International journal of STD & AIDS
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Review
Partner referral tools and techniques for the clinician diagnosing a sexually transmitted infection.
Public health agencies have insufficient resources to trace and refer to medical evaluation the sexual partners of patients with sexually transmitted infections (STI). Only a minority of such patients receives formal sex partner referral services. Hence this responsibility rests, by default, with the diagnosing clinician or with the infected patient. ⋯ Clinician and patient obstacles to successful partner referral are discussed, and brief counselling techniques are suggested. Use of patient-delivered therapy, via medication or prescription (dispensed with appropriate warnings), probably serves to emphasize the urgency and importance of notifying partners. Successful referral to medical attention has been shown to help prevent re-infection of the index patient and to curtail community transmission.
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Significant increases in genitourinary (GU) medicine clinic workloads throughout the UK have resulted in an unmet demand for appointments, and increased waiting times. In order to meet the government target of a 48-hour maximum waiting time for all patients, many clinics are modernising current practices to increase capacity and improve access to services. ⋯ Example case studies from the Six Sigma study are also presented, illustrating the applicability of this model throughout the UK. The findings of the Six Sigma project offer GU medicine clinics across the UK the opportunity to increase capacity, without adversely affecting quality of care.
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During the mid-1980s Australia experienced a remarkable decline in HIV incidence that can rightly be considered a public health milestone of global importance. The effects of this decline lasted for about 20 years and greatly benefited all Australians. In contrast, as we enter the mid-2000s, we see the global epidemic continues to intensify, HIV vaccines remain a distant possibility, and Australia is experiencing rising HIV incidence again. ⋯ The analysis reveals that the greatest decline in HIV preceded almost all substantive initiatives undertaken at the national level, which are often held responsible for Australia's successful early containment of HIV. In particular, dramatic declines were already well advanced and/or preceded (i) substantive growth in national HIV/AIDS prevention education funding, (ii) publication of the first National AIDS Strategy, (iii) establishment of key national HIV/AIDS bodies and (iv) promulgation of the 'Ottawa Charter'. Explanations for, and lessons learned from Australia's dramatic early declines in HIV incidence are discussed.
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We report a case of primary pneumococcal peritonitis in a 28-year old previously healthy woman. There are no previously reported associations between this rare form of spontaneous peritonitis and HIV infection, and it is usually associated with underlying cirrhosis, ascites or other immune compromise. In this case this was the presenting illness of HIV infection. When atypical infections such as this arise in previously healthy adults the clinician must have a high index of suspicion of HIV or other underlying immunodeficiency.