BASHH | HIV testing window

This statement from BASHH advises that new 'fourth generation' HIV tests will detect the majority of infected patients at four weeks post infection, which is much earlier than older tests. These tests look for both HIV antibodies and p24 antigen. I don't know whether this test is being offered locally - so if in doubt -…
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BASHH | Molluscum contagiosum

This is a new guideline from BASHH. It really looks mainly at genital molluscum contagiosum, but some of the evidence is useful for all forms. Basically most patients should be encouraged to just leave them alone as they go naturally within a few months without normally scarring, which is probably what most of us are doing already.…
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BASHH | Partner notification

This guideline is useful for us. It lists the time-span that you have to look back over in a patient with an STD for partner notification and is an excellent resource if you’re not sure if partner notification needs to be initiated or not. Patients really need to be referred to GU for partner notification. If…
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BASHH | Safer sex advice

This guidance is really aimed at GU Medicine – but some useful bits for us. The point of it is that even short interventions can have some impact on people having safer sex. There is an excellent patient leaflet, which could be used for people you think are at risk. Generally think about asking about…
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BASHH | Bacterial vaginosis

This guideline doesn’t really add anything new. It is very similar to the recent FSRH summary on Vaginal Discharge. Oral Metronidazole is still the treatment of choice because it is cheap. The main difference from the recent FSRH guidance is in BV in pregnancy. FSRH advised treating in pregnancy, even if BV is found as…
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BASHH | HIV post-exposure prophylaxis following sexual exposure

This guideline looks at the use of Post-Exposure Prophylaxis (PEP) following sexual exposure. For information on the use of PEP following occupational exposure, the following advice is helpful. This isn’t something we’re going to come across very often. This is an excellent resource if faced with an affected patient. It gives tables with risks from different…
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BASHH | Adolescents living with HIV

This guideline is aimed at paediatric doctors, rather than us. However, it is a really good reminder of how to approach taking a sexual history from adolescents. I’m not going to summarise it as there really isn’t much new, but there are a few bits I wasn’t aware of, so I shall list these. If…
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BASHH | Management of gonorrhoea

NAAT testing is now available for gonorrhoea* Men - send a 1st pass urine for NAAT testing or a urethral swab for microscopy. Women - you need both an endocervical and a urethral swab for microscopy. When NAAT testing is available, we’ll be able to just do an HVS (urine NAAT testing isn’t sensitive enough…
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