The management of sexually transmitted infections: a scoping survey in primary care

Dave, Jayshree, Paul, John, Johnson, Julie, Hutchinson, Jane, Phiri, Glenn, Asha, Dave, Verlander, Neville and Carrington, David (2019) The management of sexually transmitted infections: a scoping survey in primary care. BJGP Open. ISSN 2398-3795

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Abstract

Background National guidelines for sexually transmitted infections (STIs) in primary care exists but their management is uncertain.

Aim To assess the management of STIs against national standards in primary care.

Design & setting A questionnaire based study in London and Brighton. The survey was conducted in 2015 following reorganisation of sexual health services in England.

Method Questionnaires were sent to GPs in London and Brighton about testing for STIs, treatment for gonorrhoea, specialist advice, and referral services.

Results Of 119 GPs who responded, most expressed confidence in treating chlamydia (n = 105/119, 88%), trichomonas (n = 81/119, 68%), and herpes (n = 82/119, 69%) but not gonorrhoea (n = 32/119, 27%). Most referred cases of syphilis (n = 92/119, 77%) and genital warts (83/119, 70%) to genito-urinary medicine (GUM) as per guidance. Most GPs tested for gonorrhoea on patient request (n = 95/119, 80%), in tandem with chlamydia screening (n = 89/119, 75%), because of high risk status (n = 85/119, 71%) and genital symptoms (n = 108/119, 91%). Some GPs (n = 22/119, 18%) sampled urine for culture, 53/119 (45%) provided high vaginal swabs (HVS), and 28/119 (24%) provided self-taken vulvovaginal swabs (STVVS) for culture. These samples are not appropriate for gonococcal culture and not processed in the laboratory. Urethral swabs for men and endocervical swabs (ECS) are recommended for gonococcus culture. Over half (n = 60/102, 59%) of GPs did not treat gonorrhoea but some prescribed cefixime, ciprofloxacin, or azithromycin. Eighty-seven per cent (n = 104/119) sought advice from GUM, and 83/103 (81%) referred gonorrhoea nucleic acid amplification test (NAAT)-positive patients.

Conclusion There is scope for improvement of STIs management in primary care to ensure that patients are optimally investigated, treated, and referred.

Item Type: Article
Schools and Departments: Brighton and Sussex Medical School > Brighton and Sussex Medical School
Brighton and Sussex Medical School > Global Health and Infection
Subjects: R Medicine
Depositing User: Deborah Miller
Date Deposited: 11 Apr 2019 11:09
Last Modified: 04 Jun 2019 13:32
URI: http://sro.sussex.ac.uk/id/eprint/83134

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