The Manual for Sexual Health Advisers - Society of Sexual Health

349 Pages·2003·1.91 MB·English

by  Chris Faldon

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
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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
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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

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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
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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)

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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

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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

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