International journal of STD & AIDS
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Review Historical Article
Sexually transmitted disease/HIV health-care policy and service provision in Britain.
The objective of this paper was to discusses historical developments of sexually transmitted disease (STD)/HIV sexual health policies in Britain, principally from the 19th to the 21st century. Repeating trends were identified and a consideration of how history addresses today's urgent need for better management of sexual health is discussed. In January 1747, the first venereal disease (VD) treatment was established at Lock Hospital, London. ⋯ From 1918, treatment centres increasingly recognized the difficulties in persuading attendees to return for a complete course of treatment. AIDS in Britain wrecked havoc in the period 1981-86 with incidences of infection in several widely differing groups and public alarm fuelled by the media. In conclusion, education, advertising and public health counselling need to be moulded effectively so that the public recognize the real risks associated with unprotected sexual intercourse.
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There have been very few studies focusing on what form of communication patients would find acceptable from a clinic. This study looks at the differences in preferences for various partner notification methods when the respondents were index patients compared with when they had to be contacted because a partner had a sexually transmitted infection (STI). ⋯ The opposite was true for patient referral partner notification. Therefore, there are variations in the preferences of respondents for partner notification method, which depend on whether they see themselves as index patients or contacts.
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Since the late 1990s, there has been a resurgence of infectious syphilis, with notable outbreaks in Brighton, Manchester, London and Dublin, predominantly among men who have sex with men (MSM). We report a similar outbreak in Northern Ireland. Genitourinary (GU) medicine clinic attendees were assessed from 1 July 2000 to 30 June 2005 to identify those who met the agreed criteria for primary, secondary or early latent syphilis. ⋯ In conclusion, initially, cases acquired their infection in Dublin and, as the outbreak gained momentum, syphilis was contracted within Northern Ireland. The cohort was not generally associated with a high number of sexual contacts, multiple anonymous partners or specific locations. The challenge is to educate both patients and health-care professionals to sexual health issues; specifically, the risk associated with casual oral sex by MSM.
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Review
Partner referral tools and techniques for the clinician diagnosing a sexually transmitted infection.
Public health agencies have insufficient resources to trace and refer to medical evaluation the sexual partners of patients with sexually transmitted infections (STI). Only a minority of such patients receives formal sex partner referral services. Hence this responsibility rests, by default, with the diagnosing clinician or with the infected patient. ⋯ Clinician and patient obstacles to successful partner referral are discussed, and brief counselling techniques are suggested. Use of patient-delivered therapy, via medication or prescription (dispensed with appropriate warnings), probably serves to emphasize the urgency and importance of notifying partners. Successful referral to medical attention has been shown to help prevent re-infection of the index patient and to curtail community transmission.