Comment: The national strategy for level 2 in primary care
Paul Woolley
pp 4-6
To make services readily available everywhere, the national strategy for sexual health and HIV recommends that primary care trusts and primary care groups identify and support primary care teams with a special interest in sexual health so that they can provide these services to a high standard. These level 2 services might include; intrauterine contraceptive device (IUCD) insertion; contraceptive implant insertion; vasectomy; testing and treating sexually transmitted infections (STIs); invasive testing for STIs in men; partner notification.
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Psychological and psychosexual impact of HPV – effects on clinical practice
Pippa Green
pp 7-9
Anogenital human papillomavirus (HPV) infection is the most commonly diagnosed sexually transmitted infection (STI) in genitourinary medicine (GUM) clinics in this country. Yet there are few reports in the literature regarding the psychological impact of the diagnosis and the effect on sexual function. Those studies that have been published show that adverse psychological and psychosexual sequelae to the diagnosis are common. This has significant implications for clinical practice. Psychosocial intervention is recognised as a valid adjunct to the treatment of patients with recurrent herpes simplex virus; we must ask whether the same applies to patients with anogenital HPV infection.
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Legal aspects of sexual health – breaking confidentiality
Gerard Panting
pp 12-14
In the past, confidentiality has been seen primarily as a medical ethics issue but over the past 20–30 years the legal framework governing protection of medical data has become more comprehensive and complex, including the introduction of the Data Protection Act 1998, the Human Rights Act 1998 and more recently the Health Service (Control of Patient Information) Regulations 2002. The National Health ServiceÕs (Venereal Diseases) Regulations 1974 make specific provision for maintaining the confidentiality of patients being treated for sexually transmitted infection.
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Presentation of sexual health concerns in university students
James Burton
pp 15-17
‘Morning Doc. From the internet I know I’ve got prostatitis and I’ve been doing prostatic massages on myself but I need you to tell me what sort it is and whether I need antibiotics.’ So said a second-year PhD student in my thirtieth year of student health practice. I pondered how things had changed during that time! Not only has there been a vast increase in the number of higher education students, but their level of education on sexual health matters has also increased and their willingness to discover answers to their problems from doctors is now much more apparent.
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The XIV International AIDS Conference – knowledge and commitment for action
Gillian Dilke-Wing
pp 18-20
As conferences go, the biennial International AIDS Conference has become a huge event by anyone’s standards. Around 15,000 delegates gathered in Barcelona for the four-and-a-half day meeting, and were faced with a daunting display of material, submitted from 145 countries, from which to choose. And choose you must, as there were 16 plenary speeches, 692 oral presentations (with ten options for each oral session), 40 lunchtime guest lectures, 167 oral poster presentations, and 74 workshops and satellite meetings. All of which would take you around six-and-a-half 40-hour working weeks to see, excluding time to peruse the 5,370 posters on offer.
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Adolescent gynaecology – part 2
Adam Balen
pp 22-26
In Part 1 of this overview of gynaecological problems found in young women (published in the last issue), disorders of puberty and common causes of menstrual disturbance were examined. Part 2 looks at the polycystic ovary syndrome (PCOS) and disorders of intersex. PCOS is the most common endocrine disturbance affecting women. The presence of enlarged ovaries with multiple small cysts (2‹8 mm) and a hypervascularised, androgen-secreting stroma are associated with signs of androgen excess (hirsutism, alopecia, acne), obesity and menstrual cycle disturbance (oligomenorrhoea or amenorrhoea).
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Increasing depth and breadth of prescribing for genital warts
Paul Woolley
pp 28-30
Conventional therapies for the treatment of external anogenital warts have included the local destruction of warty tissue by podophyllotoxin, trichloroacetic acid, cryotherapy, electrocautery or laser vaporisation. Although such measures succeed in clearing visible disease for many patients, recurrences are frequent, probably because of persistent subclinical viral infection.
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Take yourself to the top of the mountain
David Hicks
pp 31-31
It is amazing what literature you can find yourself reading when compiling an article like this. I had never come across Sociology of Health and Illness before, but in Volume 24 is a fascinating article, 'Gender and risk assessment in contraceptive technologies'. The authors suggest that experts and policymakers take the perspective of men more seriously than that of women when introducing new methods of contraception.
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