Let’s face it: talking about syphilis and gonorrhoea can be awkward – for patients and doctors alike.
For patients it can mean sharing very private aspects of life, and for the clinician it can mean asking some direct questions.
For some people, too, including some clinicians, talking about sexual health can raise issues of stigma and invite fears of discrimination.
Nevertheless, given that case numbers for sexually transmitted infections (STIs) are surging, including instances of congenital syphilis and antimicrobial resistant strains, raising the subject during GP consultations has never been more important.
“Regular conversations about STIs can lead to early detection and treatment, reducing complications and transmission,” said Dr Melanie Bissessor, sexual health physician at the Melbourne Sexual Health Centre and clinical advisor to the Victorian HIV and Hepatitis Integrated Training And Learning (VHHITAL) program.
“Regularly discussing STIs as part of general health checks can help normalise the topic, reducing stigma and encouraging patients to be more open about their sexual health concerns.”
Of course, standard GP consultations are brief, which means finding the time to ask about matters other than the patient’s primary reason for attending can be challenging.
Nevertheless, doing so can lead not only to better health outcomes for the specific patient, but also for others in that person’s social or sexual network.
“Incorporating sexual health into routine consultations ensures a holistic approach to patient care, acknowledging that sexual health is a vital aspect of overall health,” said Dr Bissessor.
“Encouragement from trusted healthcare providers can increase testing rates, particularly among individuals who may not otherwise consider getting tested including opt out testing.”
Some GPs may feel uncomfortable discussing sexual health, or lack confidence in their ability to handle such conversations sensitively and effectively.
Dr Bissessor said the VHHITAL program is designed to help health care providers better understand and treat STIs, improving confidence and communication skills.
Operating under the aegis of North Western Melbourne Primary Health Network, in partnership with the Victorian Tasmanian Primary Health Network Alliance and others, VHHITAL delivers comprehensive education and training for the primary health care workforce for the diagnosis, treatment and management of STIs.
“GPs might not be fully aware of current STI trends, testing guidelines, or treatment options,” she said.
“Continued medical education and training, such as that offered by VHHITAL, are essential to keep them informed.”
Dr Bissessor said she hoped that in time Medicare funding arrangements will change to better enable GPs to test and treat STIs.
“I’d like to see Medicare covering all aspects of STI prevention and treatment, including consultations, testing, and follow-up care without financial barriers,” she said.
“It would be good to see financial incentives for GPs who demonstrate high rates of STI screening and education, encouraging proactive management of sexual health.
“I’d also like to see funding for innovative healthcare delivery models, such as telehealth and online services for sexual health consultations, to increase access and convenience. Plus the integration of sexual health specialists, such as sexual health nurses and counsellors, within primary care settings to provide comprehensive care.”
In Victoria, Sexual Health month runs from 4-27 September 2024.
For more information about VHHITAL, including RACGP accredited CPD education and training activities, please go to this page.
For detailed treatment options for general practice, please visit HealthPathways Melbourne.
