intrauterine Devices ◽  
Contraceptive Methods ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Hiv Infection Prevention ◽  
Combined Hormonal Contraception

Assessment of sexual health Vaginal discharge Sexually transmitted infection Chlamydia, gonorrhoea, and trichomonas Hepatitis B and C HIV infection: prevention and testing HIV infection: clinical disease Other sexually transmitted infections Summary of contraceptive methods Combined hormonal contraception Progestogen-only contraceptives Intrauterine devices Other contraceptive methods Teenagers and women over 40...

Sexual health and contraception

2020 ◽  
pp. 709-760
Author(s):  
Chantal Simon ◽  
Hazel Everitt ◽  
Françoise van Dorp ◽  
Nazia Hussain ◽  
Emma Nash ◽  
...  
Keyword(s):  
General Practice ◽  
Sexual Health ◽  
Hormonal Contraception ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Contraceptive Devices ◽  
Gender Reassignment ◽  
Intrauterine Contraceptive ◽  
And Gender ◽  
Combined Hormonal Contraception

This chapter in the Oxford Handbook of General Practice explores sexual health and contraception in general practice. It covers assessment of sexual health, vaginal discharge, sexually transmitted infection, chlamydia, trichomonas, gonorrhoea, hepatitis B and C, and HIV infection. It explores contraceptive choices, combined hormonal contraception, progestogen-only contraceptives, and intrauterine contraceptive devices. It discusses teenagers and women over 40, termination of pregnancy, infertility, sexual problems, erectile dysfunction, gender dysphoria, and gender reassignment.

UK national audit of sexual health care for people with HIV infection: clinic policies

2007 ◽  
Vol 18 (9) ◽  
pp. 635-638
Author(s):  
Hugo McClean ◽  
Chris Carne ◽  
Paul Bunting ◽  
Ed Wilkins ◽  
Linda Tucker ◽  
...  
Keyword(s):  
Health Care ◽  
Sexual Health ◽  
Hiv Infection ◽  
Service Providers ◽  
National Standard ◽  
Care Pathways ◽  
National Audit ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Sexual Health Care

A national audit of the sexual health care for people with HIV infection (PWHIV) was conducted in genitourinary medicine clinics and other clinics providing care for PWHIV in the UK in the summer of 2006. Data were aggregated by region and clinic, allowing practice to be compared between regions, as well as to national averages and against various guidelines. In this, the first of two papers, clinics were surveyed on their local policies. In total, 126 clinics participated. Only 38 clinics (30%, regional range 0–60%) had written local care pathways on management of sexually transmitted infection in PWHIV, while 73 (58, 20–100%) had unwritten policies. This compares with the national standard that 100% of service providers should be able to provide documentation of local care pathways for sexually transmitted diseases in people with HIV. Clinics should consider creating policies especially where standards are not being met.

scholarly journals Does online sexually transmitted infection screening compromise care? A service evaluation comparing the management of chlamydial infection diagnosed online and in clinic

2021 ◽  
Vol 32 (6) ◽  
pp. 528-532
Author(s):  
Nur Gasmelsid ◽  
Benjamin CB Moran ◽  
Tom Nadarzynski ◽  
Rajul Patel ◽  
Elizabeth Foley
Keyword(s):  
United Kingdom ◽  
Health Services ◽  
Sexual Health ◽  
Sexually Transmitted Infections ◽  
Sexually Transmitted Infection ◽  
Chlamydial Infection ◽  
Service Evaluation ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
The United Kingdom

Patient demand on sexual health services in the United Kingdom is so high that many services have introduced online screening to accommodate more patients. There are concerns that these services may not be accessible to all. This service evaluation was undertaken to determine whether online screening is accessible by those patients most at need by comparing the demographics and number of asymptomatic chlamydial infections detected online and in clinic. No difference was found in the age nor level of deprivation, demonstrating that online services are an accessible way to screen for sexually transmitted infections without overburdening established services.

scholarly journals Comparison of Trichomoniasis Diagnosis by Microscopic Methods and Indirect ELISA Technique in a Sample of Iraqi Women

2020 ◽  
pp. 742-748
Author(s):  
Nada H. Bedair ◽  
Hayder Z. Ali
Keyword(s):  
Trichomonas Vaginalis ◽  
Vaginal Discharge ◽  
Indirect Elisa ◽  
Elisa Method ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Wet Mount ◽  
Urine Examination ◽  
Iraqi Women ◽  
Elisa Technique

Trichomonas vaginalis is an eukaryotic parasite that causes the most common non-viral sexually transmitted infection, trichomoniasis. This disease is responsible for many serious health problems such as preterm birth. More than half of the infected women do not develop symptoms, which makes it difficult to diagnose thedisease. In this study, a specific indirect ELISA method was developed to detect anti-Trichomonas vaginalis IgM and IgG immunoglobulins in the sera of infected females. The aim of this study was to investigate the sensitivity of a simple ELISA procedure in comparison to the classical urine examination and vaginal wet mount preparation for the diagnosis of T. vaginalis. The sensitivity of the indirect ELISA was compared with the classical vaginal discharge swab and urine microscopic examination, and the results showed sensitivities of 65.5% and 57.2%, respectively. Furthermore, the infection was measurable as acute or chronic with the refined test.

scholarly journals Sexual behaviours and sexually transmitted infection outcomes in a cohort of HIV-negative men who have sex with men attending sexual health clinics in England

2018 ◽  
Vol 29 (14) ◽  
pp. 1407-1416 ◽  
Author(s):  
S Desai ◽  
F Burns ◽  
G Schembri ◽  
D Williams ◽  
A Sullivan ◽  
...  
Keyword(s):  
High Risk ◽  
Sexual Health ◽  
Receptive Anal Intercourse ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Sexual Behaviours ◽  
Increased Risk ◽  
Sex With Men ◽  
Clinical Records ◽  
Hiv Negative

Men who have sex with men (MSM) attending sexual health (SH) clinics are at high risk for HIV acquisition and are disproportionately affected by sexually transmitted infections (STIs). We collected standardised behavioural data from MSM attending clinics to characterise sexual behaviours and identify predictors for HIV and STIs. In 2012–2013, HIV-negative MSM attending five SH clinics in England reported sexual behaviours in the previous three months via a self-administered questionnaire. Behaviours were linked to the individual’s clinical records using national surveillance. The prevalence and incidence of bacterial STIs (gonorrhoea, Chlamydia, lymphogranuloma venereum and syphilis) and incidence of HIV were calculated. Adjusted odds ratios and hazard ratios with 95% confidence interval (CI) were reported for significant predictors. Of 1278 HIV-negative MSM, 54% were of white ethnicity and UK-born and 43% were 25–34 years old. Almost all men reported at least one partner in the last three months. Half reported condomless anal sex and 36% condomless receptive anal intercourse (CRAI). Incidence of bacterial STIs was 46/100 (95%CI 39–54) person years (py) and of HIV was 3.1/100 (95%CI 1.7–5.6) py. A STI at baseline and CRAI with increasing numbers of partners were associated with both incident infections. In this cohort of MSM high-risk behaviours and STIs were prevalent. Engagement in CRAI increased the likelihood of subsequent infection, while men diagnosed with a bacterial STI were at increased risk of a future STI. Clinical and behavioural risk assessments to determine an individual’s risk of infection could allow a more nuanced prevention approach that has greater success in reducing transmission.

Managing the side effects of contraception

2021 ◽  
Vol 32 (6) ◽  
pp. 226-231
Author(s):  
Katie Boog
Keyword(s):  
Side Effects ◽  
Hormonal Contraception ◽  
Oral Contraceptive Pill ◽  
Common Reason ◽  
Evidence Based ◽  
Contraceptive Methods ◽  
Mood Change ◽  
Combined Oral Contraceptive ◽  
Free Interval ◽  
Combined Hormonal Contraception

Side effects are the most common reason for the discontinuation of contraceptive methods. Dr Katie Boog summarises the available evidence on how to manage them Although often transient, side effects are the most common reason for individuals to discontinue contraception. The evidence to prove causality is limited, as is evidence-based guidance on how to manage these side effects. This article summarises the available evidence. For individuals who have new or worsening acne on progestogen-only contraception (POC), switching to combined hormonal contraception (CHC) is likely to improve their skin. Continuous or extended CHC use may be beneficial for individuals with premenstrual mood change, and for those who experience headaches in the hormone-free interval. Unpredictable bleeding patterns on POC are common. Injectable users can try reducing the interval between injections to 10 weeks. Implant, injectable or intrauterine system users can be offered a 3-month trial of a combined oral contraceptive pill (COC). CHC and POP users with unpredictable bleeding may benefit from switching to an alternative preparation.

scholarly journals Randomized Controlled Pilot Study of Antiretrovirals and a Behavioral Intervention for Persons With Acute HIV Infection: Opportunity for Interrupting Transmission

2018 ◽  
Vol 6 (1) ◽  
Author(s):  
William C Miller ◽  
Sarah E Rutstein ◽  
Sam Phiri ◽  
Gift Kamanga ◽  
Dominic Nsona ◽  
...  
Keyword(s):  
Pilot Study ◽  
Hiv Infection ◽  
Behavioral Intervention ◽  
Sexually Transmitted Infection ◽  
Health Benefit ◽  
Acute Hiv Infection ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Randomized Controlled ◽  
Acute Hiv

Abstract Background Persons with acute HIV infection (AHI) have heightened transmission risk. We evaluated potential transmission reduction using behavioral and biomedical interventions in a randomized controlled pilot study in Malawi. Methods Persons were randomized 1:2:2 to standard counseling (SC), 5-session behavioral intervention (BI), or behavioral intervention plus 12 weeks of antiretrovirals (ARVs; BIA). All were followed for 26–52 weeks and, regardless of arm, referred for treatment according to Malawi-ARV guidelines. Participants were asked to refer partners for testing. Results Among 46 persons (9 SC, 18 BI, 19 BIA), the average age was 28; 61% were male. The median viral load (VL) was 5.9 log copies/mL at enrollment. 67% (10/15) of BIA participants were suppressed (<1000 copies/mL) at week 12 vs 25% BI and 50% SC (P = .07). Although the mean number of reported condomless sexual acts in the past week decreased from baseline across all arms (1.5 vs 0.3 acts), 36% experienced incident sexually transmitted infection by 52 weeks (12% SC, 28% BI, 18% BIA). Forty-one percent (19/46) of participants referred partners (44% SC, 44% BI, 37% BIA); 15 of the partners were HIV-infected. Conclusions Diagnosis of AHI facilitates behavioral and biomedical risk reduction strategies during a high-transmission period that begins years before people are typically identified and started on ARVs. Sexually transmitted infection incidence in this cohort suggests ongoing risk behaviors, reinforcing the importance of early intervention with ARVs to reduce transmission. Early diagnosis coupled with standard AHI counseling and early ARV referral quickly suppresses viremia, may effectively change behavior, and could have tremendous public health benefit in reducing onward transmission.

Sexual health

2021 ◽  
pp. 187-240
Author(s):  
Victoria Mckenzie ◽  
Leila Frodsham ◽  
Debra Holloway
Keyword(s):  
Hepatitis B ◽  
Sexual Health ◽  
Sexually Transmitted Disease ◽  
Vaginal Discharge ◽  
Transmitted Disease ◽  
Partner Notification ◽  
Mycoplasma Genitalium ◽  
Well Being ◽  
New Developments ◽  
Sexually Transmitted

This chapter covers problems that can occur with sexual health in women. It starts with the definition, assessment, diagnosis, investigations, and treatment of different sorts of vaginal discharge. It provides information about sexual health in context, including its links with other forms of disease and psychological well-being. Protocols for partner notification in the cases of diagnosis with a sexually transmitted disease are explained. The signs, symptoms, and treatment for gonorrhea, chlamydia, and Mycoplasma genitalium are all covered. It also covers the definition, causes, diagnosis, and treatment of pelvic inflammatory disease. Hepatitis B and C are described, along with anogenital warts, genital herpes, and genital lumps and ulcers. Finally HIV and new developments such as PrEP and PEP are covered.

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