{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,10,31]],"date-time":"2023-10-31T12:50:30Z","timestamp":1698756630490},"reference-count":16,"publisher":"Royal College of General Practitioners","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BJGP Open"],"published-print":{"date-parts":[[2019,7]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>National guidelines for sexually transmitted infections (STIs) in primary care exists but their management is uncertain.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To assess the management of STIs against national standards in primary care.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design &amp; setting<\/jats:title><jats:p>A questionnaire based study in London and Brighton. The survey was conducted in 2015 following reorganisation of sexual health services in England.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Questionnaires were sent to GPs in London and Brighton about testing for STIs, treatment for gonorrhoea, specialist advice, and referral services.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 119 GPs who responded, most expressed confidence in treating chlamydia (<jats:italic>n<\/jats:italic> = 105\/119, 88%), trichomonas (<jats:italic>n<\/jats:italic> = 81\/119, 68%), and herpes (<jats:italic>n<\/jats:italic> = 82\/119, 69%) but not gonorrhoea (<jats:italic>n<\/jats:italic> = 32\/119, 27%). Most referred cases of syphilis (<jats:italic>n<\/jats:italic> = 92\/119, 77%) and genital warts (83\/119, 70%) to genito-urinary medicine (GUM) as per guidance. Most GPs tested for gonorrhoea on patient request (<jats:italic>n<\/jats:italic> = 95\/119, 80%), in tandem with chlamydia screening (<jats:italic>n<\/jats:italic> = 89\/119, 75%), because of high risk status (<jats:italic>n<\/jats:italic> = 85\/119, 71%) and genital symptoms (<jats:italic>n<\/jats:italic> = 108\/119, 91%). Some GPs (<jats:italic>n<\/jats:italic> = 22\/119, 18%) sampled urine for culture, 53\/119 (45%) provided high vaginal swabs (HVS), and 28\/119 (24%) provided self-taken vulvovaginal swabs (STVVS) for culture. These samples are not appropriate for gonococcal culture and not processed in the laboratory. Urethral swabs for men and endocervical swabs (ECS) are recommended for gonococcus culture. Over half (<jats:italic>n<\/jats:italic> = 60\/102, 59%) of GPs did not treat gonorrhoea but some prescribed cefixime, ciprofloxacin, or azithromycin. Eighty-seven per cent (<jats:italic>n<\/jats:italic> = 104\/119) sought advice from GUM, and 83\/103 (81%) referred gonorrhoea nucleic acid amplification test (NAAT)-positive patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>There is scope for improvement of STIs management in primary care to ensure that patients are optimally investigated, treated, and referred.<\/jats:p><\/jats:sec>","DOI":"10.3399\/bjgpopen18x101639","type":"journal-article","created":{"date-parts":[[2019,4,17]],"date-time":"2019-04-17T04:49:07Z","timestamp":1555476547000},"page":"bjgpopen18X101639","source":"Crossref","is-referenced-by-count":3,"title":["The management of sexually transmitted infections: a scoping survey in primary care"],"prefix":"10.3399","volume":"3","author":[{"given":"Jayshree","family":"Dave","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Paul","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julie","family":"Johnson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jane","family":"Hutchinson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Glenn","family":"Phiri","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Asha","family":"Dave","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Neville","family":"Verlander","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Carrington","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1987","published-online":{"date-parts":[[2019,4,16]]},"reference":[{"key":"2020081209181425000_3.2.bjgpopen18X101639.1","unstructured":"The Stationery Office (2013) The Local Authorities (public health functions and entry to premises by local health watch representatives) regulations. www.legislation.gov.uk\/uksi\/2013\/351\/contents\/made. 5 Apr 2019."},{"key":"2020081209181425000_3.2.bjgpopen18X101639.2","unstructured":"London Councils (2017) Sexual health London: the London sexual health programme. http:\/\/www.londoncouncils.gov.uk\/our-key-themes\/health-and-adult-services\/public-health\/sexual-health-0\/london-sexual-health. 5 Apr 2019."},{"key":"2020081209181425000_3.2.bjgpopen18X101639.3","unstructured":"Public Health England (2018) Sexual and reproductive health profiles. http:\/\/fingertips.phe.org.uk\/profile\/sexualhealth. 5 Apr 2019."},{"key":"2020081209181425000_3.2.bjgpopen18X101639.4","unstructured":"Lazaro N Royal College of General Practitioners Sex, Drugs, HIV and Viral Hepatitis Group British Association for Sexual Health and HIV (BASHH) (2013) Sexually transmitted infections in primary care 2013. https:\/\/www.bashh.org\/media\/2705\/sexually-transmitted-infections-in-primary-care-2013.pdf. 5 Apr 2019."},{"key":"2020081209181425000_3.2.bjgpopen18X101639.5","unstructured":"British Association for Sexual Health and HIV (BASHH) (2014) Standards for the management of sexually transmitted infections (STI). www.medfash.org.uk\/uploads\/files\/p18dtqli8116261rv19i61rh9n2k4.pdf. 5 Apr 2019."},{"key":"2020081209181425000_3.2.bjgpopen18X101639.6","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2015-007776"},{"key":"2020081209181425000_3.2.bjgpopen18X101639.7","unstructured":"Public Health England (2014) Information to support the commissioning of chlamydia screening in general practice and community pharmacies. https:\/\/assets.publishing.service.gov.uk\/government\/uploads\/system\/uploads\/attachment_data\/file\/373205\/Developing_service_specifications_for_chlamydia_testing_and_treatment_in_GP_and_CommPharm.pdf. 5 Apr 2019."},{"key":"2020081209181425000_3.2.bjgpopen18X101639.8","unstructured":"Bignell C Ison C FitzGerald M Clinical Effectiveness Group: British Association for Sexual Health and HIV (2012) National guideline for gonorrhoea testing 2012. https:\/\/www.bashh.org\/documents\/4490.pdf. 5 Apr 2019."},{"key":"2020081209181425000_3.2.bjgpopen18X101639.9","unstructured":"Public Health England (2017) UK Standards for Microbiology Investigations. 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