Comprehensive screening
Consultation, examination and testing are undertaken in one attendance. Every site of potential exposure can be sampled, including the throat and rectum, since infection at those sites is common and produces no symptoms. Testing is for HIV, Hepatitis B, Hepatitis C, Syphilis, Chlamydia, Gonorrhoea, Herpes, Mycoplasma genitalium, Ureaplasma, Trichomonas Vaginalis, Gardinella Vaginalis, Candida and Human Papilloma Virus. We offer tests separately and can deliver cervical smears with sedation.
Centre for HPV Medicine
Human papillomavirus causes disease at the cervix, the anus, the penis and the throat, and the Centre assesses it at each. For women, cervical testing uses extended genotyping to identify the specific high-risk type, to distinguish infection that will clear from infection that is progressing. For both sexes, anal testing with cytology and, where indicated, high-resolution anoscopy on the THD HRStation, which few clinics in London offer, and oropharyngeal testing for the throat. For men, for whom no approved screening test exists, penile genotyping is available and always accompanied by counselling on what the result can and cannot mean. The Couples HPV Pathway assesses both partners together, and nine-valent vaccination is provided at any age at which it may confer benefit.
Prevention
Prevention is provided on the same day it is discussed, with the monitoring each measure requires. Pre-exposure prophylaxis against HIV is prescribed for daily or event-based use, with the kidney and sexual health monitoring that accompanies it; post-exposure prophylaxis is available within the window in which it is effective, and doxycycline post-exposure prophylaxis where appropriate. Vaccination against hepatitis A and B, mumps and meningococcal disease is provided.
Treatment
Treatment is directed by sensitivity testing wherever it is available, so that the antimicrobial chosen is the one the organism will respond to. Genital warts are treated by the method suited to their site and extent — cryotherapy, topical therapy, electrocautery, laser or excision — and herpes simplex is managed for both the episode and its recurrence. Recurrent bacterial vaginosis and candidiasis, and persistent urethritis, are investigated to their cause rather than treated repeatedly, and where a cause lies elsewhere in your health it is pursued with the relevant department.
Sexual function
Difficulties with sexual function are assessed for their cause, jointly with Men’s health or Women’s health as appropriate, because the cause is frequently vascular, hormonal or physical rather than psychological, and is treatable when found. Erectile dysfunction and premature ejaculation, vaginismus and dyspareunia, and reduced libido are each investigated and psychosexual consultation is offered during discussion of the potential treatment options.
Support
Support is provided discreetly and without any requirement to disclose more than you choose. Partner notification is undertaken on your behalf and anonymously where you prefer. Where a consultation reveals a need beyond the department referral is made to a named specialist, with your consent and with your consultant remaining involved.
