Cuts to sexual health service budgets – the rise of home testing and treatment

Posted 8 November 2019 in Sexual Health

A pipette dripping blue chemicals into a test tube of yellow chemicals. Source: medicalimages.comIn recent years, the government has cut funds for public health services across the country. One of the most drastically affected areas is sexual health – between 2016/17 and 2017/18, the budget for sexual health services provided by local authorities was slashed by around 30%. (1)

This has led to the closure of several sexual health clinics nationwide. For the general public, this means more people will be looking at STI home testing and treatment as an option.

What is the difference between STIs and STDs?

In recent decades, there has been a shift from referring to STDs (sexually transmitted diseases) towards referring to STIs (sexually transmitted infections) - in fact, the NHS website refers solely to STIs, with no mention of STDs at all.

This is because not only does the word ‘disease’ hold more grave connotations, but ‘infection’ is the more accurate description since many cases of STIs experience no symptoms, contradicting the image of illness that ‘disease’ implies.

Furthermore, the infection leads to the potential disease, and the infection (not the disease) is what is transmitted from one person to another. For example, AIDS (acquired immune deficiency syndrome) is a disease which can occur as a result of infection with HIV (human immunodeficiency virus). AIDS itself cannot be transmitted from one person to another, despite reference in society and popular culture.

What happens at a sexual health clinic?

You’ll be asked a few questions about your sexual history, medication and medical conditions. This is to make sure you receive the medication that is the most appropriate for you, if you need it.

A sample may then be taken. The type of sample depends on the STI being tested for and can be in the form of urine, a swab of the urethra (the tube through which urine flows from the body), a vaginal swab, a swab from a genital sore, or blood. HIV results may be available instantly but urine and swab samples may need to be sent off to a lab, so the results will be available after a week or two. Dependent on this, you may then receive antibiotic or antiviral treatment. The service is provided confidentially, so your details are kept private and your GP won’t be informed unless you want them to be. (2)

Where can I get a home testing or treatment pack?

Because more and more sexual health clinics are closing, alternative sources of testing and treatment will experience increased demand, including online pharmacies.

At Webmed Pharmacy we offer confidential testing and treatment for a range of STIs, as can be found here.

Below are some examples of STIs for which treatment can be purchased online:

Chlamydia

What’s the test for chlamydia?

Testing for chlamydia involves either taking a sample of urine for men, and a vaginal swab sample for women. (3)

What’s the home treatment for chlamydia?

The first line (ideal) treatment for chlamydia is an antibiotic called doxycycline. The course lasts for a week. (4)

Is the home treatment for chlamydia the same as I would get at a clinic?

Yes. Sexual health clinics, GPs and online pharmacies all follow the same guidelines. The guidelines are those issued by the British Association for Sexual Health and HIV, BASHH.

Gonorrhoea

What’s the test for gonorrhoea?

For men, either a urine sample or a swab of the urethra. For women, a vaginal or cervical swab, and sometimes a swab of the urethra. (5)

At Webmed Pharmacy it’s a urine sample for men and a swab sample for women.

What’s the home treatment for gonorrhoea?

The home treatment is a combination of two different antibiotics, azithromycin and cefixime (Suprax), all taken as a single dose.

Is the home treatment for gonorrhoea the same as I would get at a clinic?

No, because the first line treatment for gonorrhoea is an antibiotic injection into the buttock or thigh, a procedure which is not suitable for home treatment. The home treatment is the second line. (6)

Trichomoniasis

What’s the test for trichomoniasis?

In a sexual health clinic, the healthcare professional will usually examine the area for symptoms, then take a vaginal swab for women, and either a swab of the penis or a urine sample for men. (7)

The home test involves taking either a vaginal swab for women, or a urine sample for men.

What’s the home treatment for trichomoniasis?

The treatment is a course of an antibiotic called metronidazole, either taken as a 2g single dose or as a five-day course. (8)

Is the home treatment for trichomoniasis the same as I would get at a clinic?

Yes. Sexual health clinics, GPs and online pharmacies all follow the same guidelines.

Genital herpes

What’s the test for genital herpes?

Testing is undertaken in a sexual health clinic or GP surgery. It involves taking a swab of a genital sore. If no sores are present, the test can’t be carried out. (9)

What’s the home treatment for genital herpes?

Treatment does not cure genital herpes, but it can help to clear up an outbreak of sores. A five-day course of an antiviral, either aciclovir or valaciclovir, is taken. (9)

Is the home treatment for genital herpes the same as I would get at a clinic?

Yes. Sexual health clinics, GPs and online pharmacies all follow the same guidelines.

Genital warts

What’s the test for genital warts?

Testing for genital warts is done at a sexual health clinic or at your GP surgery. Diagnosis is in the form of an examination of the area. (10)

What’s the home treatment for genital warts?

Imiquimod (Aldara) cream can be used for any type of external genital warts – soft or hard, and in the genital or anal area. It is applied three times weekly for several weeks until warts have cleared. (11)

Podophyllotoxin (Warticon) is an alternative that comes as a cream or a topical solution. It can only be used on external soft warts of the genital area. It is applied for three consecutive days each week for a total of four weeks. (11)

Is the home treatment for genital warts the same as I would get at a clinic?

It depends on several factors, including how big your warts are and where they are positioned. A doctor or nurse may freeze, cut, burn or laser the warts off if topical treatments aren’t suitable or haven’t worked. (10)

How quickly can I get a test kit delivered?

If you order before 4pm Monday to Friday, then your test kit will be delivered the next working day by tracked delivery. The packaging is very discreet with no mention of the contents or who it’s from.

How quickly will I receive my test results?

The time taken for test results varies according to the test ordered.

For HIV lab tests we receive the results within 24 hours of the lab receiving your test sample.

For most other tests we receive results within 48 hours of the lab receiving your test sample.

What are the advantages of ordering online?

The advantages of ordering from us at Webmed Pharmacy are that you can order and test in the comfort of your own home at a time that is most suitable to you and receive your test results much quicker than you would from a sexual health clinic. It also saves the embarrassment of having to attend a clinic if you can still find one that’s near to where you live or work with all the recent cut-backs.  

References

  1. British Medical Association. Feeling the squeeze: The local impact of cuts to public health budgets in England [cited 9 October 2019]. Available at: https://www.bma.org.uk/-/media/files/pdfs/collective%20voice/policy%20research/public%20and%20population%20health/public-health-budgets-feeling-the-squeeze-briefing-march-2018.pdf?la=en

  2. NHS. Visiting an STI clinic [cited 9 October 2019]. Available at: https://www.nhs.uk/live-well/sexual-health/visiting-an-sti-clinic/

  3. NHS. Chlamydia – Diagnosis [cited 9 October 2019]. Available at: https://www.nhs.uk/conditions/chlamydia/diagnosis/

  4. NHS. Chlamydia - Treatment [cited 9 October 2019]. Available at: https://www.nhs.uk/conditions/chlamydia/treatment/

  5. NHS. Gonorrhoea – Diagnosis [cited 9 October 2019]. Available at: https://www.nhs.uk/conditions/gonorrhoea/diagnosis/

  6. NHS. Gonorrhoea – Treatment [cited 9 October 2019]. Available at: https://www.nhs.uk/conditions/gonorrhoea/treatment/

  7. NHS. Trichomoniasis [cited 9 October 2019]. Available at: https://www.nhs.uk/conditions/trichomoniasis/diagnosis/

  8. NHS. Trichomoniasis – Treatment [cited 9 October 2019]. Available at: https://www.nhs.uk/conditions/trichomoniasis/treatment/

  9. NHS. Genital herpes [cited 9 October 2019]. Available at: https://www.nhs.uk/conditions/genital-herpes/

  10. NHS. Genital warts [cited 9 October 2019]. Available at: https://www.nhs.uk/conditions/genital-warts/

  11. British National Formulary (version 2.1.23) [Mobile application software]. Retrieved from: www.bnf.org

    Author
    Gabby Gallagher MPharm

    Medically reviewed by
    Superintendent pharmacist Margaret Hudson BSc(Hons) MRPharmS
     6th November 2019

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