Sexual Health Service & Addictions. Dr Anne McLellan September 2014
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1 Sexual Health Service & Addictions Dr Anne McLellan September 2014
2 Effect of alcohol and drugs on sexual function?
3 Cannabis & Sex Males, Low Dose Use: physical sensitivity, desire; lowers inhibitions especially if used with alcohol. Females, Low Dose Use: physical sensitivity desire. Males, High Dose Use: inhibitions; effects vary according to THC content of drug. Females, High Dose Use: Same as males.
4 Heroin (Opiates & Sex) Males, Low Dose Use: desire and erectile ability; delays ejaculation. Females, Low Dose Use: desire and the strength of orgasm. Males, High Dose Use: Replaces desire; greatly erectile and ejaculation ability. Females, High Dose Use: Greatly desire and orgasm.
5 Opiates & Sex Prolonged Use Males, Prolonged Use: Greatly decreases desire except during withdrawal from the opiate; decreases erectile and ejaculation ability. Females, Prolonged Use: Irregular menstruation; greatly decreases desire and the quality and strength of an orgasm.
6 Cocaine & Sex Males, Low Dose Use: Stimulates desire and erectile ability while delaying ejaculation. Females, Low Dose Use: / desire and intensity of orgasm. Males, High Dose Use: Prolongs erection, delays ejaculation; strong tendency to atypical/high-risk sexual practices such as multiple partners. Female, High Dose Use: Usually desire, / orgasmic ability; tendency to atypical and high risk sexual practices.
7 Priorities For Sexual Health Service Recognise and access different vulnerable client groups Identifying and treating STIs Prevention and risk reduction Serum screening for blood borne viruses Hepatitis A and B vaccination Contraceptive service provision Identifying victims of abuse and violence Facilitating use of specialist services
8 Standard Sexual Health Screen Chlamydia Gonorrhoea HIV Syphilis BBV risk assessment
9 How to test for Chlamydia and Gonorrhoea in an asymptomatic patient
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13 Fast-track Card for Adult Clients with Addictions (>20)
14 Fast-track Card for Adult Clients with Addictions (>20)
15 Role of Sexual Health and Life Style Nurse Establish and build a relationship with YP and assess needs Carry out a well being assessment. Liaise with other professionals, family Review plan and assess impact of intervention
16 Sexual Health/Lifestyle Nurses See clients < 20years Address substance misuse/sexual health issues. Multi Agency referrals Work one to one or small groups YP These nurses also work at the general YP clinics
17 Contact Based in Sexual Health office, Coathill North: Karen Murray, Karen Stewart, South: Maria Dickson, all on NHSL global
18 TRAINING 2013 > 100 staff working in addictions attended generic training 10 days delivered in 2013 Delivered by Adrienne Hannah through SDF funded by Scottish Government Evaluated well Staff identified for higher level training
19 Think prevention talk CONDOMS
20 Preventing Pregnancy What is safe What is effective Patient choice What is suitable What is left
21 Methods of Emergency Contraception
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26 NICE Guideline on LARC October 2005 LARC methods Intrauterine devices (IUD) Intrauterine system (IUS) Injectables (DMPA) Implants (IMPLANON) Key Priorities Choice for all Money All LARC methods more cost effective than COC
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28 IMPLANON
29 TRAINING 2014 Morning session focussing on LARC methods delivered to 30 Addiction Staff Practical sessions delivered subsequently Certificates of completed training Pilot sites identified
30 YP PLUS Drop-In for <20 s 1 st May 2014 DAY OF WEEK VENUE TIMES OF CLINIC MONDAY TUESDAY WEDNESD AY Coatbridge Health Centre 1 Centre Park Court COATBRIDGE ML5 3AP Motherwell Health Centre 138 Windmillhill Street MOTHERWELL ML1 1TB Bellshill Clinic Greenmoss Place BELLSHILL ML4 1PS 4.00pm 6.00pm 4.00pm 6.00pm 4.00pm 6.00pm Remember that Hunter Health Centre is a YP Plus Clinic too. This has been running for some time. THURSDAY Airdrie Health Clinic 88 Graham Street AIRDRIE ML6 6DB 4.00pm 6.00pm Hunter Health Centre Andrew Street EAST KILBRIDE G74 1AD 3.30pm 5.30pm WHAT IS AVAILABLE 1.All contraception, including coils and Implants 2.All STI tests and treatment 3. Wart treatment (freezing)
31 Sexual Health Integrated Clinics - January 2014 Appointment Line: MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY AM 9.30am 1.00pm Coatbridge Carluke Health Centre Health Centre 1 Centre Park Court 40 Chapel St Coatbridge Carluke ML5 3AP ML8 4BA (Drop-In) Motherwell Health Centre 138 Windmillhill Street Motherwell ML1 1TB (Drop-In) Blantyre Health Centre Victoria Street Blantyre G72 0BS Hamilton New Douglas Street Clinic 19 Douglas Street Hamilton ML3 0BP Cumbernauld Central Health Centre North Carbrain Road Cumbernauld G67 1BJ PM 1.30pm 4.30pm Coatbridge Carluke Health Centre Health Centre 1 Centre Park Court 40 Chapel St Coatbridge Carluke ML5 3AP ML8 4BA Motherwell Health Centre 138 Windmillhill Street Motherwell ML1 1TB Hunter Health Centre Andrew Street East Kilbride G74 1AD (Drop-In) Blantyre Health Centre Victoria Street Blantyre G72 0BS Airdrie Airdrie Community Health Clinic 88 Graham Street Airdrie ML6 6DB EVENING 7.00pm 9.00pm Coatbridge Health Centre 1 Centre Park Court Coatbridge ML5 3AP Hunter Health Centre Andrew Street East Kilbride G74 1AD Airdrie Airdrie Community Health Clinic 88 Graham Street Airdrie
32 Sexual & Reproductive Health Clinics January 2014 Appointment Line: FP CLINICS MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY AM 9.30am 1.00pm Hunter Health Centre Andrew Street East Kilbride G74 1AD Viewpark Health Centre 119 Burnhead Street Viewpark G715RR PM 1.30pm 4.30pm Wishaw Health Centre Kenilworth Avenue Wishaw ML2 7BQ Bellshill Greenmoss Place Bellshill ML4 1PS (1.00pm 4.00pm) Hunter Health Centre Andrew Street East Kilbride G74 1AD EVENINGS 7pm 9pm Hunter Health Centre Andrew Street East Kilbride G74 1AD Cumbernauld Central Health Centre North Carbrain Road Cumbernauld G67 1BJ Lanark Health Centre Woodstock Road Lanark ML11 7DH Bellshill Greenmoss Place Bellshill ML4 1PS Hamilton New Douglas Street Clinic 19 Douglas Street Hamilton ML3 0BP
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34 What Next? Proactive promotion of CDS Proactive pregnancy planning Clear reporting systems Improve data collection
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36 Lanarkshire Sexual Health Service Glenalmond House Coathill Hospital Hospital Street Coatbridge ML5 4DN Tel: /1
37 Thanks for Listening!
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