Sexual Health

性健康
  • 文章类型: Journal Article
    本指南提供了有关诊断的建议,在包括外生殖器在内的肛门生殖器部位有效管理人乳头瘤病毒(HPV)相关疣所需的治疗和健康促进原则,阴道,子宫颈,尿道,肛周和肛管。该指南主要针对16岁或以上的患者,向英国从事3级性健康服务的医疗保健专业人员介绍。然而,建议的原则可能适用于其他护理环境,包括初级保健,在适当的情况下使用当地适应的护理途径。HPV相关的肛门生殖器发育不良或其他生殖器外部位疣的管理不在本指南的范围内。
    This guideline offers recommendations on the diagnosis, treatment and health promotion principles needed for the effective management of human papillomavirus (HPV)-related warts at anogenital sites including the external genitals, vagina, cervix, urethra, perianus and anal canal. The guideline is aimed primarily at patients aged 16 years or older presenting to healthcare professionals working in level 3 sexual health services in the United Kingdom. However, the principles of the recommendations may be applied in other care settings, including in primary care, using locally adapted care pathways where appropriate. The management of HPV-related anogenital dysplasia or warts at other extragenital sites is outside the scope of this guideline.
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  • 文章类型: Journal Article
    这篇综述评估了性健康和生殖健康(SRH)指南中对性别敏感的语言,包括多囊卵巢综合征的指南。我们对像Medline这样的数据库进行了系统的搜索,EMBASE,和Cochrane,直到2023年7月31日,使用与性别包容性相关的术语,SRH,和指南协议。纳入标准是对性别问题有敏感认识的语言,SRH焦点,和指导方针的相关性,不包括非英语文章或没有政策考虑的文章。我们的搜索产生了25项研究,其中包括6个用于定性合成。结果显示,在SRH指南中使用对性别敏感的语言方面存在显著差距。关于这种语言的辩论反映了更广泛的社会话语。认识到性别多样性对研究至关重要,临床实践,和社会规范。在促进包容的同时,如意外删除或误传等缺点也应得到解决。性别相加方法平衡了包容性和生物学准确性。准确和包容的话语至关重要。未来的研究应集中在SRH部门的系统方法上。
    This review assesses gender-sensitive language in sexual and reproductive health (SRH) guidelines, including a guideline for polycystic ovary syndrome. We conducted a systematic search across databases like Medline, EMBASE, and Cochrane until July 31, 2023, using terms related to gender-inclusivity, SRH, and guideline protocols. Criteria for inclusion were gender-sensitive language, SRH focus, and guideline relevance, excluding non-English articles or those without policy considerations. Our search yielded 25 studies, with 6 included for qualitative synthesis. Results showed significant gaps in using gender-sensitive language in SRH guidelines. The debate on this language mirrors broader societal discourse. Recognizing gender diversity is essential for research, clinical practices, and societal norms. While promoting inclusion, drawbacks like unintended erasure or miscommunication should also be addressed. A gender-additive approach balances inclusivity and biological accuracy. Precise and inclusive discourse is crucial. Future research should focus on systemic approaches in the SRH sector.
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  • 文章类型: Practice Guideline
    目的:“2023年AHA/ACC/ACCP/ASPC/NLA/PCNA慢性冠心病患者管理指南”提供了更新并巩固了自“2012年ACCF/AHA/ACP/AATS/PCNA/SCAI/STS《稳定性缺血性心脏病患者诊断和管理指南》”和相应的“2014年ACCF/ASCNA《ACCF/ACP/ACATHA稳定性心脏病
    方法:从2021年9月至2022年5月进行了全面的文献检索。临床研究,系统评价和荟萃分析,以及对人类参与者进行的其他证据被确定为从MEDLINE(通过PubMed)以英文发表,EMBASE,Cochrane图书馆,医疗保健研究和质量机构,以及与本指南相关的其他选定数据库。
    本指南为慢性冠心病患者的管理提供了以证据为基础和以患者为中心的方法。考虑健康的社会决定因素,并纳入共同决策和基于团队的护理原则。相关主题包括治疗决策的一般方法,指南指导的管理和治疗,以减少症状和未来的心血管事件,关于慢性冠心病患者血运重建的决策,特殊人群的管理建议,患者随访和监测,证据缺口,以及未来需要研究的领域。如果适用,基于成本效益数据的可用性,还为临床医生提供了成本价值建议.以前发布的指南中的许多建议已经更新了新的证据,并且在发布的数据支持下创建了新的建议。
    The \"2023 AHA/ACC/ACCP/ASPC/NLA/PCNA Guideline for the Management of Patients With Chronic Coronary Disease\" provides an update to and consolidates new evidence since the \"2012 ACCF/AHA/ACP/AATS/PCNA/SCAI/STS Guideline for the Diagnosis and Management of Patients With Stable Ischemic Heart Disease\" and the corresponding \"2014 ACC/AHA/AATS/PCNA/SCAI/STS Focused Update of the Guideline for the Diagnosis and Management of Patients With Stable Ischemic Heart Disease.\"
    A comprehensive literature search was conducted from September 2021 to May 2022. Clinical studies, systematic reviews and meta-analyses, and other evidence conducted on human participants were identified that were published in English from MEDLINE (through PubMed), EMBASE, the Cochrane Library, Agency for Healthcare Research and Quality, and other selected databases relevant to this guideline.
    This guideline provides an evidenced-based and patient-centered approach to management of patients with chronic coronary disease, considering social determinants of health and incorporating the principles of shared decision-making and team-based care. Relevant topics include general approaches to treatment decisions, guideline-directed management and therapy to reduce symptoms and future cardiovascular events, decision-making pertaining to revascularization in patients with chronic coronary disease, recommendations for management in special populations, patient follow-up and monitoring, evidence gaps, and areas in need of future research. Where applicable, and based on availability of cost-effectiveness data, cost-value recommendations are also provided for clinicians. Many recommendations from previously published guidelines have been updated with new evidence, and new recommendations have been created when supported by published data.
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  • 文章类型: Journal Article
    目的“2023年AHA/ACC/ACCP/ASPC/NLA/PCNA慢性冠心病患者管理指南”提供了更新并巩固了自“2012年ACCF/AHA/ACP/AATS/PCNA/SCAI/STS稳定性缺血性心脏病患者诊断和管理指南”和相应的“2014年ACC/AHA/ASCATNA稳定性心脏病/Focus诊断指南”以来的新证据。方法2021年9月至2022年5月进行了全面的文献检索。临床研究,系统评价和荟萃分析,以及对人类参与者进行的其他证据被确定为从MEDLINE(通过PubMed)以英文发表,EMBASE,Cochrane图书馆,医疗保健研究和质量机构,以及与本指南相关的其他选定数据库。本指南为慢性冠心病患者的管理提供了基于证据和以患者为中心的方法。考虑健康的社会决定因素,并纳入共同决策和基于团队的护理原则。相关主题包括治疗决策的一般方法,指南指导的管理和治疗,以减少症状和未来的心血管事件,关于慢性冠心病患者血运重建的决策,特殊人群的管理建议,患者随访和监测,证据缺口,以及未来需要研究的领域。如果适用,基于成本效益数据的可用性,还为临床医生提供了成本价值建议.以前发布的指南中的许多建议已经更新了新的证据,并且在发布的数据支持下创建了新的建议。
    The \"2023 AHA/ACC/ACCP/ASPC/NLA/PCNA Guideline for the Management of Patients With Chronic Coronary Disease\" provides an update to and consolidates new evidence since the \"2012 ACCF/AHA/ACP/AATS/PCNA/SCAI/STS Guideline for the Diagnosis and Management of Patients With Stable Ischemic Heart Disease\" and the corresponding \"2014 ACC/AHA/AATS/PCNA/SCAI/STS Focused Update of the Guideline for the Diagnosis and Management of Patients With Stable Ischemic Heart Disease.\"
    A comprehensive literature search was conducted from September 2021 to May 2022. Clinical studies, systematic reviews and meta-analyses, and other evidence conducted on human participants were identified that were published in English from MEDLINE (through PubMed), EMBASE, the Cochrane Library, Agency for Healthcare Research and Quality, and other selected databases relevant to this guideline.
    This guideline provides an evidenced-based and patient-centered approach to management of patients with chronic coronary disease, considering social determinants of health and incorporating the principles of shared decision-making and team-based care. Relevant topics include general approaches to treatment decisions, guideline-directed management and therapy to reduce symptoms and future cardiovascular events, decision-making pertaining to revascularization in patients with chronic coronary disease, recommendations for management in special populations, patient follow-up and monitoring, evidence gaps, and areas in need of future research. Where applicable, and based on availability of cost-effectiveness data, cost-value recommendations are also provided for clinicians. Many recommendations from previously published guidelines have been updated with new evidence, and new recommendations have been created when supported by published data.
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  • 文章类型: Journal Article
    这是英国性健康与HIV协会(BASHH)关于性传播肠道感染(STEI)管理的第一个国家指南。该指南主要针对3级性健康诊所;然而,它也可能适用于其他设置,如初级保健或其他有STEI患者可能出现的医院部门。本指南对测试提出了建议,管理,STEI的合作伙伴通知和公共卫生控制。
    This is the first British Association of Sexual Health and HIV (BASHH) national guideline for the management of sexually transmitted enteric infections (STEI). This guideline is primarily aimed for level 3 sexual health clinics; however, it may also be applicable to other settings such as primary care or other hospital departments where individuals with STEI may present. This guideline makes recommendations on testing, management, partner notification and public health control of STEI.
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  • 文章类型: Journal Article
    南非少女意外怀孕和包括艾滋病毒在内的性传播感染的发生率很高。为文化上量身定制的双重保护干预措施提供信息,以防止意外怀孕和性传播感染/艾滋病毒,这项研究定性地检查了女孩的性健康干预偏好。参与者年龄为14-17岁,讲塞索托语(N=25)。为了阐明共同的文化信仰,个别访谈检查了参与者对其他少女怀孕的看法和性传播感染/艾滋病毒预防干预的偏好。面试在塞索托进行,并翻译成英文。两个独立的编码器使用传统的内容分析方法确定了数据中的关键主题,差异由第三个编码器解决。参与者指出,干预内容应包括有效的怀孕和性传播感染/艾滋病毒预防方法以及应对同伴压力的方法。干预措施应该是可以获得的,避免批评,提供高质量的信息。首选的干预形式包括在线,SMS/text,或由社会工作者或更年长的人交付,知识渊博的同龄人,父母或同龄同龄人对分娩的接受度参差不齐。学校,青年中心和性健康诊所是首选的干预机构.结果强调了文化背景在调整双重保护干预措施以解决南非少女生殖健康差距方面的重要性。
    South African adolescent girls experience high rates of unintended pregnancy and sexually transmitted infections including HIV. To inform culturally-tailored dual protection interventions to prevent both unintended pregnancy and STIs/HIV, this study qualitatively examined girls\' sexual health intervention preferences. Participants were aged 14-17 years old and Sesotho-speaking (N = 25). To elucidate shared cultural beliefs, individual interviews examined participants\' perceptions about other adolescent girls\' pregnancy and STI/HIV prevention intervention preferences. Interviews were conducted in Sesotho and translated into English. Two independent coders identified key themes in the data using a conventional content analysis approach with discrepancies resolved by a third coder. Participants indicated that intervention content should include efficacious pregnancy and STI/HIV prevention methods and ways to navigate peer pressure. Interventions should be accessible, avoid criticism and provide high-quality information. Preferred intervention formats included online, SMS/text, or delivery by social workers or older, knowledgeable peers, with mixed acceptability for delivery by parents or same-age peers. Schools, youth centres and sexual health clinics were preferred intervention settings. Results highlight the importance of cultural context in tailoring dual protection interventions to address the reproductive health disparities among adolescent girls in South Africa.
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  • 文章类型: Review
    背景:前列腺癌患者在治疗后出现明显的性功能障碍,这对他们和他们的伴侣在心理上产生了负面影响,紧张他们的关系。
    目的:我们召集了一个国际小组,旨在制定指导临床医生的指南,患者和伴侣了解前列腺癌治疗(PCT)对患者和伴侣性健康的影响,他们的关系,以及前列腺癌(PC)幸存者的生物心理社会康复。
    方法:指南小组包括国际专家研究人员和临床医生,和指导方法学家。对文献进行了系统的回顾,使用OvidMEDLINE,Scopus,CINAHL,心理信息,LGBT生活,根据Cochrane干预措施系统审查手册进行了Embase数据库(1995-2022年)。研究选择基于系统评价和荟萃分析(PRISMA)指南的首选报告项目。每个陈述都被分配了一个证据强度(A-C)和一个建议级别(强,中度,有条件)基于利益/风险评估。数据综合包括对被认为质量足够的研究的荟萃分析(3),使用测量工具评估系统评论(AMSTAR)。
    结果:制定了前列腺癌患者性保健指南,基于现有证据和国际小组的专业知识。
    结果:指南考虑了患者的文化,民族,种族多样性。他们关注具有不同性取向和性别认同的个人的独特需求。该指南基于文献综述,PCT术后性恢复的理论模型,和6个原则,促进临床医生发起的对性结果的现实期望的讨论,并通过生物心理社会康复减轻性副作用。47份声明涉及性心理,关系,和功能领域,除了关于生活方式改变的声明,评估,提供者教育,以及在PC幸存者中提供性健康护理的系统性挑战。
    结论:该指南为临床医生提供了针对前列腺癌患者的性健康护理的综合方法。
    UNASSIGNED:这项研究的力量是对前列腺癌性功能障碍和康复的现有证据的综合评估,连同可用的专业知识,最好的基础临床实践。局限性在于支持干预措施的证据的差异以及缺乏对低收入和中等收入国家前列腺癌患者面临的问题的研究。
    结论:指南记录了PCT令人痛苦的性后遗症,提供基于证据的性康复建议,并概述未来研究的领域。
    Patients with prostate cancer suffer significant sexual dysfunction after treatment which negatively affects them and their partners psychologically, and strain their relationships.
    We convened an international panel with the aim of developing guidelines that will inform clinicians, patients and partners about the impact of prostate cancer therapies (PCT) on patients\' and partners\' sexual health, their relationships, and about biopsychosocial rehabilitation in prostate cancer (PC) survivorship.
    The guidelines panel included international expert researchers and clinicians, and a guideline methodologist. A systematic review of the literature, using the Ovid MEDLINE, Scopus, CINAHL, PsychINFO, LGBT Life, and Embase databases was conducted (1995-2022) according to the Cochrane Handbook for Systematic Reviews of Interventions. Study selection was based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Each statement was assigned an evidence strength (A-C) and a recommendation level (strong, moderate, conditional) based on benefit/risk assessment. Data synthesis included meta-analyses of studies deemed of sufficient quality (3), using A Measurement Tool to Assess Systematic Reviews (AMSTAR).
    Guidelines for sexual health care for patients with prostate cancer were developed, based on available evidence and the expertise of the international panel.
    The guidelines account for patients\' cultural, ethnic, and racial diversity. They attend to the unique needs of individuals with diverse sexual orientations and gender identities. The guidelines are based on literature review, a theoretical model of sexual recovery after PCT, and 6 principles that promote clinician-initiated discussion of realistic expectations of sexual outcomes and mitigation of sexual side-effects through biopsychosocial rehabilitation. Forty-seven statements address the psychosexual, relationship, and functional domains in addition to statements on lifestyle modification, assessment, provider education, and systemic challenges to providing sexual health care in PC survivorship.
    The guidelines provide clinicians with a comprehensive approach to sexual health care for patients with prostate cancer.
    The strength of the study is the comprehensive evaluation of existing evidence on sexual dysfunction and rehabilitation in prostate cancer that can, along with available expert knowledge, best undergird clinical practice. Limitation is the variation in the evidence supporting interventions and the lack of research on issues facing patients with prostate cancer in low and middle-income countries.
    The guidelines document the distressing sexual sequelae of PCT, provide evidence-based recommendations for sexual rehabilitation and outline areas for future research.
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  • 文章类型: Journal Article
    前列腺癌患者在治疗后出现明显的性功能障碍,这对他们和他们的伴侣在心理上产生了负面影响,紧张他们的关系。
    我们召集了一个国际小组,旨在制定指导临床医生的指南,患者和伴侣了解前列腺癌治疗(PCT)对患者和伴侣性健康的影响,他们的关系,以及前列腺癌(PC)幸存者的生物心理社会康复。
    指南小组包括国际专家研究人员和临床医生,和指导方法学家。对文献进行了系统的回顾,使用OvidMEDLINE,Scopus,CINAHL,心理信息,LGBT生活,根据Cochrane干预措施系统审查手册进行了Embase数据库(1995-2022年)。研究选择基于系统评价和荟萃分析(PRISMA)指南的首选报告项目。每个陈述都被分配了一个证据强度(A-C)和一个建议级别(强,中度,有条件)基于利益/风险评估。数据综合包括对被认为质量足够的研究的荟萃分析(3),使用测量工具评估系统评论(AMSTAR)。
    制定了前列腺癌患者性健康护理指南,基于现有证据和国际小组的专业知识。
    指南对患者的文化、民族,种族多样性。他们关注具有不同性取向和性别认同的个人的独特需求。该指南基于文献综述,PCT术后性恢复的理论模型,和6个原则,促进临床医生发起的对性结果的现实期望的讨论,并通过生物心理社会康复减轻性副作用。47份声明涉及性心理,关系,和功能领域,除了关于生活方式改变的声明,评估,提供者教育,以及在PC幸存者中提供性健康护理的系统性挑战。
    该指南为临床医生提供了全面的前列腺癌患者性健康护理方法。
    这项研究的力量是对前列腺癌性功能障碍和康复的现有证据的综合评估,连同可用的专业知识,最好的基础临床实践。局限性在于支持干预措施的证据的差异以及缺乏对低收入和中等收入国家前列腺癌患者面临的问题的研究。
    指南记录了PCT令人痛苦的性后遗症,提供基于证据的性康复建议,并概述未来研究的领域。WittmannD,MehtaA,麦考恩·E,etal.前列腺癌患者性保健指南:国际小组的建议。JSexMed2022;19:1655-1669。
    Patients with prostate cancer suffer significant sexual dysfunction after treatment which negatively affects them and their partners psychologically, and strain their relationships.
    We convened an international panel with the aim of developing guidelines that will inform clinicians, patients and partners about the impact of prostate cancer therapies (PCT) on patients\' and partners\' sexual health, their relationships, and about biopsychosocial rehabilitation in prostate cancer (PC) survivorship.
    The guidelines panel included international expert researchers and clinicians, and a guideline methodologist. A systematic review of the literature, using the Ovid MEDLINE, Scopus, CINAHL, PsychINFO, LGBT Life, and Embase databases was conducted (1995-2022) according to the Cochrane Handbook for Systematic Reviews of Interventions. Study selection was based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Each statement was assigned an evidence strength (A-C) and a recommendation level (strong, moderate, conditional) based on benefit/risk assessment, according to the nomenclature of the American Urological Association (AUA). Data synthesis included meta-analyses of studies deemed of sufficient quality (3), using A Measurement Tool to Assess Systematic Reviews (AMSTAR).
    Guidelines for sexual health care for patients with prostate cancer were developed, based on available evidence and the expertise of the international panel.
    The guidelines account for patients\' cultural, ethnic, and racial diversity. They attend to the unique needs of individuals with diverse sexual orientations and gender identities. The guidelines are based on literature review, a theoretical model of sexual recovery after PCT, and 6 principles that promote clinician-initiated discussion of realistic expectations of sexual outcomes and mitigation of sexual side-effects through biopsychosocial rehabilitation. Forty-seven statements address the psychosexual, relationship, and functional domains in addition to statements on lifestyle modification, assessment, provider education, and systemic challenges to providing sexual health care in PC survivorship.
    The guidelines provide clinicians with a comprehensive approach to sexual health care for patients with prostate cancer.
    The strength of the study is the comprehensive evaluation of existing evidence on sexual dysfunction and rehabilitation in prostate cancer that can, along with available expert knowledge, best undergird clinical practice. Limitation is the variation in the evidence supporting interventions and the lack of research on issues facing patients with prostate cancer in low and middle-income countries.
    The guidelines document the distressing sexual sequelae of PCT, provide evidence-based recommendations for sexual rehabilitation and outline areas for future research. Wittmann D, Mehta A, McCaughan E, et al. Guidelines for Sexual Health Care for Prostate Cancer Patients: Recommendations of an International Panel. J Sex Med 2022;19:1655-1669.
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  • 文章类型: Journal Article
    澳大利亚和新西兰泌尿外科学会(USANZ)和澳大利亚皇家内科医学院(RACP)的性健康医学澳大利亚分会(AChSHM)的这些临床实践建议提供了有关治疗的循证临床指南。澳大利亚的勃起功能障碍(ED)。
    全面的临床病史和量身定制的体格检查至关重要(证据等级[LoE]3;B级)。实验室检查应包括空腹血糖,血脂和总睾酮水平(LoE3;A级)。在选定的病例中,建议进行专门的诊断测试,并对患者进行相应的咨询(LoE4;B级)。生活方式的改变和现有医疗条件的优化应伴随所有ED治疗方案(LoE1;A级)。口服5型磷酸二酯酶抑制剂(PDE5i)是一种有效的一线药物治疗(LoE1;A级)。推荐使用海绵体内注射和真空勃起装置作为二线治疗(LoE1;B级)。对于医学上难治或无法耐受药物治疗副作用的男性,可以考虑使用阴茎假体植入物(LoE4;B级)。促勃起再生疗法在很大程度上仍是实验性的(LoE3;B级)。
    改变生活方式的行为,可逆风险因素的管理和现有医疗条件的优化仍然至关重要,和现有的标准ED疗法在心血管危险分层后通常是有效和安全的。由于长期结果未知,应谨慎使用再生技术。
    These clinical practice recommendations by the Urological Society of Australia and New Zealand (USANZ) and the Australasian Chapter of Sexual Health Medicine (AChSHM) for the Royal Australasian College of Physicians (RACP) provide evidence-based clinical guidelines on the management of erectile dysfunction (ED) in Australia.
    A comprehensive clinical history and a tailored physical examination are essential (Level of evidence [LoE] 3; GRADE B). Laboratory testing should include fasting glucose, lipid profile and total testosterone level (LoE 3; GRADE A). Specialised diagnostic tests are recommended in selected cases and the patient should be counselled accordingly (LoE 4; GRADE B). Lifestyle changes and optimisation of existing medical conditions should accompany all ED treatment regimens (LoE 1; GRADE A). Oral phosphodiesterase type 5 inhibitor (PDE5i) is an effective first line medical therapy (LoE 1; GRADE A). Intracavernosal injections and vacuum erection devices are recommended as second line therapy (LoE 1; GRADE B). A penile prosthesis implant can be considered in men who are medically refractory or unable to tolerate the side effects of medical therapy (LoE 4; GRADE B). Pro-erectile regenerative therapy remains largely experimental (LoE 3; GRADE B).
    Modification of lifestyle behaviour, management of reversible risk factors and optimisation of existing medical conditions remain pivotal, and existing standard ED therapies are often effective and safe following cardiovascular risk stratification. Caution should be exercised on the use of regenerative technology in ED due to unknown long term outcomes.
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  • 文章类型: Journal Article
    本指南的主要目的是帮助从业人员管理被诊断为阴道毛滴虫(TV)的个体。它提供了诊断测试的建议,有效管理电视所需的治疗方案和健康促进原则。它涵盖了初始演示文稿的管理,以及如何防止传播和未来的再感染。它主要针对16岁或以上的人,向医疗保健专业人员介绍,在英国提供性传播感染(STI)管理专科护理的部门工作。然而,建议的原则适用于各级性传播感染护理提供者(N.B.非专业服务可能需要发展,在适当的情况下,当地护理途径)。
    The main objective of this guideline is to assist practitioners in managing individuals diagnosed with Trichomonas vaginalis (TV). It offers recommendations on the diagnostic tests, treatment regimens and health promotion principles needed for the effective management of TV. It covers the management of the initial presentation, as well as how to prevent transmission and future re-infection. It is aimed primarily at people aged 16 years or older presenting to health care professionals, working in departments offering specialist care in sexually transmitted infection (STI) management within the United Kingdom. However, the principles of the recommendations are applicable across all levels of STI care providers (N.B. non-specialist services may need to develop, where appropriate, local care pathways).
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