Thursday, January 29, 2009

Sexual health clinics

Sexual health clinics specialize in the prevention and treatment of sexually transmitted infections.

Sexual health clinics provide only some reproductive health services. Few clinics perform abortions or offer birth control other than condoms

Terminology

Sexual health clinics are also called Sexually transmitted disease (STD) clinics, Venereal disease (VD) clinics, or Genitourinary medicine (GUM) clinics.

Sexual health clinics differ from reproductive health and family planning clinics. Sexual health clinics offer only some reproductive health services. Reproductive health clinics, such as Planned Parenthood, offer most of the services of sexual health clinics.

Services

Sexual health clinics provide some or all of the following:

  • Information about safer sex, birth control, reproductive health and general
    • sex educationCondoms
  • Sexual health examinations
  • Tests to detect some sexually transmitted infections
  • Antibiotics to cure chlamydia, gonorrhea, and syphilis
  • Medications and other treatments
  • Counseling and education
  • Referrals for additional information or services

Many clinics provide vaccinations to prevent infections from the hepatitis A and B viruses.[1] Young women may receive vaccinations to prevent infection from some strains of the human papillomavirus (HPV).

Many clinics provide interpreting for the hearing impaired or speakers of other languages.

Many clinics will help patients tell their sexual contacts if they have a sexually transmitted infection, anonymously if needed.

Public governmental and non-profit clinics often provide services for free or adjust the fee based on a patient's ability to pay.

Sexual health clinics often offer services without appointments. Some clinics open evenings or weekends.

Some clinics have separate hours or facilities for men and women. Some clinics serve only specific populations such as women, men, MSM, youths, LGBT, ethnic groups, the poor, or students.

Examinations


With the patient's consent, a clinician will inspect the patient visually and by touch. If needed, the clinician will take samples to test for sexually transmitted infections.

In a private room or space, the patient will partially undress.

The clinician may inspect the patient's:

  • Throat and lymph nodes of the neck for inflammation
  • Pubic hair for lice
  • Lymph nodes of the groin for swelling
  • Genitals, anus, and surrounding areas for sores and warts

The clinician may swab the patient's:

  • Throat to test for gonorrhea and possibly chlamydia
  • Cheek, inside, to test for HIV
  • Sores of the genitals, anus, and surrounding areas to test for herpes
  • Urethra to test for gonorrhea and possibly chlamydia
  • Vagina to test for chlamydia and possibly gonorrhea
  • Cervix to test for cervical intraepithelial neoplasia (a Pap test)
  • Rectum to test for gonorrhea and possibly chlamydia

The clinician may take small blood samples by pricking a finger or from a vein to test for HIV, syphilis, and possibly herpes and hepatitis C

The clinician may ask for a small urine sample, given in private, to test for chlamydia and possibly gonorrhea.

The inspections and taking samples don't hurt, but swabbing the urethra and cervix, and a finger prick blood sample feel uncomfortable.

Women will often receive a pelvic exam, both external and internal, but usually less thorough than a reproductive health exam.

A patient can choose a female or male clinician if available. A patient can have a chaperone. Some clinics have separate hours or facilities for men and women.




Posted by at 1 comment:
Subscribe to: Posts (Atom)

Prevention STDs

Prevention is key in addressing incurable STIs, such as HIV & herpes.

Vaccines are available that protect against some viral STIs, such as Hepatitis B and some types of HPV. Vaccination before initiation of sexual contact is advised to assure maximal protection.

The most effective way to prevent sexual transmission of STIs is to avoid contact of body parts or fluids which can lead to transfer, not necessarily any sexual activity with an infected partner. No contact minimizes risk. Not all sexual activities involve contact: cybersex, phonesex or masturbation from a distance are methods of avoiding contact. Proper use of condoms (male or female) reduces contact and risk.

Ideally, both partners should get tested for STIs before initiating sexual contact, or before resuming contact if a partner engaged in contact with someone else. Many infections are not detectable immediately after exposure, so enough time must be allowed between possible exposures and testing for the tests to be accurate. Certain STIs, particularly certain persistent viruses like HPV, may be impossible to detect with current medical procedures.

Many diseases that establish permanent infections can so occupy the immune system that other diseases become more easily transmitted. The innate immune system led by defensins against HIV can prevent transmission of HIV when viral counts are very low, but if busy with other viruses or overwhelmed, HIV can establish itself. Certain viral STI's also greatly increase the risk of death for HIV infected patients.

Condoms

Condoms only provide protection when used properly as a barrier, and only to and from the area that it covers. Uncovered areas are still susceptible to many STDs. In the case of HIV, sexual transmission routes almost always involve the penis, as HIV cannot spread through unbroken skin, thus properly shielding the insertive penis with a properly worn condom from the vagina and anus effectively stops HIV transmission. An infected fluid to broken skin borne direct transmission of HIV would not be considered "sexually transmitted", but can still theoretically occur during sexual contact, this can be avoided simply by not engaging in sexual contact when having open bleeding wounds. Other STDs, even viral infections, can be prevented with the use of latex condoms as a barrier. Some microorganisms and viruses are small enough to pass through the pores in natural skin condoms, but are still too large to pass through latex condoms.

Condoms are designed, tested, and manufactured to never fail if used properly. There has not been one documented case of an HIV transmission due to an improperly manufactured condom

Proper usage entails:

  • Not putting the condom on too tight at the end, and leaving 1.5 cm (3/4 inch) room at the tip for ejaculation. Putting the condom on snug can and often does lead to failure.
  • Wearing a condom too loose can defeat the barrier.
  • Avoiding inverting, spilling a condom once worn, whether it has ejaculate in it or not, even for a second.
  • Avoiding condoms made of substances other than latex or polyurethane, as they don't protect against HIV.
  • Avoiding the use of oil based lubricants (or anything with oil in it) with latex condoms, as oil can eat holes into them.
  • Using flavored condoms for oral sex only, as the sugar in the flavoring can lead to yeast infections if used to penetrate.

Not following the first five guidelines above perpetuates the common misconception that condoms aren't tested or designed properly.

In order to best protect oneself and the partner from STIs, the old condom and its contents should be assumed to be still infectious. Therefore the old condom must be properly disposed of. A new condom should be used for each act of intercourse, as multiple usage increases the chance of breakage, defeating the primary purpose as a barrier.