Sexual Health
AKT High-Yield Breakdown
Sexual health in primary care covers STI diagnosis and management, HIV testing and antiretroviral therapy principles, contraception, and safeguarding considerations. The AKT tests empirical treatment protocols, partner notification principles, PEP and PrEP indications, and UKMEC contraception categories in specific patient scenarios.
What You'll Learn
Master the empirical STI treatment protocols, chlamydia screening criteria, syphilis stages and treatment, HIV testing thresholds, PEP and PrEP eligibility, gonorrhoea resistance patterns, and the UKMEC 3/4 contraindications that are highest-yield for the AKT.
Practise Sexual Health MCQs
From gonorrhoea resistance and chlamydia screening to PEP and PrEP eligibility, syphilis staging, emergency contraception choices, and HIV indicator conditions — tackle focused MCQs across the full Sexual Health curriculum.
Chlamydia and Gonorrhoea
Chlamydia is the most commonly diagnosed STI in England. Gonorrhoea is the second most common bacterial STI and of increasing concern due to antimicrobial resistance.
Chlamydia (Chlamydia trachomatis)
National Chlamydia Screening Programme (NCSP): offer chlamydia testing to all sexually active young people under 25 attending primary care, regardless of symptoms. Nucleic acid amplification test (NAAT) on urine (males) or self-taken vulvovaginal swab (females) — most sensitive method.
- Often asymptomatic (50% females, 70% males); when symptomatic: urethral discharge, dysuria, pelvic pain, postcoital/intermenstrual bleeding in females
- Complications: pelvic inflammatory disease (PID), tubal infertility, ectopic pregnancy, epididymo-orchitis, reactive arthritis (Reiter's syndrome: urethritis + conjunctivitis + arthritis)
- Treatment: doxycycline 100 mg BD for 7 days (first-line — superior cure rate to azithromycin); azithromycin 1 g stat (single dose) if adherence concern or doxycycline contraindicated
- Doxycycline in pregnancy: contraindicated; use azithromycin or amoxicillin instead
- Test of cure: only required in pregnancy, pharyngeal infection, or if re-exposure suspected
- Partner notification: all sexual partners in the last 6 months should be tested and treated empirically
Gonorrhoea (Neisseria gonorrhoeae)
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