Junior - 37-year-old who identifies as male (he/him) who three years ago immigrated from Africa to the Northern Territory. He attends the sexual health centre for a routine STI screen. Junior regularly attends the clinic given he is a sex worker. Junior has sex with both male and female (including people with a penis and vagina) partners for work and uses condoms most of the time. Recently a rash has appeared on Junior’s penis. Junior has been searching the internet regarding his symptoms and signs. You address the misinformation from online platforms.
- Culturally and linguistically diverse people
- Syphilis Outbreak region
- Sex worker
Key learnings and take away
- Normalising – Normalising the reasons for asking the types and depth of questions to determine what tests need to be performed. Although Francisco is a regular patient and had previous sexual health check-ups this is still important.
- Normalising – The role of the internet when searching for answers related to health but also the way in which the internet may reinforce anxiety related to health concerns.
- Role of assumptions – Without the right questioning and making assumptions that Junior might not have sexual contact outside work a full understanding regarding his risk profile might not be obtained.
Vaughn - 68-year-old who identifies as male (he/him) and attends clinic for a routine diabetes monitoring. Vaughn’s wife of 35 years passed away two years ago. Recently Vaughn met Astrid 71-year-old who identifies as female (she/her)), and they have commenced a sexual relationship. Vaughn does not see the need to use condoms as Astrid cannot get pregnant. Prior to meeting Astrid, Vaughn had visited Thailand on multiple occasions and engaged sexually with sex workers. Vaughn notes penile discharge, but this does not cause him any discomfort.
- Unprotected sexual activity
- Sex worker (partners)
- Penile discharge
Key learnings and take away
- Normalising – Normalising the reasons for asking the types and depth of questions to determine what tests need to be performed.
- Role of assumptions – Without the right questioning in this scenario and possible assumptions being made about Vaughan being married for many years and newly widowed, it may have resulted in him not having the correct tests and his presenting problem being assumed to be prostate issues due to his age.
- Role of assumptions – If assumed Vaughan had not had any sexual contact since the passing of his wife, it would mean the opportunity would have been lost to discuss safer sex but also different risks due to having sexual contact with someone from a high-risk country due to the increased prevalence of HIV in Thailand.
- Importance of language – Note that Vaughan refers to a sex worker as a prostitute. Sex workers preferred to be titled this as this implies sex work is like every day labour as opposed to prostitute can be associated with describing a victim.