Standards for comprehensive sexual health services for young people under 25 years

2002 ◽  
Vol 13 (6) ◽  
pp. 420-424 ◽  
Author(s):  
K E Rogstad ◽  
I H Ahmed-Jushuf ◽  
A J Robinson

This document is a first response to the need to develop sexual health services for young people on a single site whilst awaiting research from pilot studies of 'one stop shops' suggested in the Sexual Health and HIV strategy. It is a document which is intended to be a tool to use for those wishing to set up a service providing testing for sexually transmitted infections and provision of contraceptive services for those under 25 years. It is not intended that such a service would replace existing specialist or general practice care but complement it, allowing clients to choose the service most appropriate and acceptable to them, with close links and clear pathways of care for referral between services. This paper should be used as a template when initiating and monitoring a clinic but some of the standards may not be achievable without significant financial input. However, economic limitations should not detract from striving to achieve the best possible care for those most at risk from sexually transmitted infections and unwanted pregnancies. For example, not all clinics will be able to provide the recommended tests for the diagnosis for gonorrhoea and chlamydia immediately, but should work towards achieving them. Although the upper age limit in this document is defined as 25 years, some providers may wish to limit clinics to those under 20 depending on local needs. Detailed information on specific issues such as consent and confidentiality, provision of contraception, investigation of non-sexually transmitted vaginal infections and sexually transmitted infection management and diagnosis are referenced and we recommend these are accessed by the users of this document. Many of the references themselves are live documents available on the worldwide web, and are constantly updated. The Sexual Health and HIV Strategy has now been published and these standards are aimed at those who wish to provide a level 2 sexual health service for young people wherever the setting e.g. genitourinary outreach clinic, contraceptive services, general practice. This document is a starting point to be reviewed and updated as new research becomes available, as the Sexual Health Strategy is implemented and with further input from providers of care (family planning, general practice, genitourinary medicine, gynaecology and paediatrics) and service users. All service providers must maintain a high quality of care and have networks both with those who provide more specialized services (Level 3) and Level 1 services. This document is an initial attempt to ensure that there is equity of clinical provision wherever a Level 2 sexual health service is provided and should be a useful tool for those setting up or monitoring services.

2019 ◽  
Vol 95 (3) ◽  
pp. 171-174
Author(s):  
Jonathan Syred ◽  
Gillian Holdsworth ◽  
Chris Howroyd ◽  
Kez Spelman ◽  
Paula Baraitser

ObjectiveTo describe the outcomes of user-led, choice of test within an online sexual health service.MethodsWe analysed routinely collected data from a free, online sexual health service in Essex, UK that enabled users to select their tests. The service website provided information on all sexually transmitted infections, recommended a testing package based on sexuality and ethnicity, and invited users to modify this if they chose. Data on orders were analysed for the 6 months before (May–October 2016) and after (October–April 2017) implementation.ResultsWe compared 7550 orders from 6253 users before and 9785 orders from 7772 users after implementation. There was no difference in the proportion of chlamydia (p=0.57) or gonorrhoea (p=0.79) tests that were positive between the two periods. HIV and syphilis positives were too few in our sample during both periods for analysis. During implementation, men who have sex with men (530 users) were offered genital, rectal and oral chlamydia and gonorrhoea testing plus HIV and syphilis testing. In 17.2% of orders, users removed tests. Black or ethnic minority users excluding those who reported as men who have sex with men (805 users) were offered chlamydia, gonorrhoea and HIV testing. In 77.9% of orders, users added a test. All other users were offered chlamydia and gonorrhoea tests only. In 65.2% of orders, users added tests. We observed a reduction in orders of 3083 blood tests (31%).ConclusionUsers engaged with the ‘choose to test’ intervention. Although a majority added tests, the intervention was cost saving by reducing the HIV and syphilis tests ordered.


2005 ◽  
Vol 16 (5) ◽  
pp. 353-356 ◽  
Author(s):  
O J Barney ◽  
M Nathan

A retrospective study was undertaken of all women attending a sexual health service during their pregnancies in the year 2000 in order to find the prevalence of sexually transmitted infections (STIs) and other conditions commonly screened for in sexual health services among this population. Data relating to demographics, sexual health screen and infections diagnosed were collected. All new female registrations during the same period were additionally identified. The prevalence of disease in the two groups was compared. Data on 164 patients who attended during their pregnancies in the year 2000 were analysed. One STI was identified in 59 patients (36%), two infections in nine patients (5%) and three infections in three patients (2%). An increased prevalence of STIs was noted in those aged 25 and under, compared with those over 25 ( P <0.001). Prevalence of STIs increased with gestation (0.01 < P>0.05). Prevalence of STIs was higher in pregnant women (63/164; 38.4%) compared with all new female registrations (1094/5273; 20.7%; P <0.001) during the same period. Additionally, 8.5% of pregnant women had a negative screen compared with 20% of all new female cases. This study shows the prevalence of STIs to be significantly higher among the pregnant women as compared with all women attending. A trend towards more frequent occurrence of an STI was seen with increasing gestation and young age. Prospective studies are needed to verify these results among an unselected population of pregnant women.


2021 ◽  
Vol 32 (6) ◽  
pp. 528-532
Author(s):  
Nur Gasmelsid ◽  
Benjamin CB Moran ◽  
Tom Nadarzynski ◽  
Rajul Patel ◽  
Elizabeth Foley

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.


2015 ◽  
Vol 19 (5) ◽  
pp. 1-116 ◽  
Author(s):  
Jackie A Cassell ◽  
Julie Dodds ◽  
Claudia Estcourt ◽  
Carrie Llewellyn ◽  
Stefania Lanza ◽  
...  

BackgroundPartner notification is the process of providing support for, informing and treating sexual partners of individuals who have been diagnosed with sexually transmitted infections (STIs). It is traditionally undertaken by specialist sexual health services, and may involve informing a partner on a patient’s behalf, with consent. With an increasing proportion of STIs diagnosed in general practice and other community settings, there is a growing need to understand the best way to provide partner notification for people diagnosed with a STI in this setting using a web-based referral system.ObjectiveWe aimed to compare three different approaches to partner notification for people diagnosed with chlamydia within general practice.DesignCluster randomised controlled trial.SettingGeneral practices in England and, within these, patients tested for and diagnosed with genital chlamydia or other bacterial STIs in that setting using a web-based referral system.InterventionsThree different approaches to partner notification: patient referral alone, or the additional offer of either provider referral or contract referral.Main outcome measures(1) Number of main partners per index patient treated for chlamydia and/or gonorrhoea/non-specific urethritis/pelvic inflammatory disease; and (2) proportion of index patients testing negative for the relevant STI at 3 months.ResultsAs testing rates for chlamydia were far lower than expected, we were unable to scale up the trial, which was concluded at pilot stage. We are not able to answer the original research question. We present the results of the work undertaken to improve recruitment to similar studies requiring opportunistic recruitment of young people in general practice. We were unable to standardise provider and contract referral separately; however, we also present results of qualitative work aimed at optimising these interventions.ConclusionsExternal recruitment may be required to facilitate the recruitment of young people to research in general practice, especially in sensitive areas, because of specific barriers experienced by general practice staff. Costs need to be taken into account together with feasibility considerations. Partner notification interventions for bacterial STIs may not be clearly separable into the three categories of patient, provider and contract referral. Future research is needed to operationalise the approaches of provider and contract partner notification if future trials are to provide generalisable information.Trial registrationCurrent Controlled Trials ISRCTN24160819.FundingThis project was funded by the National Institute for Health Research Health Technology Assessment programme and will be published in full inHealth Technology Assessment; Vol. 19, No. 5. See the NIHR Journals Library website for further project information.


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