Whether it’s hiking in Patagonia, surfing in Indonesia, eating sushi in Tokyo, and everything in between, travel is often a time of adventure, relaxation, and new experiences. Travel can also be a time when people engage in sexual behaviours outside of their usual patterns and increase their exposure to different sexual health risks. As healthcare professionals (HCPs), including GPs, nurses, and nurse practitioners, are likely to encounter patients before they embark on overseas travel, or those who have just returned, HCPs are well placed to discuss sexual health with travellers.
To aid in this, ASHM has developed an on-demand learning module to introduce HCPs to typical sexual health travel concerns, and to give practical skills on how to raise these concerns with patients in a way that is informative, and non-judgemental.
The online learning module (OLM) was developed with several clinical advisors, including Dr Deb Mills, a pioneer of travel medicine in Australia. Speaking to ASHM, she believes sexual health travel consultations are an area all HCPs can upskill in.
“People are catching sexually transmitted infections overseas and travellers are very unaware of the dangers. [Additionally], doctors have not had a lot of training raising this issue, so doctors are not talking about it and they’re missing opportunities to help people avoid these kinds of illnesses,” she says.
One reason she believes practitioners may overlook this element of travel consults comes down to assumptions about patients.
“Doctors can also be making judgements about who is going to be sexually active when they’re overseas, and these judgements have been shown to be wrong,”
“They have this idea of who needs to have this discussion, but it's actually always much broader than that. You cannot pick who is planning to have sex. You just cannot pick it.”
Another reason Dr Deb believes doctors might be leaving sexual health out of travel consults is a lack of confidence bringing up the topic. However, she emphasises that doctors are well placed to start the conversation.
“Patients are remarkably comfortable discussing things with their doctors. They really trust their doctors, especially their GP, so if the GP thinks of [sexual health] as normal, the patients will too,”
“The patients will kind of buy into their sense that it's a normal thing to discuss, so it really is very important for it to be a normal thing for GPs to discuss.”
She believes that sexual health is something that can easily be added to GPs travel health consultations with patients, and that it needn’t be complicated.
“If you’re talking to people about diarrhea and altitude and motion sickness and those sorts of things, it’s worth having sexually transmitted infections in your repertoire too.
“But the most important thing is to flag it with people, because people just do not realise they are personally going to be at risk.
“Having their GP say, ‘you need to have a test before you go, you need to have a test when you come back, condoms are important,’ has such weight and such importance and can make such a difference to people's safety.”
She highlights that it’s not only doctors who can raise sexual health travel concerns with patients.
“Nurses have a very important role to play here, because people believe their nurses and nurses have more time with the patient,” says Dr Deb.
“I would encourage nurses to do this module as well because it will give them more comfort and understanding about what the evidence base is, who the groups are, and what sort of things need to be done.”
Upon completing this course, HCPs will be able to identify travellers to start conversations about sexual health with and apply strategies for normalising these discussions. For patients heading away, you will be able to identify what leads to increased STI risk during travel and recommend appropriate medications and vaccinations. For those recently returned, you’ll learn to apply current guidelines for asymptomatic STI testing and outline post-travel STI care and follow-up, including referral to sexual health clinics, and access useful written information to share with travellers.
GPs and other medical professionals can complete the on-demand module now and gain 1 CPD point.
