If you cannot find what you are looking for, or require additional information or help, please contact us on 0117 342 6913.
Please read the guidance below before calling.
COVID 19 Update November 2020: Our testing and referral pathways have changed and will continue to change as a result of COVID-19. We will keep this page updated with current pathways
If you wish to contact Unity Sexual Health you may do so in the following ways:
Urgent referrals or for sexual health advice:
Emergency IUD referral:
Routine/ non-urgent/ psychosexual referrals:
For detailed instructions on testing for STIs, please see the British Association for Sexual Health and HIV (BASHH) STI testing guidance 2015.
Infections in alphabetical order:
The test
For people with a penis
Vaginal, throat and rectal sampling
Contacts of infection
Other testing
The test
Who to test
Hepatitis B is a recommended part of sexual health screening for the following groups of patients:
Those who have a risk factor for Hepatitis B (see list above) can be offered vaccination against Hepatitis B. Please see High Risk Groups.
Management
The test
Who to test
Other tests
Management
The test
Other tests
Management
The test
Clinical features
Other tests
Management
Unity’s guidance is based on national guidelines.
National guidelines on the management of STIs are available through the British Association for Sexual Health and HIV (BASSH)
National guidance on contraception is available through the Faculty of Sexual and Reproductive Healthcare (FSRH)
National guidance on the management of HIV is available through the British HIV Association (BHIVA)
Clinical guidelines are available to download from the Document Management Service, which can be accessed from any NHS (nww) computer. Click on ‘Clinical Guidelines’ then ‘University Hospitals Bristol NHS Foundation Trust’ then ‘Medicine’ and select ‘Sexual Health’If you have any queries you may call us on 0117 342 6913.
We have abridged versions of our guidance for primary care which may be found on the BNSSG Remedy Website – under Sexual Health
Other helpful websites include:
British Pregnancy Advisory Service (BPAS)
Introduction
When a patient is diagnosed with a sexually transmitted infection, it is important to ensure that any sexual contacts are informed. This helps reduce the spread of infection, reduce risk of health problems for partners and ensure the asymptomatic are aware. The patient should understand the infection, be able to comply with treatment and ensure follow-up arrangements are adhered to. Any patients diagnosed with the following STI’s should have partner notification processes initiated:
Approaching Partner Notification
It is important to take a sexual history from patients diagnosed with a sexually transmitted infection. This serves to identify anybody at risk, relative risk factors in sexual behavior and acts as a cue for the health professional to remind the patient of who needs to be informed and why.
If the patient is concerned about informing partners, it may help to:
Discuss with the patient how, where and when their contacts may be informed. Discussing the most appropriate time, place and how to broach the topic can help the patient minimise embarrassment. Usual methods of informing partners would be:
Try to encourage patients to talk to contacts privately, rather than in public or on publicly-viewable media networks. It may help to emphasise not to blame anybody, and to tell partners that they have been to the clinic and have been diagnosed with an infection.
If the patient specifies the infection to their partners (for example, saying ‘chlamydia’ rather than ‘an infection’) then the partners can access treatment immediately as a contact, rather than getting a test and awaiting a result prior to treatment. This minimises the risk of further transmission or health complications.
Please see the table below for time frames :
Infection | Who needs to be informed? | |
Chlamydia | Male with urethral symptoms | All contacts within the 4 weeks prior to onset of symptoms |
Female/ asymptomatic male/male with infection at other (non urethral) sites | All contacts within the last 6 months | |
Gonorrhoea |
Male with urethral symptoms |
All contacts within the 2 weeks prior to onset of symptoms |
Female/ asymptomatic male/male with infection at other (non urethral) sites | All contacts within the last 3 months | |
Syphilis |
Primary |
All contacts within the last 3 months |
Secondary/early latent | All contacts within the last 2 years | |
Non specific urethritis (NSU) | All contacts within the 4 weeks prior to onset of symptoms | |
Pelvic inflammatory disease (PID) | All contacts within the 6 months prior to onset of symptoms | |
Trichomonas Vaginalis (TV) | All current sexual partners | |
HIV | Sexual partners within the time frame of previous testing results or, if no previous results, then depending on risk assessment by the health professional
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Hepatitis B | All sexual or needle-sharing contacts within 2 weeks prior to the onset of jaundice or until surface antigen negative.
Consider vaccinating household contacts or providing immunoglobulin to those at immediate risk. Other contacts dependent on risk assessment by the health professional.
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There is some useful information on the sexual health pages of the Remedy website.
Long acting reversible contraception (LARC) patient group directions (PGDs)
The CCG and Local Authorities have authorised LARC PGDs for use by registered nurses at BNSSG GP Practices. There following PGDs are available on the formulary website here, https://bit.ly/3kZkc6b.
Full training requirements are included within each PGD and include successful completion of the Faculty of Reproductive and Sexual Health Letter of Competence for subdermal implants and intrauterine techniques, level 2 or equivalent safeguarding children and vulnerable adults and basic life support and anaphylaxis.
UK Medical Eligibility Criteria tables for contraception use (UKMEC)
Spotting the Signs proforma (for child sexual exploitation)
Brook Sexual Behaviour Traffic Light Tool
Are you at risk of osteoporosis? National Osteoporosis Society
Alcohol Use Disorders Identification Test (AUDIT)
How to calculate the latest time in the cycle and that an emergency IUD may be fitted – please see document
National Chlamydia Screening Programme – NCSP
Changes are occuring to the Chlamydia Screening Programme commencing on 1st April 2022.
There has been a national programme of Chlamydia screening in England since 2003. BNSSG, Bristol North Somerset and South Gloucestershire and BANES, Bath and North East Somerset areas have had an active service since 2007 with the aim of preventing onward transmission and the harms of chlamydia though early detection and treatment.
To ensure the NCSP service is based on the best available evidence, Public Health England (PHE) convened a review of the evidence based research by national and international experts and consulted with stakeholders and public (including focus groups with young people) on the recommended way forward.
As a result, the aim of the NCSP is changing to focus on reducing the harms from untreated chlamydia infection. The harmful effects of chlamydia occur predominantly in women so the opportunistic screening (that is the proactive offer of a chlamydia test to young people without symptoms) should focus on women*, combined with re-testing after treatment:
· Reducing time to test results and treatment
· Strengthening partner notification
Everyone can still get tested if they need, but men will not be proactively offered a test unless an indication has been identified, such as being a partner of someone with chlamydia or having symptoms.
In light of these changes, the screening office will still provide test kits with vaginal swabs for use in the 15-24 yr old age range. A small number of urine test kits for male or transfemale clients will also continue to be available.
The Unity website for test requests can be found at www.unitysexualhealth.co.uk. This provides access to STI screening kits that link to a client’s own patient account in Unity Sexual Health.
Please contact the Chlamydia Screening team on 0117 342 9299 or csp.avon@UHBW.nhs.uk if you have any questions.
*References to women includes cisgender women, transgender men and non-binary (assigned female at birth) people who have not had hysterectomy or bilateral oophorectomy.
Consider the need for emergency contraception.
Advise other means of contraception.
Organise an ultrasound to confirm the position of the coil.
Refer to Unity- complex LARC clinic , please see Clinical services and How to Refer
Refer to Unity – Complex LARC clinic, please see Clinical services and How to refer
Please consider whether the attempted removal may have dislodged the intra-uterine contraceptive device and offer bridging contraception if necessary.
The patient should be referred to Gynaecology rather than Unity sexual health in this instance for removal with hysteroscopy.
Advise other means of contraception.
Note if the USS reports that one of the arms has embedded into the myometrium, we may consider removal at Unity.
Sayana Press is a subcutaneous version of depot medroxy progesterone acetate. It is licensed for self-administration and therefore advance supplies may be provided.
Whether it is an IUD or an IUS, the coil should not be removed if there has been any unprotected sex in the last 7 days due to risk of pregnancy from any remaining viable sperm. The removal should be deferred until 7 days after the last episode of condom-less vaginal sex, even if a refit is planned.
Do not attempt removal. Consider the need for emergency contraception. Advise interim contraception.
Refer to the Deep Implant clinic, please see Clinical services and How to refer
Refer to the Deep Implant clinic, please see Clinical services and How to refer
Yes you can. The FSRH guidance recommends giving oral emergency contraception for every episode of unprotected sex in a cycle.
For further guidance:
FSRH Emergency contraception guideline
Note however that ulipristal acetate must not be given in the 7 days after any other form progestogen – including levonorgestrel.
Levonorgestrel must not be given in the 5 days after ulipristal.
Enzyme inducers, like carbamazepine, can affect all progesterone containing contraception, with the exception of depot medroxyprogesterone acetate and the Intra-uterine system.
So carbamazepine does not have any significant interaction with the IUS
For further guidance:
From FSRH CEU statement
The medical help required by transgender and non-binary patients is highly individualised. People’s goals, from hormone therapy and surgery vary enormously, therefore so will the appropriateness and acceptability of different methods of contraception. Sensitive communication, with a clear attempt to avoid any stigmatising language, is therefore the key issue.
The Faculty of sexual and reproductive healthcare have produced a statement on Contraceptive Choices and Sexual Health for Transgender and Non-Binary People (October 2017).
Aciclovir is safe to use at any point during pregnancy. Normal dosing regimen applies.
If she is more than 28 weeks, and if this is a primary episode, she will need to be referred for consultant led antenatal care and may require caesarean delivery.
For further guidance:
We advise that patients are seen by our service so they can have cultures taken to check for antimicrobial sensitivities, receive the correct IM treatment, discuss partner notification and have a test of cure.
If you are happy to do this is in surgery then they do not need to be seen by us.
Please refer to our local guidelines for recommended treatment regimens.
For further guidance:
Yes.
We recommend partner notification and treatment for recent sexual partners.
All partners should be treated empirically with Doxycycline 100mg BD for 7days. Advise no sex until both partners finished treatment.
Yes.
We recommend partner notification and treatment for recent sexual partners.
All partners should be treated empirically with Doxycycline 100mg BD for 7days. Advise no sex until both partners finished treatment.
No, treat the patient as per guidelines for TV but the coil does not need to be removed.
No, treat the patient for PID but the coil does not need to be removed routinely.
If there is no improvement after 72 hours you may wish to consider removal.
Please see Clinical services and How to refer
If you feel they need to be seen urgently, please ring us on 0117 342 6900
As of April 2018 the 4YP brand longer exists in Bristol.
Unity Sexual Health has taken over the sexual health related training that was previously provided by 4YP and has been renamed UYP ( Unity Young People Training).
The UYP training programme is available on the professional development pages of our website