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Sexual health service update 2011 Dr Jean Irvine Consultant Sandyford

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Page 1: NAATs and STI diagnoseslibrary.nhsggc.org.uk/mediaAssets/CHP Inverclyde/GP_HVS.pdf · 2018. 10. 24. · NAAT pH < 4.5 Treat for VVC pH > 4.5 Treat for BV Either seated or standing,

Sexual health service update 2011

Dr Jean Irvine

Consultant

Sandyford

Page 2: NAATs and STI diagnoseslibrary.nhsggc.org.uk/mediaAssets/CHP Inverclyde/GP_HVS.pdf · 2018. 10. 24. · NAAT pH < 4.5 Treat for VVC pH > 4.5 Treat for BV Either seated or standing,
Page 3: NAATs and STI diagnoseslibrary.nhsggc.org.uk/mediaAssets/CHP Inverclyde/GP_HVS.pdf · 2018. 10. 24. · NAAT pH < 4.5 Treat for VVC pH > 4.5 Treat for BV Either seated or standing,

Laboratory tests

Page 4: NAATs and STI diagnoseslibrary.nhsggc.org.uk/mediaAssets/CHP Inverclyde/GP_HVS.pdf · 2018. 10. 24. · NAAT pH < 4.5 Treat for VVC pH > 4.5 Treat for BV Either seated or standing,

What have the advances been?

Dual testing for gonorrhoea and chlamydia

‘Architect’ machine for BBV testing

Molecular testing for syphilis

Page 5: NAATs and STI diagnoseslibrary.nhsggc.org.uk/mediaAssets/CHP Inverclyde/GP_HVS.pdf · 2018. 10. 24. · NAAT pH < 4.5 Treat for VVC pH > 4.5 Treat for BV Either seated or standing,

Impact…

Self-taken swabs

More tests on one swab

More on one blood

Page 6: NAATs and STI diagnoseslibrary.nhsggc.org.uk/mediaAssets/CHP Inverclyde/GP_HVS.pdf · 2018. 10. 24. · NAAT pH < 4.5 Treat for VVC pH > 4.5 Treat for BV Either seated or standing,

PREFERRED SAMPLE

VULVOVAGINAL SWAB

Page 7: NAATs and STI diagnoseslibrary.nhsggc.org.uk/mediaAssets/CHP Inverclyde/GP_HVS.pdf · 2018. 10. 24. · NAAT pH < 4.5 Treat for VVC pH > 4.5 Treat for BV Either seated or standing,

What to do in practice?

… FOR WOMEN

Page 8: NAATs and STI diagnoseslibrary.nhsggc.org.uk/mediaAssets/CHP Inverclyde/GP_HVS.pdf · 2018. 10. 24. · NAAT pH < 4.5 Treat for VVC pH > 4.5 Treat for BV Either seated or standing,

Asymptomatic female

HIV/syphilis blood

Chlamydia/GC testing according to risk:

(Self)-vaginal NAAT

Page 9: NAATs and STI diagnoseslibrary.nhsggc.org.uk/mediaAssets/CHP Inverclyde/GP_HVS.pdf · 2018. 10. 24. · NAAT pH < 4.5 Treat for VVC pH > 4.5 Treat for BV Either seated or standing,

PRIMARY CARE VAGINAL DISCHARGE PROTOCOL

CT/GC NAAT

BV- bacterial vaginosisVVC- vulvovaginal candidaCT/GC NAAT- Chlamydia/Gonorrhoea molecular testGUM- genitourinary medicine clinic

Page 10: NAATs and STI diagnoseslibrary.nhsggc.org.uk/mediaAssets/CHP Inverclyde/GP_HVS.pdf · 2018. 10. 24. · NAAT pH < 4.5 Treat for VVC pH > 4.5 Treat for BV Either seated or standing,

5m = £10.00

5 pence per test

Page 11: NAATs and STI diagnoseslibrary.nhsggc.org.uk/mediaAssets/CHP Inverclyde/GP_HVS.pdf · 2018. 10. 24. · NAAT pH < 4.5 Treat for VVC pH > 4.5 Treat for BV Either seated or standing,

Symptomatic female with recurrent/problematic discharge

Speculum & pH

Gram-film

Endocx GC/CT NAAT

HIV/syphilis blood

High vag swab

Page 12: NAATs and STI diagnoseslibrary.nhsggc.org.uk/mediaAssets/CHP Inverclyde/GP_HVS.pdf · 2018. 10. 24. · NAAT pH < 4.5 Treat for VVC pH > 4.5 Treat for BV Either seated or standing,

Genital ulcer RT-PCR test

HSV type 1

HSV type 2

Treponema pallidum

Page 13: NAATs and STI diagnoseslibrary.nhsggc.org.uk/mediaAssets/CHP Inverclyde/GP_HVS.pdf · 2018. 10. 24. · NAAT pH < 4.5 Treat for VVC pH > 4.5 Treat for BV Either seated or standing,

Over to you…