Second National Sexually Transmissible Infections Strategy 2010 - 2013

6.3 Clinical management, care and support

Page last updated: July 2010

The vast majority of testing and treatment for STIs in Australia occurs in general practice and any strategy for STI control therefore needs to recognise and support general practitioners and other primary care providers in this role, and to develop strategic relationships between strategy stakeholders and other peak bodies. A common feature of this strategy’s priority populations is their difficulty in accessing health services. The improvement to clinical management, care and support through the consideration of issues associated with improved service access and delivery is supported.

Divisions of General Practice and other professional associations and Colleges need to be encouraged and supported to become more involved in the delivery of educational and support services to their members related to sexual health. Professional organisations, Colleges and Divisions serving rural and remote communities nationally are well equipped to work with specialist education providers to respond to local epidemiology, and to tailor education and quality improvement initiatives to increase practice capacity to respond to local STI needs.

General practitioners are the main providers of primary healthcare services in Australia, including for sexual health. Australian research has indicated that the key trigger for individuals going to a sexual health service is a symptom or sign of infection. The asymptomatic nature of most STIs means that seeking medical care specifically for STI-related symptoms is unlikely to lead to the detection of most infections.

Although many people with asymptomatic infection may not access healthcare services specifically for STI testing and treatment, they may access primary healthcare for other health concerns. General practitioners are able to initiate discussion on sexual health and encourage targeted testing for people who are considered to be at risk. General practice plays a vital role in encouraging appropriate testing and thus reducing the pool of undiagnosed and untreated STIs in the community.

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As general practices are the main providers of sexual health services, it is important that they have access to STI resources and to education and training programs. These programs need to address issues relevant to general practice including sexual history taking, screening and treating non-complex STI presentations, disease notification, contact tracing, and gathering referral information. STI resources and education and training programs could also highlight the sexual health needs of priority population groups. A focus on sexual health training needs to be embedded in medical training for general practitioners and is best initiated during university medical education programs and reinforced through professional medical education.

The role of practice nurses in providing STI services—including testing, counselling treating and assisting in a range of partner notification approaches—needs to be further explored in the setting of the primary healthcare team. Practice nursing staff and new advances in data collection could be explored to ensure evidence on the efficacy of various interventions is collected and promulgated.

Use of existing health checks, including antenatal, adolescent and well person’s checks, will assist in treating syphilis and eradicating congenital syphilis.