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Risk assessment, referral skills
- 1. Dr. Meenakshi Sharma Specialist Dept Obstetrics & Gynaecology DHAS 2012
- 2. Her husband is a migrant worker Her husband has other partners She is a street child She is a sex worker Her partner has had STI/RTI
- 3. It requires asking difficult, sensitive questions Clients may feel embarrassed about answering such questions, especially if the provider is of opposite sex
- 4. Clients may not understand the questions being asked since some of the scientific words or sentences cannot be translated in local language Information given may be inaccurate, poorly recalled, or untruthful
- 5. Ensuring the client that the confidentiality will be maintained Risk assessment is most effective when the questions are developed according to local needs and conditions Tailoring questions to reflect local STI/RTI prevalence Making questions more culturally appropriate Ways to help clients assess their own risk (self-assessment)
- 6. If history suggests symptoms of STI/RTI including HIV/AIDS Patient is a known case of STI/RTI and gives symptoms suggestive of reinfection If there is Partner history of STI/RTI If there is history of risky sexual behavior ANC cases having symptoms History of recent abortion and symptoms like fever or pain abdomen Post natal women with symptoms of infection
- 7. Patient should be referred to the nearest center where facilities for managing STI/RTI are available i.e. to PHC or Rural hospital, District hospital Voluntary testing for HIV/AIDS is done at ICTC centers
- 8. Patient record to be maintained properly along with history, symptoms, diagnosis and referral history Patient to be advised properly where and how to go Referral slip to be given with clear directions of where to go Partner should ideally accompany the patient Patient should be advised for follow up visit Patient should carry the old records with them
- 9. Framing statement “In order to provide the best care for you and to understand your risk for certain infections, it is necessary for us to talk about your sexual behavior.” Screening questions Have you recently developed any of these symptoms?
- 10. For men Discharge or pus (drip) from the penis Urinary burning or frequency Genital sores (ulcers) or rash or itching Scrotal swelling Swelling in the groin Infertility
- 11. For women Abnormal vaginal discharge (increased amount, abnormal odor, abnormal color, consistency) Genital sores (ulcers), rash or itching Urinary burning or frequency Pain in lower abdomen Dysmenorrhoea, menorrhagia, irregular menstrual cycles? Infertility
- 12. For all adolescents: Have you begun having any kind of sex yet?
- 13. If sexually active do you use condom consistently?
- 14. Do you have any reason to think you might have a sexually transmitted disease? If so, what reason?
- 15. Have you had sex with any man, woman, with a gay or a bisexual?
- 16. Have you or your Partner had sex with more than one Partner? Has your sex Partner(s) had any genital infections? If so, which ones? Do you indulge in high risk sexual activity like anal sex Do you practice correct and consistent condom usage while having sex? If yes, whether every time or sometimes?
- 17. Has your sex Partner(s) had any genital infections? If so, which ones?
- 18. Do you indulge in high risk sexual activity like anal sex
- 19. Do you practice correct and consistent condom usage while having sex? If yes, whether every time or sometimes?