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Warzywoda S, Fowler JA, Debattista J, Mills DJ, Furuya-Kanamori L, Durham J, Lau CL, Mullens AB, Istiko SN, Santaolaya C, Malhotra J, Dean JA. The provision of sexual and reproductive health information and services to travellers: an exploratory survey of Australian travel medicine clinicians. Sex Health 2024; 21:SH23098. [PMID: 38219736 DOI: 10.1071/sh23098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 12/14/2023] [Indexed: 01/16/2024]
Abstract
BACKGROUND International travel can increase the risk of exposure to infectious diseases including sexually transmissible infections (STI). Pre-travel medical consultation provides an opportunity for travel-related health risk assessments and advice. This study explored how travel medicine clinicians integrate sexual and reproductive health (SRH) services into clinical practice. METHODS A convenience sample of travel medicine clinicians completed a cross-sectional survey online or via hard-copy disseminated at an annual national Australian travel medicine conference. RESULTS Of the 67 respondents, most (n , 51; 76.1%) had a postgraduate qualification relevant to travel medicine and 55.2% (n , 37) had worked in travel medicine for over 10years. Only 22.4% (n , 15) reported conducting a SRH history/STI risk assessment for all travel patients. STI testing pre-departure was conducted on patient request (48, 71.6%), if symptomatic (32, 47.8%) or based on risk history (28, 41.8%). SRH information pre-departure was most frequently provided if prompted by patient questions (n , 42; 62.7%), or based on the patient's history (n , 37; 55.2%). Over half the sample (n , 40; 59.7%) expressed interest in further training in SRH. CONCLUSION Providing and engaging with additional training may assist travel medicine clinicians to take a more proactive approach to SRH consultations and STI testing. Additional research is needed to explore models of care that will allow comprehensive SRH and STI services to be integrated into standard pre- and post-travel care.
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Affiliation(s)
- Sarah Warzywoda
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Qld, Australia
| | - James A Fowler
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Qld, Australia
| | - Joe Debattista
- Metro North Public Health Unit, Metro North Hospital and Health Service, Windsor, Qld, Australia
| | - Deborah J Mills
- Dr Deb The Travel Doctor, Travel Medicine Alliance, Brisbane, Qld, Australia; and UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Herston, Qld, Australia
| | - Luis Furuya-Kanamori
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Herston, Qld, Australia
| | - Jo Durham
- School of Public Health and Social Work, Australian Centre for Health Services Innovation (AusHSI), Centre for Healthcare Transformation, Faculty of Health Queensland University of Technology, Kelvin Grove, Qld, Australia
| | - Colleen L Lau
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Herston, Qld, Australia
| | - Amy B Mullens
- School of Psychology and Wellbeing, Centre for Health Research, Institute for Resilient Regions, University of Southern Queensland, Ipswich, Qld, Australia
| | - Satrio Nindyo Istiko
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Qld, Australia
| | - Carlos Santaolaya
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Qld, Australia
| | - Juhi Malhotra
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Qld, Australia
| | - Judith A Dean
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Qld, Australia
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Abstract
PURPOSE OF REVIEW The present review considers recent evidence on travel-associated sexual intercourse and sexually transmitted infection (STI) risks and travel with regards to risk behavior and implications of travel on communities. It highlights the lack of research in this area and topics for consideration. RECENT FINDINGS A population-based study, and others, shows significant levels of sex abroad and risk behavior with inconsistent condom use despite increasing travel advice about risks. There is an increasing association of STIs in military personnel from local rather than deployment-associated sex contacts shown in United States and French studies, probably related to deployment of women. Innovative studies are showing the effect of female sex-tourism on the communities involved, and the sexual interaction and risk for tourism employees from tourists. New social networking apps require evaluation as to both their potential to increase and decrease risks. Travel sex continues to be a vector for the global spread of multidrug resistant gonorrhoeae. SUMMARY New research challenges previous perspectives with changes to risk behavior in the military, female sex tourism, the change in social networks and ongoing risk behavior research and evidence of increased cross-country partnerships. The lack of high-quality studies evaluating travel advice to reduce risk is a key area for future work.
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