16th March 2023
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Most at risk populations - market engagement event
Yorsexual Health is keen to hear from partners working with people and communities who are at increased risk of sexual ill-health and inequalities. We are reviewing our models of care in the Yorkshire region and are exploring ways in which we can work with partners to improve health and wellbeing outcomes for these groups.
Want to find out more? You can register for our market engagement event taking place on the 18th January here:
https://www.find-tender.service.gov.uk/Notice/032123-2021?origin=SearchResults&p=1
BASHH Update - Needle Spiking in Nightclubs
There have been recent media reports of spiking by injection, where a person is allegedly “spiked” by an injection from an unknown source. This has typically been happening to young women attending nightclubs across the UK.
Sexual health services and the national Sexual Health helpline on 0300 123 7123 have recently seen an increase in enquiries from members of the public concerned about the potential risk of HIV and Blood Borne virus transmission due to needlestick injury.
https://www.nhs.uk/live-well/sexual-health/where-can-i-get-sexual-health-advice-now/
BASHH has been contacted by several sexual health services from around the country about the risk of HIV and Blood borne virus transmission risks from needlestick injuries.
There have been no reports of HIV, Hepatitis B or Hepatitis C transmission from any of the incidents in the press.
BASHH advises that if patients attend medical services (Sexual Health Services, Emergency Department) they should be assessed for
1. HIV Post-Exposure Prophylaxis (PEP) as per the BASHH guidelines https://www.bashhguidelines.org/media/1269/pep-2021.pdf
2. Hepatitis B status and vaccination/prophylaxis if appropriate
3. Hepatitis C testing at appropriate intervals (3 and 6 months)
The patient should also be referred to a local Sexual Assault Referral Centre (SARC) if appropriate.
In general, PEP is not recommended following a community needlestick exposure as the risk is extremely low and usually not possible to determine. Whilst there have been a handful of cases of hepatitis B and C transmission from community needlestick, there have been no reported cases of HIV transmission.
April 2020 - Coronavirus (Covid-19) guidance for professionals
The ADPH UK - COVID-19 guidance/ recommendations on the Prioritisation of Sexual & Reproductive Health Services has just been published, as four downloadable PDF docs.
FSRH advice for women seeking contraception, abortion and SRH advice during the COVID-19 pandemic
Please note current contraceptive advice includes:
Supported extended use of nexplanon to 4 years, mirena/levosert to 6 years and T-safe 380 to 12 years. Prescribing of combined hormonal contraception can be extended by up to 12 months if a woman has had a BP and BMI reading which was satisfactory within the last 12 months.
FPA/Sexwise unplanned pregnancy/abortion and Covid-19
BASHH support for local responses to COVID-19 and contingency planning
NHS Cervical Screening Programme Guidance for Sample Taking during Coronavirus pandemic
Sexwise Information for Professionals
Safe sex reminder as antibiotic resistant gonorrhoea investigations continue
Public Health England (PHE) is issuing a reminder to the public to practise safe sex by using a condom with new or casual partners.
The call comes as an increase in antibiotic resistant cases of gonorrhoea continues, a further sign of the very real threat of antibiotic resistance to our ability to treat infections.
Finding this sort of extensively drug resistant gonorrhoea in the UK serves as an important reminder of the need to practice safer sex. This includes using condoms consistently and correctly with all new and casual sexual partners. Anyone with symptoms of a sexually transmitted infection (STI) or who is concerned they may have an STI should seek advice from their sexual health clinic.
For more information visit https://www.gov.uk/government/news/two-cases-of-resistant-gonorrhoea-diagnosed-in-the-uk
At the present time, the advice to frontline clinicians remains unchanged - as before we would still be advising all cases of suspected/confirmed gonorrhoea to be referred to local sexual health services for appropriate management, encouraging regular STI testing and protected sex with condoms.
Chlamydia treatment guidelines changed in September 2018
BASHH:
Chlamydia treatment guidelines changed in September 2018:
First line treatment is Doxycycline 100mg bd for seven days (contraindicated in pregnancy) and second line treatment is Azithromycin 1g orally as a single dose, followed by 500mg once daily for two days
Publication of updated guideline for the management of infection with Neisseria gonorrhoeae (2019) The updated guideline for the management of infection with Neisseria gonorrhoeae is available at https://www.bashh.org/guidelines Changes since the 2011 guideline include: • First line empirical treatment is now monotherapy with ceftriaxone 1g • If antimicrobial susceptibility test results from all sites of infection are available prior to treatment and the isolate is sensitive to ciprofloxacin, then this should be used for treatment in preference to ceftriaxone • Recommendations for extra-genital testing in those with suspected or confirmed antimicrobial resistance • Epidemiological treatment is recommended only for those presenting within 14 days of exposure. For those presenting after 14 days of exposure we recommend treatment based on the results of testing.
The recent changes from the Neisseria gonorrhoeae, chlamydia treatment guidelines and the publication of BASHH Mycoplasma genitalium guidelines have impacted upon the first line treatment for Pelvic inflammatory disease, non-gonococcal urethritis. Please see BASHH website for the guidelines: https://www.bashh.org/guidelines
FRSH:
Combined Hormonal Contraception
The FSRH CHC Clinical Guideline is now available on the FSRH website https://www.fsrh.org/news/fsrh-publishes-clinical-guideline-on-combined-hormonal/
What is new in this guideline?
- The updated FSRH guideline highlights that there is no health benefit from the seven-day hormone-free interval
- Women can safely take fewer (or no) hormone-free intervals to avoid monthly bleeds, cramps and other symptoms
- If a hormone-free interval is taken, shortening it to four days could potentially reduce the risk of pregnancy if pills, patches or rings are missed
- Consultations about CHC do not necessarily have to be face-to-face; online CHC provision is possible
- At the first consultation, many women can safely be prescribed a one year supply of CHC instead of the current three month supply
- What is not new, but is still very important?
- It’s important to use combined hormonal contraception correctly: if used perfectly, it is over 99% effective; however, with typical use, about 9% of users become pregnant in the first year of use
- There are some health risks with combined hormonal contraception: use increases a woman’s risk of having a blood clot or breast cancer (although the risk remains small)
- Combined hormonal contraception should not generally be used by women over 50
- Combined hormonal contraception has some important benefits in addition to contraception: it can help with heavy or painful periods, acne and PMS, and it reduces