STI services in the United Kingdom: how shall we cope?

Bradbeer, Caroline; Mears, Alison

doi:10.1136/sti.79.6.435

Cited by 21 publications

(17 citation statements)

References 14 publications

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“…1 It is routine for women attending sexual health services to have a vaginal examination, however, this can be intrusive 2 and it is uncertain whether all asymptomatic women require one. Non-invasive testing for Chlamydia trachomatis and Neisseria gonorrhoeae using nucleic acid amplification tests is now available so speculum examination is not necessarily required for STI screening.…”

Section: Introductionmentioning

confidence: 99%

Is routine vaginal examination necessary for asymptomatic women attending sexual health services?

et al. 2006

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The aim of this study was to determine whether our sexual health service could be streamlined by dispensing with routine vaginal examination of asymptomatic women, without missing important diagnoses.This was an audit of asymptomatic women presenting to the centre who had had a Papanicolaou (PAP) smear in the previous two years.Of the 421 women who were eligible, no abnormalities were found on genital inspection in 392 (93%) individuals. Abnormalities detected on clinical examination included one case (0.2%) with mucopurulent cervicitis that tested positive for Chlamydia trachomatis, four (1%) with warts or molluscum contagiosum, and one with an asymptomatic genital ulcer of unknown cause.Dispensing with the vaginal examination in asymptomatic women who have had a speculum examination as part of biennial cervical screening may be appropriate in settings where sensitive non-invasive testing for sexually transmitted infections (STI) is in use and STI prevalence is low.

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Section: Introductionmentioning

confidence: 99%

Is routine vaginal examination necessary for asymptomatic women attending sexual health services?

et al. 2006

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“…1 In a recent study, Miles et al 2 demonstrated that experienced nurses perform as well as, or better than junior doctors, when assessing female patients. Critics of this study pointed out that it was unfair to compare relatively inexperienced doctors with experienced nurses.…”

Section: Introductionmentioning

confidence: 98%

The role of the nurse in screening asymptomatic male and female patients in a sexual health clinic

et al. 2005

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We allocated 278 patients, who said they were asymptomatic and agreed to be randomized to a nurse or doctor clinic, to appointments using a random number system. In all, 35 patients did not attend and 16 were excluded because they did not meet the entry criteria. We used a screening protocol which excluded microscopy from the immediate assessment of patients. The outcome measures were completeness of documentation, proportion of patients accepting HIV tests, infections detected and patient satisfaction. Overall, 3% of items were not completed by doctors and 6% by nurses. HIV tests were carried out on 65% of patients who saw a doctor and 52% who saw a nurse. Thirteen infections were detected by doctors and 27 by nurses. No new cases of gonorrhoea, syphilis or HIV infection were identified. Eighty-eight patients completed a questionnaire after their attendance. Almost all patients were very satisfied with the service and most were prepared to see a nurse on a subsequent visit. We concluded that there are few differences between the performance of doctors and nurses in routine screening of asymptomatic patients.

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“…1,2 Ideally, concentrating on changes in clinic practices and staff roles within the clinic can avoid the need for additional resources. This was the outcome when, in August 2001, Melbourne Sexual Health Centre (MSHC) changed from an appointment to a nurseled walk-in triage system (WITS).…”

Section: Introductionmentioning

confidence: 99%

Use of the Delphi sorting technique to establish a core sexual history

Tideman

Pitts²,

Fairley

2006

Int J STD AIDS

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The objective of this study was to develop a core sexual history to be used as a supplementary tool to assist sexual health physicians assess new clients attending a sexual health centre. Eight experts in sexual health medicine employed the Delphi technique and sexual history items from a previous study to generate a core sexual history. The core history contained 15 questions for men and women, with three additional specific questions for men and five for women. The current state of the clients' sexual health was explored (rather than a client's history of sexual behaviour) and three months (compared with 12 months and lifetime) came out strongly as the preferred timeframe for asking clients' behavioural questions. This core history may be useful in many clinics in Australia and New Zealand as its development was based on expert clinical experience of respected authorities within the field of sexual health medicine.

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STI services in the United Kingdom: how shall we cope?

Cited by 21 publications

References 14 publications

Is routine vaginal examination necessary for asymptomatic women attending sexual health services?

Is routine vaginal examination necessary for asymptomatic women attending sexual health services?

The role of the nurse in screening asymptomatic male and female patients in a sexual health clinic

Use of the Delphi sorting technique to establish a core sexual history

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