Travellers and mobile workers
Scenario_2_v2.mp4 from ASHM on Vimeo.
Joey– 23-year-old who identifies as male (he/him) and heterosexual attends clinic for travel vaccinations as travelling to Philippines for three-week holiday. Joey has not had an STI screen in several years, and only had sex with people with a vagina. Joey is in a hurry as he has another appointment to attend. The practice nurse administers Joey’s travel vaccinations.
Clinical indicator
- Young person (< 30 years old).
- Travellers and mobile workers
Key learnings and take away
- Normalising – Normalising STI screening as part of a ‘travel health’ consult.
- Normalising – The common belief that people will know they have an STI but in fact the majority of STIs are asymptomatic.
Scenario_11_v2.mp4 from ASHM on Vimeo.
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.
Clinical indicator
- 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.