Widening the net: Testing for sexually transmissible infections in general practice

Amanda Lyons

30/01/2018 3:56:25 PM

Changing trends in sexually transmissible infections in Australia have led to a need for broader screening measures among patients.

Sexual health physician Dr Siobhan Bourke feels increasing rates of STIs means screening should be carried out among a broader range of patients.
Sexual health physician Dr Siobhan Bourke feels increasing rates of STIs means screening should be carried out among a broader range of patients.

Recent data from global research organisation the Kirby Institute has shown that rates of chlamydia, gonorrhoea and syphilis have risen in Australia over the past five years. It has also been estimated that up to 400,000 Australians may be carrying a sexually transmitted bacterium called mycoplasma genitalium, or MG, which is often asymptomatic.
Dr Siobhan Bourke, a sexual health physician at the Centre for Excellence in Rural Sexual Health, believes the fact GPs deal with patients on a personal level makes them key figures in this area of public health.
‘It’s good to have some statistics, epidemiology and ideas about risks behind you, but what creates great public healthcare is individual care for the particular patient that’s sitting in front of you,’ she told newsGP.
Dr Bourke believes the increasing rates of sexually transmissible infections (STIs) means screening and testing should now be carried out among a wider range of patients.
A variety of risk factors have been attributed to the need for wider screening, from the growth of online dating to increased rates of travel bringing people into contact with a broader range of partners. To keep up with these developments, Dr Bourke recommends practitioners refer to the Australian STI guidelines.
‘Their recommendation is that everybody gets tested for chlamydia if they’re sexually active and under the age of 30, or if they have a new partner,’ Dr Bourke said. ‘Then you need to check the individual risk factors for people if you’re going to test them for other things.
‘So for men who have sex with men, for example, you add in gonorrhoea, syphilis, HIV. We also know that there is an increased rate of gonorrhoea and syphilis among Aboriginal and Torres Strait Islander peoples.
‘But now, we also actually need to start looking at risk factors among heterosexuals and all women, such as number of partners, unprotected sex, any anal sex and any sex with people from overseas.’
While it is necessary for GPs to start a conversation about sexual health to conduct the relevant screening, this can be difficult in many cases, especially if the patient has come for an unrelated matter. However, Dr Bourke has found a few simple stock sentences can help to make the process easier.
‘For example, “The recommendation is that we should do some STI screening if you’re under 30. Are you okay if we have that conversation?”’ Dr Bourke said.
‘Often … you might find that when you mention STIs the patient says, “Oh great, I’ve been meaning to bring this up but I haven’t been able to”.’
Dr Bourke would like to see sexual health screening become ‘just another part of healthcare’, and believes a key is accepting sexuality as a normal and positive part of life.
‘The reality is that the majority of people like having sex for pleasure, but when we talk about all this stuff we often make it sound bad and nasty and scary,’ she said.
‘We’ve got to make it more about protecting yourself; the prevention of having a bad thing but not taking away the good thing.’

sexual-health sexually-transmissable-infections STI-guidelines

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