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Sexually transmitted infections
Published in Suzanne Everett, Handbook of Contraception and Sexual Health, 2020
Today clinics known as sexual health clinics are increasingly integrated with contraception to provide both services. Information in sexual health clinics is anonymised to maintain confidentiality and is not disclosed without clients’ consent to general practitioner; every effort is made to ensure that patients’ confidentiality is maintained to encourage men and women to attend.
Sexually transmitted infections in adolescents
Published in Joseph S. Sanfilippo, Eduardo Lara-Torre, Veronica Gomez-Lobo, Sanfilippo's Textbook of Pediatric and Adolescent GynecologySecond Edition, 2019
For treatable infections, partner therapy is an essential element of management. Sexual partners for at least the past 2 months should be informed that they have been exposed to an STI and treated appropriately. Providing simple, written information on the diagnosis and the necessary next steps may assist the adolescent patient with the difficult task of partner notification. Ideally, partners will receive comprehensive sexual health evaluation, counseling, testing, and treatment with their own provider or at a sexual health clinic. Unfortunately, this does not reliably occur. If it is felt that the sexual partner is unable or unlikely to seek such treatment, the diagnosing clinician may be able to provide the patient with a prescription for an additional dose of medication for the treatment of C. trachomatis, N. gonorrhoeae, or T. vaginalis infections, without examining the partner. This practice, known as Expedited Partner Therapy (EPT), is legal or potentially permissible in most states, but specific requirements and infections that may be treated vary. The CDC maintains an online resource to assist clinicians in determining the legality and implementation of this practice in their own state (https://www.cdc.gov/std/ept).32 The patient should be encouraged to abstain from sexual activity until both partners have completed treatment.
From the body to the mind
Published in Ruth Skrine, Blocks and Freedoms in Sexual Life, 2019
Another recent development within medicine and allied disciplines is the concept of sexual health. There are now sexual health clinics, where different aspects of sexual life can be considered as a whole. There must be many advantages to such a service, and I would not want to decry the thinking behind such a development. Yet there is something rather 'clean' about the idea of sexual health, and there are overtones of sex education and health advice. I do not for one moment argue with the idea that such education is necessary and important, but I am not sure how much it has to do with doctoring or understanding the real-life frailties of men and women. Education and the giving of information carry the implication that the educator knows best, that he has superior knowledge about what ails the patient and why. As Bruno Bettelheim has said about his own introduction to psychoanalysis, 'We were equal in our efforts to learn significant things about me. This I found most reassuring, since it allayed my anxiety that things might be done to me without my knowing what they were ...4
Supporting sexuality after spinal cord injury: a scoping review of non-medical approaches
Published in Disability and Rehabilitation, 2022
Chloe Bryant, Louise Gustafsson, Tammy Aplin, Jenny Setchell
Within the studies reviewed, different services were discussed as potential settings for delivering non-medical sexuality support, such as inpatient and outpatient services. One article described a dedicated outpatient sexual health clinic in Canada as a specialised service where people with SCI have lifetime access [46]. The clinic featured person-centred practice, sexual counselling and education programs as examples of non-medical approaches to sexuality. Considering the studies reviewed together, the following sub-themes were created which discuss the types of non-medical interventions or strategies identified and how they may be provided: education and counselling, peer support and group therapy, types of resources, access to information and resources, sexuality programs and, moving beyond fixing it.
Examining Sexual Behavior Among U.S. Transgender Adolescents
Published in The Journal of Sex Research, 2021
Anne J. Maheux, Yiyao Zhou, Brian C. Thoma, Rachel H. Salk, Sophia Choukas-Bradley
Despite the low prevalence of sexual health problems among this population, the present study also highlights the low rates of STI tests reported by participants in this sample. Previous work has shown that adolescents, even those who are at high risk of STIs, often underestimate their vulnerability to STIs and related conditions (Ethier et al., 2003; Nsuami & Taylor, 2012). Adolescents report forgoing STI testing in part due to this misperception of risk, but also because of financial constraints or concerns about confidentiality (Cuffe et al., 2016). Adolescents in the sample were from across the United States and some – particularly those in rural areas – may not have access to sexual health clinics with free or affordable services. Moreover, transgender adolescents in the process of socially transitioning or who are beginning to explore their sexuality may have concerns about parental confidentiality. Removing barriers to sexual health care for transgender adolescents, including making clinics affordable and accessible across U.S. communities so that adolescents can access care without their parents, may increase rates of STI testing. Additionally, greater access to information about preventative sexual health, including the importance of sexual protection for a variety of genders and sexual identities (Bay-Cheng, 2003; Bradford et al., 2018), may protect transgender adolescents from acquiring STIs or experiencing unwanted pregnancies.
“Belt and braces approach; added benefit and … extra reassurance”: a multi-stakeholder examination of the challenges to effective provision of pre-exposure prophylaxis (PrEP) for HIV prevention among men who have sex with men (MSM) in Northern and Central England
Published in AIDS Care, 2021
Alyson Hillis, Jennifer Germain, Matthew Peter Hibbert, Vivian Hope, Marie Claire Van Hout
Findings indicated that some non-eligible trial participants “played the system” to obtain PrEP, highlighting inequity of access. Eligibility is risk-based, however, many felt that PrEP should be available to all that may benefit from it. Furthermore, the setting and PrEP provision should be regionally reviewed and offered through multiple channels. We additionally highlight the need to support trust building and enhance communication in order to optimise the PrEP cascade and widen availability (Hillis et al., 2020; Patel et al., 2018). If this is achieved, patients will arguably have greater adherence, increase testing and reduce HIV/STI transmission, allowing resources to be consolidated and the removal of pressure from an overstrained system. More specifically, we found a need for PrEP-specific consultations within sexual health clinics to provide a streamlined service throughout the patient pathway.