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The Manual for Sexual Health Advisers - Society of Sexual Health PDF

349 Pages·2003·1.91 MB·English
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DEPARTMENT OF HEALTH The Manual for Sexual Health Advisers Society of Sexual Health Advisers (SSHA) www.ssha.info (Inside cover) TABLE OF CONTENTS PAGE Foreword 5 Background and acknowledgments 7 Contributors 8 Society of Sexual Health Advisers (SSHA) 10 Introduction 11 Grading scheme 14 Section A: Partner Notification 1. Introduction 16 2. Interviews 23 3. Provider referrals 41 4. HIV 47 5. Ethics 51 6. Audit 55 7. Further research 61 Section B: Managing Sexual Infections 8. Sexually transmitted infections 67 9. Patient recall 83 10. Ethical issues in patient recall 93 11. Triage 96 12. Ethical issues in triage 100 Section C: Counselling in Sexual Health Adviser Practice 13. Counselling 104 14. HIV testing and management 125 15. Ethical issues in pre and post HIV test discussion 141 16. Working with the ‘worried well’ 144 17. Hepatitis C testing and management 148 18. Psychosexual counselling 155 19. Pregnancy options 163 3 20. Rape and sexual assault 176 Section D: Legal and Professional Framework 21. History of sexual health advising 188 22. Law and the sexual health adviser 194 23. Ethical issues in sexual health advising 208 24. Code of professional conduct 221 25. Leading a team of sexual health advisers 226 Section E: Community Settings 26. Community health advising 245 27. Outreach work 251 28. Ethical issues in outreach work 264 29. Working in prisons 267 Section F: Sexual Health Promotion 30. Theories and principles 277 31. Standards and guidelines 287 Section G: Working with Specific Groups 32. Working with African people 310 33. Working with young people 314 34. Working with gay men 326 35. Working with lesbians 339 36. Working with interpreters 343 Tables 2.1 Motivating the patient 30 2.2 Contact slips 31 2.3 Required contact data 36 3.1 Provider referral methods 43 6.1 Standards for good practice in partner notification 58 8.1 Major groups of sexually transmitted infections 68 8.2 Gonorrhoea - Signs & Symptoms 69 4 8.3 Chlamydia - Signs & Symptoms 70 8.4 Syphilis - Signs & Symptoms 72 8.5 Trichomonas - Signs & Symptoms 73 8.6 Partner notification – Look back periods 80 9.1 Recall - Recommended actions 90 11.1 Triage - Recommended maximum waiting times 98 23.1 Respect for autonomy 212 23.2 Beneficence/non-maleficence 213 23.3 Justice 216 23.4 Management of confidentiality 217 23.5 Guidelines for managing an ethical dilemma 219 Appendices Ch.2 Partner notification – patient leaflet 39 Ch.9 Patient recall - sample letters 92 Ch.18 Psychosexual assessment 162 Ch.19 Integrated care pathway for discussing pregnancy options 170 Ch.19 Pregnancy testing protocol 174 Ch.20 Sexual assault sample information sheet for patients 184 Ch.20 Rape trauma syndrome 185 Ch.22 Sex laws at a glance 205 Ch.22 NHS Trusts and Primary Care Trusts (Sexually Transmitted Diseases) Dir. 2000 205 Ch.25 Measuring health adviser activity 241 Ch.25 Health adviser questionnaire/ interview tool 242 Ch.25 Health adviser annual objectives 243 Ch.31 Sample condom distribution protocol 306 Ch.33 Under 16’s - example proforma 322 Ch.33 Under 16’s - suggested proforma for health advisers 324 5 Foreword P R O F E S S O R M I C H A E L A D L E R 6 Background and acknowledgments It has been 23 years since the publication of the 'Handbook on Contact Tracing in Sexually Transmitted Diseases'. * A need existed to have a working document that aims to better equip practitioners seeking to respond to the challenges of sexually transmitted infections in the 21st century. The ‘Manual for Sexual Health Advisers’ has been written primarily for sexual health advisers working in genitourinary medicine. However it will also have relevance and value to other professionals working in sexual health. This will include practitioners in community settings of primary care as well as managers and commissioners of services. The Steering group would like to thank the many people who have been actively involved in it being published. Individuals who have contributed to specific material are acknowledged at the end of the relevant chapters. In addition we would like to thank the following for their assistance; Professor Michael Adler, Dr Patrick French, Dr George Kinghorn, Dr Keith Radcliffe, Dr Beng Goh, Tomas Campbell, Sally Wellsteed, Shelly Mehigan, Philippa Matthews, Gill Frances and Dr Mark FitzGerald. We would like to express posthumous thanks to Dr Robbie Morton for his encouragement and support in the preparation of this manual. STEERING GROUP GILL BELL CHRIS FALDON (CHAIR) SANDRA JARRETT KATHRYN LEE DORINDA THIRLBY HEATHER WILSON * Health Education Council. A handbook on contact tracing in sexually transmitted diseases. Health Education Council. London. 1980 7 Contributors GILL BELL BA (Hons)Politics, BA (Hons) Nursing, RGN Health Adviser, Department GUM, Royal Hallamshire Hospital, Sheffield. Health adviser manual steering group member Past SSHA posts: Regional Representative (North East), Conference Officer Present SSHA post: President CARON DEL RIO BSc (Hons) Psychology, RGN Health Adviser, Women's Health Clinic, HMP Holloway, London CHRIS FALDON MSc Research Methods, BSc(Hons) Nursing, RGN, Diploma Health Visiting, Cert Counselling Public Health Infection Control Nurse, NHS Borders, Roxburghshire, Scotland. Formerly Senior Health Adviser, Dept. GUM, Newcastle Health adviser manual steering group chair Past SSHA posts: Regional Representative (Northern) Vice President Web Administrator SANDRA JARRETT CQSW, Certificate of Counselling Skills and Theory, Diploma in Anatomy, Physiology & Massage Senior Health Adviser, Marlborough Department, Royal Free Hospital, London Health adviser manual steering group member Past SSHA posts: Regional Representative (Southern) Conference and Education Officer Present SSHA post: Education Officer MIKE JONES BA (Hons), Cert Counselling Health Adviser, Marlborough Clinic, Royal Free Hospital, London & Roehampton Clinic, Queen Mary’s Hospital, London Present SSHA post: Registrar DEBBY KLEIN BA (Hons), Diploma Stress Management Associate Trainer for FPA , London Health Observatory and Age Concern Freelance Consultant and Trainer, 8b Golders Way, London, NW11 8JY GEORGE LEACH MA Psychology, RMN, RGN, RNT, Dip Psychosocial Nursing, Dip Advanced Psychodynamic Counselling, Post Grad Cert Adult Education, Dip Supervision, BACP Accredited Counsellor. Head of Staff Counselling at Barts and The London NHS Trust. KATHRYN LEE BA (Hons), RGN Health Adviser, North Manchester General, Manchester Health adviser manual steering group member Present SSHA post: Regional representative (North West) 8 LINDA LEWINGTON RGN, SCM, Cert Marital & Couples Counselling, Dip Psychosexual Therapy Health Adviser, Department of GUM, Milton Keynes General Hospital HELEN MCILVEEN M.A.(Counselling), BSc.(Hons), RGN, D.N. Health Adviser, 1 To 1 Centre, North Shields, Tyne and Wear FIONA SAWNEY BSc, MSc Health promotion, RGN Independent consultant - sexual health policy and practice Contracts with PCTs, Local Authorities and Voluntary organisations in London. [email protected] TINA SHARP BA Hons, RGN Chlamydia co-ordinator for Camden and Islington in London, Mortimer Market Centre, London DORINDA THIRLBY RGN, Dip IHSM, Cert Counselling Senior Health Adviser and Clinic Manager, Roehampton Clinic, Queen Mary's Hospital, London Health adviser manual steering group member Past SSHA posts: Vice President BFSTD /Sex Education Forum Representative Regional Representative (Southern) HEATHER WILSON MSc, BSoc Stud, CQSW, Cert IHSM Senior Health Adviser, Clare Simpson Clinic, Barnet Hospital, North London Health adviser manual steering group member Past SSHA posts: Regional representative (Southern) President Present SSHA post: Communications Officer 9 The Society of Sexual Health Advisers Sexual health advisers work in Departments of Genitourinary Medicine (GUM clinics) in the UK and Ireland The Society of Sexual Health Advisers (SSHA) is a U.K. national organisation with approximately 300 members out of an estimated 350 sexual health advisers in the country. It provides an opportunity for members to meet and work towards further professional development. The role of the sexual health adviser varies enormously from clinic to clinic. It involves working with individuals and groups affected by issues related to sexual health in general and sexually transmitted infections (including HIV) in particular. Their role will commonly embrace the following features: (cid:131) Partner notification/ contact tracing (cid:131) Sexual health promotion (cid:131) Teaching / training (cid:131) Counselling (cid:131) Research and audit There is as yet no core qualification for health advising. Training courses are run by various educational establishments to better equip them in their role. Sexual health advisers come from a variety of professional backgrounds including nursing, health visiting and social work. Local groups meet regularly and an annual conference is held each Spring. A Council of elected officers and regional representatives meets 6 times a year. It sets standards, produces statements and addresses specific issues by setting up working groups. SSHA is part of the Amicus/MSF union. Members benefit from expert help in raising and resolving problems encountered at the workplace. http://www.ssha.info 10

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Jan 8, 2010 A handbook on contact tracing in sexually transmitted diseases This manual has been commissioned by the Department of Health (DH) as
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