Sexual health advisors

A sexual health advisor is a person who is available to provide advice on sexual health matters. Sexual health advisors are available in sexual health clinics, or genito-urinary medicine (GUM) clinics.

Sexual health clinics were set up to help people deal with concerns about their sexual health and are also (formally and informally) known as STD clinics, Special clinics, VD clinics and ‘Clap’ clinics.

A sexual health advisor can help a person understand what is happening when they are undergoing tests, have received test results, or when they are undergoing treatment. The advisor can also help the person to decide what to do about current or previous partners who may need to be examined or treated, and can also take on the responsibility of contacting partners who may have been exposed to the sexually transmitted disease.

Websites associated with sexual health advisors

The Society for Sexual Health Advisers (SSHA) is a professional organisation for health advisers working in departments of genito-urinary medicine and sexual health. It has lots of information on sexual health, including a manual for sexual health advisers.
www.ssha.info

TheSite.org aims provides support and guidance for young adults. It provides factsheets and articles on all the key issues facing young people including: sex and relationships; drinking and drugs; work and study; housing, legal and finances; and health and wellbeing. It has a whole section on sexual health, including information on sexual health and GUM clinics.
www.thesite.org

The Recommended Standards for Sexual Health Services are the result of a major project managed by MedFASH and commissioned by the Department of Health. The standards are housed on the Department of Health website.
www.dh.gov.uk
The Department of Health also has a sexual health section in its policy and guidance website, which includes guidance documents for health professionals.

The NHS Direct on-line health encyclopaedia contains a section on sexual health clinics.
www.nhsdirect.nhs.uk/en

One-stop-shop services

One of the actions in The national strategy for sexual health and HIV implementation action plan is to develop and evaluate three models for one-stop-shop sexual health services. These services provide advice, contraceptive and genito-urinary services on the same site. The three models are:

• a dedicated integrated genito-urinary and contraceptive service for young people
• a specialist primary care led service
• a specialist service to meet the needs of all age groups.

These services are currently being piloted and evaluated. A final report will be produced in January 2006.

Websites associated with one-stop-shop services

NHS Magazine has an article on sexual health services and the need to increase their accessibility.
www.nhs.uk

The spring 2004 issue of the Sexual Health Independent Advisory Group Newsletter, housed on the British Association for Sexual Health and HIV, contains an article on one-stop-shop sexual health services.
www.bashh.org

Genito-urinary medicine (GUM)

The primary focus of genito-urinary medicine (GUM) is the diagnosis and treatment of sexually transmitted infections (STI), including HIV. Screening and vaccination for sexually transmissible hepatitis viruses (A and B) and hepatitis C virus screening are also routinely offered at GUM clinics. Some clinics provide additional services, such as sexual dysfunction clinics and young people’s clinics. GUM services may be delivered alongside family planning clinics. GUM clinics also often support or provide outreach services to commercial sex workers, injecting drug users and prison inmates are frequently supported or provided by GUM clinics.

Sexually transmitted infections are generally diagnosed in settings other than sexual health clinics or GUM clinics, for example in clinics for pregnancy terminations, family planning, antenatal care, well woman and general practice. Once a person has been diagnosed with a sexually transmitted disease, it is common for them to be referred to a GUM clinic for further management.

Only GUM clinics record routine statistics on sexually transmitted infections. Over 500,000 diagnoses are made in GUM clinics in the UK each year, making them a vital service in controlling the spread of sexual infections.

Websites associated with genito-urinary medicine

RCP Joint Speciality Committee on Genitourinary Medicine has produced the guidelines Intimate examinations in genitourinary medicine clinics.
www.bashh.org

The British Association for Sexual Health and HIV has produced a directory of GUM clinics in the UK and the Republic of Ireland.
www.bashh.org

Genito Urinary Nurses Association (GUNA) is a national association for genito-urinary nurses. It promotes GU nurses’ skills and development by improving education and training and encouraging networking with colleagues in the GU field of medicine. This site is designed for nurses and other healthcare professionals working within or who have an interest in sexual health.
www.guna.org.uk

GP notebook is a system designed to provide a concise synopsis of the entire field of clinical medicine, with material organised systematically to ensure rapid retrieval of information. There is a section on genito-urinary medicine.
www.gpnotebook.co.uk

The NHS Direct on-line health encyclopaedia contains a section on genito-urinary medicine.
www.nhsdirect.nhs.uk/en

Primary care trust services

The national strategy for sexual health and HIV implementation action plan recommends that general practice and community reproductive health services contribute to managing sexually transmitted diseases by assessing risk and offering tests as appropriate. The strategy recommends a range of levels of sexual health services from level 1 which includes some of the basic elements of sexual health services already provided in many general practices, to level 2, which specifies a wider range of care. These services may be undertaken by clinicians in primary care with a special interest in sexual health. (Level 3 describes a specialist service that would not be available in a primary care setting.) The strategy also specifies that all general practice surgeries should be able to provide STI testing for women and non-invasive testing for men.

Primary care services, in particular general practice, community reproductive health services and pharmacy services, play an important role in the delivery of, and in some cases referral to, sexual health services. This is demonstrated by the following facts:

• around 75 to 80% of contraception is provided in primary care
• over one third of women found to have chlamydia were diagnosed in primary care
• primary care is highly accessible to all people.

Further information on the services provided by primary care organisations can be found on the British Medical Association website.

Websites associated with primary care trust services

The Medical Foundation for AIDS and Sexual Health has a range of publications on sexual health, including the guidelines HIV in primary care.
www.medfash.org.uk

The Royal College of General Practitioners has published a response to The national strategy for sexual health and HIV.
www.rcgp.org.uk

The National Library for Health Effective sexual health promotion: a toolkit for primary care trusts and others working in the field of promoting good sexual health and HIV prevention.
www.dh.gov.uk

A presentation ‘Education for sexual health in primary care’ is available on the Royal College of General Practitioners (RCGP) website.
www.rcgp.org

The British Association for Sexual Health and HIV has a primary care page.
www.bashh.org

Health Protection Scotland has published a number of reports on sexually transmitted diseases, for example the document ‘Setting the Scene’ which looks at sexually transmitted infections, including HIV, in Scotland.
www.show.scot.nhs.uk/scieh/