1. SEXUAL HEALTH: SCREENING, VACCINES AND REFERRALS Dr Kate Morton

2. OVERVIEW Screening Vaccinations When to refer Local services

3. 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

4. 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

5. 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

7. HPV VACCINATION Rationale: cervical cancer = 2 nd 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%)

8. 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 1 st Sept 1990 Still need to have smear tests after age 25 More info at www.nhs.uk/hpvwww.nhs.uk/hpv

9. REFERRALS Refer to: Gynaecology GU medicine Urology Infectious diseases Sexual dysfunction specialists Don’t forget your local cytology and microbiology lab for specialist advice!