Sexually transmitted infections

This research found that for people with a medically incurable STI, gender, relationship status, level of guilt, and disclosure factors were associated with respondents' sexual self-concept, and their feelings of stigmatization. This research has significant implications for health practitioners involved in the management and care of individuals with an STI.

Guided reflection: transcending a routine approach in the management of sexually transmissible infections

This paper describes a distinctive approach to the sexually transmissible infections (STI) clinical consultation: 'the guided reflection approach'. The authors coined this term and identified the guided reflection approach through analysis of 22 in-depth interviews with practitioners who provide care for people with STI, and 34 people who had attended a healthcare facility in Australia for screening or treatment of an STI. A grounded theory method was used to collect and analyse this information. The data revealed when the STI consultation is conducted using the principles characterized by the guided reflection approach creates contexts for sexual empowerment that have the potential to effectively assist people to gain autonomy for safe sex. Routinely, most of the practitioners in this study were shown to direct the STI consultation towards risk behaviours and practices and prevention of transmission, with minimal intervention. However, this study shows that if clinical interaction is to make a difference to the patient's autonomy for sexual behaviour, two changes will be required. First, practitioners need to adopt the goal of assisting patients to attain levels of autonomy, and second, practitioners require education to assist them to develop the interactive skills needed to engage patients in dialogue and reflection about sexual behaviour.

"Sexually transmitted debts":the scope of defences to directors' liability for insolvent trading

The recent demise of prominent Australian corporations, such as GIO Australia Holdings Ltd, One.Tel Ltd, HIH Insurance Ltd and Ansett Australia Ltd, have highlighted the relevance of, inter alia, the Australian insolvent trading provisions embodied in the Corporations Act 2001 (Cth) (formerly Corporations Law). What may not be appreciated, however, is that insolvent trading is not only concerned with large public companies. Many of the insolvent trading cases that come before the courts involve small proprietary companies. Moreover, in many cases these are small “family” companies where there may only be one active director. This gives rise to a difficult issue as to the appropriateness of imposing liability for insolvent trading on a spouse who is, factually, merely a dormant director. This article explores the issue of spousal liability for insolvent trading, particularly focusing on the scope of the current defences to insolvent
trading under s 588H.

The impact of stigma on couples managing a sexually transmitted infection

Recent research has indicated that the stigma surrounding sexually transmitted infections (STIs) creates a psychological and emotional burden for individuals with these conditions. It would be expected that the stigma of having a STI would also alter the dynamics of an intimate relationship. This paper reviews the literature on the impact of STIs on intimate relationships, and considers the relevance of this research to both clinicians and researchers. In particular, the types of relationships in which the presence of a STI may have a varying degree of impact are examined. Since disclosure of a STI would also be expected to impact on a relationship, an overview of the factors involved in the disclosure of a STI to a partner is also considered. Finally, the implications of this research for both clinicians and researchers are discussed.

Effects of sexually transmitted infection status, relationship status, and disclosure status on sexual self-concept

Research has indicated that having a sexually transmitted infection (STI) such as genital herpes and genital human papilloma virus (HPV) can have a negative impact on an individual's sexuality. The current study was designed to evaluate the effect of STI status, relationship status, and disclosure status on various dimensions of sexual self-concept. A questionnaire that evaluated the above variables was completed by 117 individuals with genital herpes, 82 individuals with HPV, and 75 individuals with no STI. The results demonstrated that having herpes or HPV had a significant negative impact on aspects of sexual self-concept. It does not appear that an individual's relationship status is a factor associated with the impact of having an STI on the sexual self-concept. Respondents who had disclosed their STI to their partners, however, had significantly more positive feelings about aspects of their sexual self-concept than those who had not disclosed their STI to their partners. The implications of these research findings for health practitioners are discussed.

Sexually transmitted infections: Impact on individuals and their relationships

The impact of having genital herpes and genital human papilloma virus (HPV) on individuals and their relationships was investigated. A qualitative research methodology explored the lived experiences of 30 adults with genital herpes (15 men, 15 women), and 30 adults with HPV (15 men, 15 women). This study addressed individuals' feelings about the impact of stigma associated with having an STI, the impact of having an STI on sexuality and on intimate relationships, and feelings surrounding the process of disclosure. Implications of the findings for research and clinical practice are discussed.

General practitioner and the control of sexually transmissible infections

Sexually transmissible infections (STIs), one of the major preventable health problems affecting the Australian population, are often asymptomatic and, if undetected, can cause sub-fertility, infertility and chronic morbidity. In addition to these significant and costly consequences, STIs increase the risk of transmission of HIV. Given that 80% of Australian patients attend their General Practitioner (GP) each year, GPs are well placed to have a significant impact on STI transmission by diagnosing and treating both asymptomatic and symptomatic disease. Good professional practice would suggest that all GPs will undertake certain actions when they are consulted by a patient who either has symptoms of an STI or who appears to be at risk of acquiring an STI. This expectation is based on the premise that all GPs share the same detailed knowledge of STI risk factors and symptoms. It assumes that they will have no difficulty in eliciting such information from the patient, that the patient will comply with STI testing and treatment and that the patient will return for follow-up, to ensure that they and their sexual partners have been adequately treated. Given the constraints of the real world in which general practice exists, the sensitive nature of sexual health, and the stigma associated with STIs, there are many barriers to achieving such an outcome. My own previous research has highlighted some of the difficulties experienced by GPs in the area of STI control. This study has used data from four different sources (policy and stakeholder documents, literature, key informant interviews and my own past research) to examine ideal practice and actual practice in the prevention and treatment of STIs. A number of discrepancies were identified, and from these arose a series of recommendations for ways of making STI control in general practice less complex. To ensure that the results of the study were firmly embedded in the reality of general practice, comments on the recommendations were sought from GPs employed in a variety of practice settings, including those with low STI caseloads. These comments were used to modify the recommendations to ensure they would offer a practical and effective contribution to STI control in Victoria.