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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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Abraha M, Egli-Gany D, Low N. Epidemiological, behavioural, and clinical factors associated with antimicrobial-resistant gonorrhoea: a review. F1000Res 2018; 7:400. [PMID: 29636908 PMCID: PMC5871945 DOI: 10.12688/f1000research.13600.1] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/21/2018] [Indexed: 01/03/2023] Open
Abstract
Antimicrobial-resistant
Neisseria gonorrhoeae is a global public health problem in the 21st century.
N. gonorrhoeae has developed resistance to all classes of antibiotics used for empirical treatment, and clinical treatment failure caused by extensively resistant strains has been reported. Identifying specific factors associated with an increased risk of antimicrobial-resistant
N. gonorrhoeae might help to develop strategies to improve antimicrobial stewardship. In this review, we describe the findings of 24 studies, published between 1989 and 2017, that examined epidemiological, behavioural, and clinical factors and their associations with a range of antimicrobial agents used to treat gonorrhoea. Antimicrobial-resistant
N. gonorrhoeae is more common in older than younger adults and in men who have sex with men compared with heterosexual men and women. Antimicrobial-resistant
N. gonorrhoeae is less common in some black minority and Aboriginal ethnic groups than in the majority white population in high-income countries. The factors associated with antimicrobial-resistant gonorrhoea are not necessarily those associated with a higher risk of gonorrhoea.
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Affiliation(s)
- Million Abraha
- Institute of Social and Preventive Medicine, University of Bern, Finkenhubelweg 11, 3012 Bern, Switzerland
| | - Dianne Egli-Gany
- Institute of Social and Preventive Medicine, University of Bern, Finkenhubelweg 11, 3012 Bern, Switzerland
| | - Nicola Low
- Institute of Social and Preventive Medicine, University of Bern, Finkenhubelweg 11, 3012 Bern, Switzerland
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Memish ZA, Osoba AO. International travel and sexually transmitted diseases. Travel Med Infect Dis 2006; 4:86-93. [PMID: 16887730 DOI: 10.1016/j.tmaid.2005.01.003] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2005] [Accepted: 01/18/2005] [Indexed: 11/16/2022]
Abstract
Despite concerted efforts to control sexually transmitted diseases (STDs) worldwide, they still remain a major public health problem. Out of the 25 organisms known to be transmitted sexually, travelers are at greater risk of acquiring HIV and other STDs in developing countries in view of the high prevalence rates in these countries, particularly after sexual exposure to local commercial sex workers (CSWs). Some of the STDs acquired during international travel are more likely to be resistant to standard antimicrobial regimens for the STDs. HIV, gonorrhoea, syphilis, non-specific urethritis, hepatitis B, hepatitis C, and other STDs are a significant risk for travelers who engage in unprotected sex, especially with overseas CSWs. It is recognized that barrier contraceptives provide considerable protection against STDs, but they are not regarded as 100% protective. Sexual abstinence and sexual monogamy with a 'known' partner carry a much lower risk than the safest of 'safer sex' practices. However, in the event of a sexual exposure to a new partner in the country being visited, prior hepatitis B immunization and the consistent and proper use of a latex condom are strongly advised, followed by proper medical investigations and physical examination on returning home, before sexual activity is resumed.
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Affiliation(s)
- Ziad A Memish
- Division of Infectious Diseases, Department of Medicine and Infection Prevention and Control Program, King Abdulaziz Medical City, King Fahad National Guard Hospital, Riyadh, Saudi Arabia.
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Fulford M, Keystone JS. Health Risks Associated with Visiting Friends and Relatives in Developing Countries. Curr Infect Dis Rep 2005; 7:48-53. [PMID: 15610671 PMCID: PMC7089204 DOI: 10.1007/s11908-005-0023-z] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
An increasingly large proportion of immigrants to developed countries is arriving from less developed countries in Africa, Asia, and Latin America. When these immigrants return to their country of origin to visit friends and relatives, they are at high risk of acquiring tropical infections, compared with other travelers. Immigrants who return to their country of origin to visit friends and relatives (VFRs) are more likely to travel to rural areas for long periods of time, to consume contaminated food and beverages, and to have more prolonged, intimate contact with local populations. As a group, they are less likely to seek pretravel advice or take antimalarial chemoprophylaxis. This article discusses the increased risk of tuberculosis, malaria, food- and waterborne illnesses, hepatitis A, and HIV and other sexually transmitted infections in VFRs.
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Affiliation(s)
- Martha Fulford
- University of Toronto; Toronto General Hospital, 200 Elizabeth Street 9ES-411A, Toronto, Ontario M5G 2C4, Canada.
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