The World Health Organisation (WHO) defines sexual health as, "a state of physical, emotional, mental and social wellbeing related to sexuality; it is not merely the absence of disease, dysfunction or informity. Sexual health requires a positive and respectful approach to sexuality and sexual relationships, and the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination and violence. For sexual health to be attained and maintained, the sexual rights of all persons must be respected, protected and fulfilled".

STIs are a public health issue in Australia. It's estimated that 20.2% of males and 16.9% of females have reported an STI diagnosis at some stage in their life.

Our catchment has the highest rates of chlamydia notification in both men and women.

It is estimated that 325 million people were living with chronic hepatitis infections (HBV or HCV) worldwide in 2015.

In 2015, our catchment area had the third highest prevalence of heptatis B in NSW, and the fourth highest prevalence nationally. Our catchment also has the highest number of people living with hepatitis C.

It is now possible to eliminate hepatitis C. There are new direct acting anti-viral hepatitis C treatments listed on the PBS. These treatments are, safe and highly effective with a cure rate of greater than 95%.

With improvements in treatment medication and prevention strategies such as Pre-Exposure Prophylaxis (PrEP), new HIV diagnoses continue to reduce every year. NSW aims to eliminate HIV transmission by 2026.

Sexually transmissible infections (STIs) are frequently seen in general practice, especially chlamydia, which is typically asymptomatic. It's important to detect STIs early to prevent transmission to others and minimise potential complications, such as infertility.

With more than 80% of chlamydia infections occurring in people under 29 years of age, screening  for chlamydia infection in all sexually active people up to 29 years of age is recommended.

Many patients and doctors can feel uncomfortable discussing sexual histories, even when indicated or the patient requests an STI testing. A non-judgemental attitude and environment will enable disclosures on sexual matters.

To encourage conversation, make broad statements like, "In this practice, we ask all patients if they'd like an STI check" and/or, "In line with the guidelines, I'm asking if you'd like an STI test today?"

It's important to ask open-ended questions and avoid assumptions about sexual orientation by using the term 'partner'. Gentle enquiry about recent sexual activity, gender, number of partners, contraception (including the use of condoms), travel history and immunisation status helps to inform decision-making.

Ask about the risk for blood-borne viruses (hepatitis b, C and HIV), such as injecting drug use, tattooing and piercing. Investigations should be explained and patients should be asked for concent before tests such as HIV or hepatitis C are ordered.

Electronic versions of templates (Best Practice and Medical Director) for Management Plans, referrals and other documents can be found in our templates section.

Documents need to be downloaded and imported into the clinical software, please read the instructions.

• Australian STI Management Guidelines - an excellent resource that has been endorsed by the RACGP
• Sexual Health Infolink - call 1800 451 624, weekdays, 9am to 5:30pm. The Sexual Health Infolink is a service to support health professionals. This includes providing clinical information about HIV and STI testing, treatment and referrals. The service also performs enhanced partner notification activities
• Post-exposure phrophylaxis (PEP) - to find out where patients can access PEP, call the NSW PEP Hotline on 1800 737 669. This hotline is specifically for PEP and not a general hotline about HIV or AIDS.
• HIV Information Line - call 9332 9700 or 1800 451 600 Monday to Friday, 9am-4pm (except publish holidays). This line is for general and/or non-urgent, HIV information
• HealthPathways Sydney - web-based information portal supporting primary care clinicians to plan patient care through our primary, community and secondary health care systems within Sydney's inner west
• pdf STI Testing Tool (1.08 MB) - includes STI/HIV testing table, plus how to test and contact tracing details
• pdf STI/HIV testing guidelines for men who have sex with men (309 KB) (MSM)
• pdf STI Contact Tracing Tool for General Practice (288 KB)
• Australasian Contact Tracing Guidelines - includes sample letters
• List of NSW Sexual Health Services
• STIGMA (Sexually Transmissible Infections in Gay Men Action Group) - men who have sex with men resources, including guidelines and information for General Practice and Primary Health Care
• Information for medical practitioners to manage hepatitis C virus in primary care
• EPIC NSW - expanded PrEP Implementation in Communities in NSW clinical trial.

General practitioners who see patients who are at high risk of HIV can become EPIC-NSW enrolment sites. The study requires patients to attend follow-up visits every three months for review and STI screening. Full and ongoing support will be provided to you by the study team.

To become an EPIC-NSW site plase contact:

Cherie Bennett (HIV CNC NSW STI Programs Unit)
Ph: 9382 7449 
Fax: 9382 7475

RPA Sexual Health Clinic
16 Marsden Street, Camperdown NSW, 2050
Phone: 9515 1200

Sydney Sexual Health Centre 
Sydney Hospital, Nightingale Wing, Macquarie Street, Sydney 2000
Phone: 9382 7440

Short Street Centre Sexual Health Clinic
St George Hospital, Ground Floor - Prichard Wing, Short Street, Kogarah, NSW 2217
Phone: 9113 2742

Men's Sexual Health

Andrology Australia

Women's Sexual and Reproductive Health

Becoming more gay-friendly in your practice: This Online Learning Module (OLM) aims to inform health professionals about the specific health needs of gay men and other men who have sex with men. The case-based modules explore stigma and discrimination, sexual health screening and common STIs. It is an accredited course (2 Cat 2 QI&CP points) and takes just over an hour to complete.

Hepatitis C in Drug and Alcohol Settings: This online learning module consists of four individual modules covering:

• HCV epidemiology, prevention and natural history
• HCV testing and liver disease staging
• treatment options for HCV
• monitoring, adherence and post-treatment follow-up.

These modules are designed for medical practitioners working in drug and alcohol settings or with people who inject drugs.

E-learning module about hepatitis C - an introduction to hepatitis C for people who work in sectors that may need hepatitis C information

• ThinkGP Education - this news and education site offers interactive case studies on men's health, women's health and sexual health. It also includes activities for practicing sexual history-taking and managing specific sexual health issues.

• STIGMA (Sexually Transmissible Infections in Gay Men Action Group) - STIGMA aims to provide leadership and strategic direction to reduce and prevent sexually transmissible infections (STIs) amongst gay men and men who have sex with men (MSM), including HIV positive men in the Sydney metropolitan area.
• NSW STI Programs (STIPU) - arm of the Ministry of Health providing state-wide leadership on STI health promotion and service development
• Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine (ASHM) - peak organisations supporting the Australian, New Zealand and the Asia Pacific Region health workforce in viral hepatitis and HIV management.
• Australasian Sexual Health & HIV Nurses Association (ASHNA) - supporting professional development and nursing networks.
• The Australasian Chapter of Sexual Health Medicine - peak body for sexual health physicians.
• Australasian Sexual Health Alliance (ASHA) - group of organisations to improve national and local responses to sexual health issues, via a multidisciplinary support network for sexual health workforce.
• NSW Health-Sexual Health Plus - webpage to all state strategies, reports, policies and guidelines.
• Kirby Institute UNSW - global research institute dedicated to the prevention and treatment of infectious diseases.
• Gastroenterological Society of Australia
• Hepatitis NSW - non-profit organisation supporting the community and health professionals and hepatitis.