Comment: The national strategy – implementation action plan
Paul Woolley
pp 4-6
The first national strategy for sexual health and HIV was published with the following aims: to reduce the transmission of sexually transmitted infections (STIs) and HIV; to reduce the prevalence of undiagnosed STIs and HIV; to reduce the rate of unintended pregnancies; to improve healthcare for persons with HIV infection; to reduce the stigma associated with STIs and HIV.
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Screening for osteoporosis in perimenopausal women
Jean Hodson
pp 7-10
A 50-year-old woman faces a 40% risk of sustaining an osteoporotic fracture in her lifetime. This is a daunting thought, not only because of the mortality, morbidity and loss of independence associated with these fractures, but also because of the enormous cost to the NHS. The average cost of osteoporotic fractures to a primary care group of 100,000 patients is currently around £1.5 million annually. Life expectancy continues to rise, with the number of osteoporotic fractures forecast to double over the next 50 years.
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School-based sex education
Simon Forrest
pp 12-14
How, and what, young people learn about sex is a source of controversy in the UK. The debate about whether sex education encourages sexual activity, or delays its onset, predates the existence of reliable data about young people’s sexual behaviour. These data have only been available within the UK in the last decade, and show that the median age of first intercourse has fallen from 17 to 16 years, the number of partners is increasing, and that contraceptive use has risen to the point where 80% of young people report using a condom at first intercourse.
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Postexposure prophylaxis for HIV transmission
Nneka C Nwokolo
pp 15-17
It is now standard practice to recommend the prescription of antiretroviral agents to healthcare workers occupationally exposed to HIV in most parts of the world where antiretroviral therapy is available for the treatment of HIV-infected individuals. This recommendation is based on data from an international case-control study of healthcare workers which showed that in subjects who had received zidovudine monotherapy following occupational exposure to HIV infection, there was an 81% reduction in HIV transmission compared with subjects who did not receive zidovudine.
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Genital warts – an overview
Deborah M Wardle and Rak Nandwani
pp 20-23
Anogenital warts (condylomata acuminata) represent the most commonly diagnosed sexually transmitted infection (STI) in genitourinary medicine (GUM) clinics throughout the UK, and constitute a large proportion of their workload. The government’s national sexual health strategy for England encourages a more integrated approach to the recognition and treatment of STIs. GPs will therefore become more involved in genital wart management alongside established GUM clinics. However, with both funding limitations and increased waiting times due to rising numbers of STIs, an appointment in a GUM clinic may be more time consuming than a consultation with their own GP.
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Sex and hysterectomy
Anthony M Mander
pp 24-26
Every year more than 60,000 women undergo hysterectomy in the UK, usually as a procedure for relieving symptoms and improving the quality of life in those with benign conditions (for example fibroids, dysfunctional uterine bleeding, endometriosis, chronic pelvic pain and prolapse). Women considering hysterectomy are often concerned about its potential effects on their sexual functioning; indeed, several studies show that concern about post-hysterectomy sexual functioning is the most frequent preoperative anxiety.
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Male genital dermatoses
Sylvia Bates
pp 27-30
Male patients frequently attend genitourinary medicine (GUM) clinics because they are concerned about skin lesions in the genital area. Although such lesions may be manifestations of sexually transmitted infections (STIs), this is not always the case, and other dermatological conditions need to be considered in the differential diagnosis.
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A dog's dinner
David Hicks
pp 31-31
Unlike the majority of mammalian species, women do not exhibit an evident time of heightened sexual activity when they are attractive, proceptive and receptive to males. This periodic sex appeal is referred to as ‘heat’ or ‘oestrus’. The latter term comes from the Greek meaning ‘gadfly’, by the way. The question as to whether women have a hidden heat period has recently been reviewed.
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