Only water based lubrication should be used e. Hepatitis B is more common in men who have sex with other men but has not been shown to be spread by any specific sexual practices. STIs are transmitted similarly for vaginal and anal sex, although HIV is more easily transmitted through anal sex. A common stereotype is that people with same sex partners have a much higher incidence of STIs due to many sexual contacts and frequent casual or anonymous sex. If a patient attends as a contact of someone who has been infected, this person must not be identified. This is gained by maintaining privacy, confidentiality and a respectful, non-judgemental attitude at all times.
Only water based lubrication should be used e. Patient referral, where patients themselves notify their sexual contacts to seek treatment Provide a referral, where the healthcare provider agrees to undertake the task of notifying sexual contacts to seek treatment. These can be purchased from family planning clinics and some pharmacies or alternatively a cut open latex glove may be used. How to talk to patients about sex A discussion about sexual health can take place with any patient, however, in particular consider talking to people who: English not first language, hearing impaired, learning difficulties. Conversely, the contacts attendance or non-attendance or clinical condition must not be revealed. It is not necessary to use spermicidal condoms — they are no more effective in preventing pregnancy and can cause vaginal irritation. This is gained by maintaining privacy, confidentiality and a respectful, non-judgemental attitude at all times. Issues that usually should be covered include: Ideas for practice audits Patients asked about gender of sexual partner or if they have ever had a same sex partner Patients asked about condom use and offered condom prescription if appropriate Comprehensive sexual history noted Updated sexual history taken with new genitourinary complaints Patients asked if they have ever experienced sexual abuse or non-consensual sexual contact Further reading and resources. Do not use Vaseline, oils e. This enables the patient to relax and any problems or risks can be assessed in context. Provide a welcoming and comfortable environment A consultation setting that is welcoming, comfortable and confidential is more likely to encourage openness when talking about sex. Men or women may have a curiosity to experience same gender sex sometimes Further information about Hepatitis B is available from: However by modifying risky behaviours, sex can be made safer. Hepatitis B is more common in men who have sex with other men but has not been shown to be spread by any specific sexual practices. Condoms should be stored in a cool, dry place and kept away from sunlight. Ask about marital status, duration of relationship with current partner, number of previous partners and their gender, home environment, family support, activities and interests. The legal age of consent to sexual intercourse is 16 Are there issues of vulnerability self harm, psychiatric illness, drug or alcohol misuse, internet grooming? STIs are transmitted similarly for vaginal and anal sex, although HIV is more easily transmitted through anal sex. An oral dam also known as a dental dam is a thin square of latex that is placed over the vagina or anal area during oral sex. There are a variety of products available in sizes 49 — 60 mm, regular, extra strength or shaped. If used properly, they protect against STIs that are transferred through contact with genital secretions such as gonorrhoea, chlamydia, trichomonias, syphilis, HIV and hepatitis B and C. This may include referral for counselling for younger patients who require assistance in exploring their feelings and telling their friends and family. Questions should not be prescriptive and should be tailored to the individual patient and circumstances. The only way to completely prevent STIs and other sexual health issues is to remain abstinent.
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