SEXUAL HEALTH: SCREENING, VACCINES AND REFERRALS

Dr Kate Morton

OVERVIEW

• Screening

• Vaccinations

• When to refer

• Local services

BACKGROUND

• “England is facing increasing levels of poor sexual health”– Rising levels of STIs and HIV– Rising level of high risk sexual behaviour– Continuing high rates of unintended

pregnancy and abortion

BACKGROUND

• Several papers:• DOH’s national standards, local action: health and social

care standards and planning framework (2008)• Choosing health• Recommended standards for sexual health services (2005)

• Activity indicators:• the percentage of patients attending GUM clinics who are

offered an appointment to be seen within 48 hours of contacting a service. Aiming to reach 100 % by 2008

• number of new diagnoses of gonorrhoea per 100,000• the percentage of the sexually active population aged 15-24

accepting screening for chlamydia• the under-18 conception rate

CHLAMYDIA SCREENING

• Rationale: chlamydia usually has no symptoms and can have serious complications

• National Chlamydia Screening Programme: free screening for under 25’s

• Under 25’s should be tested annually, or if they have a new sexual partner

• Men: urine sample• Women: urine sample or lower vaginal swab• Variety of places offer the test: GP surgeries, pharmacies,

sexual health clinics etc

• Over 25’s need to contact their GP, practice nurse or sexual health clinic

HPV VACCINATION

• Rationale: cervical cancer = 2nd most common cancer in women worldwide

• 3000 new cases diagnosed in the UK each year, 1000 women die from it

• Cervical ca caused by HPV in 99% of cases

• HPV vaccine protects against strains 16 and 18 that cause the most cases (> 70%)

• Consists of 3 injections over 6 months

• Recommended for all girls in year 8 at school (12-13 year olds)

• Either done through school or GP surgery

• Catch-up programme for all girls born on or after 1st Sept 1990

• Still need to have smear tests after age 25

• More info at www.nhs.uk/hpv

REFERRALS

• Refer to:• Gynaecology• GU medicine• Urology• Infectious diseases• Sexual dysfunction specialists

• Don’t forget your local cytology and microbiology lab for specialist advice!