We aimed to investigate whether patients with genital warts experience greater feelings of shame and lower self-esteem compared with controls. Sixty patients with genital warts were compared with 60 asymptomatic genitourinary (GU) medicine patients and 60 orthopaedic outpatients. The shame scores of those with warts (31.08) were significantly higher (P < 0.0001) than either control group (GU medicine controls 20.77; orthopaedic controls 19.00). The impact on health-related quality of life (HRQoL) by each of the individual emotional parameters of shame, low self-esteem, intrusive thoughts, avoidance behaviour and self-efficacy impact was examined in the wart sample group. Only internalized shame (P = 0.001) and intrusive thoughts (P < 0.0001) were significant in predicting HRQoL scores. There are emotional implications in having genital warts, which can have a profound effect on a patient's quality of life and these need addressing just as much as the physical warts.
The aim of this study was to observe the proportion of concurrent rectal Chlamydia (RCt) infection in women who have cervical Chlamydia (CCt) and to observe whether there was any correlation with receptive anal intercourse (RAI). Untreated CCt-positive women were invited to take part. Women chose either to have a physician-collected or self-taken rectal swab. Treatment was then commenced. 17 samples were physician-collected and 80 were self-collected. 75/97 (77.3%, 95% Confidence Interval [95%CI] 69.0-85.7%) were RCt positive. 25/97 (25.8%, 95%CI 17.1-34.5%) reported RAI. There was no difference in the positivity rate whether RAI was reported (80%) or not (76%) (P = 0.71); or whether swabs were physician-collected (65%) or self-taken (80%) (P = 0.17). Only one of those with RCt reported rectal symptoms. One woman had concurrent gonococcal infection. 34/97 (35%) had a history of past sexually transmitted infections. Verified contact attendance was 0.52 and 72% of verified contacts were Chlamydia positive. Reported RAI may not be helpful in guiding RCt testing. RCt infection in women may be more prevalent than previously thought. We do not know whether RCt infections are clinically significant or whether they may act as a reservoir for re-infection. RCt infections in women require further study.
The aim of this study was to investigate consultant genitourinary (GU) physicians' and health advisers' views regarding acceptability of patient-delivered partner therapy (PDPT) in the United Kingdom (UK). A postal questionnaire was sent to all consultant GU physicians and senior health advisers: 206 (65%) physician questionnaires and 153 (77%) health-adviser questionnaires were returned. One hundred and three (50%) physicians and 31 (22%) health advisers reported ever having used PDPT. Approximately one-third of professionals are strongly opposed to PDPT. However, the majority of both professional groups are cautiously prepared to consider PDPT, but only if there is no other option and only if a health professional first makes contact with the partner. Chief concern among health professionals is the legal status of PDPT in the UK. Here, the current General Medical Council (GMC) guidance on remote prescribing is helpful. The outcome of the Medical Research Council randomized controlled trial on accelerated partner therapy, which fits in with GMC guidance, is eagerly awaited as professionals would welcome evidence-based national guidance.
The Southwest Regional Genitourinary Physicians' Audit Group conducted a survey to determine regional benchmarks for patient satisfaction with quality of care received in genitourinary medicine (GUM) clinics. Eight clinics participated, producing 1747 responses. Most patients were very satisfied with the standard of care in southwest GUM clinics resulting in high regional averages (74-90% very satisfied--score 5 on linear analogue scale 1-5). Revalidation/appraisal guidance suggests that physicians should actively participate in validated surveys relevant to their practice to provide evidence of relationships with patients. This questionnaire (with suggested improvements) may be used as part of that monitoring process.
We conducted a survey of patients attending two GUM clinics to evaluate the use of the internet for seeking sexual partners and for seeking on-line sexual health information. Prevalence of internet sex-seeking (ISS) was 11% (57/500) in Plymouth and 21% (50/237) in London. ISS was more common among men who have sex with men (MSM) (43/92 = 47%) than men who have sex with women (MSW) (38/280 = 14%, P< 0.0001) and more common amongst MSW than women who have sex with men (WSM) (25/350 = 7%, P = 0.007). In both samples, accessing sexual health information online was associated with ISS (Plymouth, P = 0.05 and London, P = 0.001), as was reporting more than 10 sexual partners per year (Plymouth and London, P < 0.001). It remains to be seen whether the potential sexual health promotion benefits of the internet could balance potential risks of STI acquisition.
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