Travel medicine and sexual health

GPs can assist patients who are planning to travel by conducting a pre-travel risk assessment. A comprehensive pre-travel risk assessment should include:

  • a detailed travel itinerary
  • reasons for travel
  • list of planned activities
  • type of accommodation
  • modes of transport
  • medical history (including vaccinations)
  • social history (e.g., smoking, drinking).

Depending on information supplied by the patient, GPs can give more specific advice. For example, if a young male says he is planning an adventurous holiday with high levels of alcohol consumption, GPs can give advice on monitoring alcohol intake as well as ask about possibilities of recreational drug use. If injecting drug use is possible, GPs can advise the prevalence of blood-borne viruses in destination countries and encourage appropriate vaccinations (e.g. hepatitis B).

The mix of ‘being on holiday’, increased alcohol intake and meeting new people means sexual encounters often occur during travels. GPs can assist travellers by discussing safe sex and sexual risk facilitators as well as conducting pre- and post-travel sexual health screening. Sexual history taking can improve understanding of patient’s risk, and may involve asking:

  • number of recent sexual partners
  • previous STI diagnosis
  • use of condoms
  • types of sexual activities.

Depending on the country of travel, GPs can advise patients to take their own condoms as they may not always be of high quality or easily accessible. It is worth noting STI prevalence, including HIV, chlamydia, gonorrhoea and syphilis, is much higher in some countries, particularly Africa and Southeast Asia.

When appropriate, GPs can inform patients about cultural attitudes and legalities of homosexuality in their destination countries, as these may vary significantly from those in Australia, including criminal prosecution. A list of sexuality orientation laws around the world is available from the International Lesbian, Gay, Bisexual, Trans and Intersex Association.