Tables, figures, and boxes are indicated by an italic t, f, and b following the page number.
A
abacavir (ABC) hypersensitivity reaction 640
acalculous cholecystitis 506
access to clinics 6
accessory proteins 459t
aciclovir resistance and anogenital herpes 285
actinomyces-like organisms (ALOs) 179
adoption 654
advance decisions/statements 36
Age of Legal Capacity (Scotland) Act 1991: 21
agglutination and syphilis 127
aggressive patients 48
aims of GUM services 4
amiodarone and epididymo-orchitis 195
amoebiasis: Entamoeba histolytica 253, 265–266
anal canal and anogenital warts 301–302
anal carcinoma 618
anal problems and sexual problems 435
anaphylactic shock 133
angiokeratomas 346
animals, sex with 51
anogenital blisters or ulcers in children 112t
common benign lesions/anomalies 346
degenerative condition 347
genital allergic contact hypersensitivity 348b
infective conditions 347
inflammatory conditions 348–351
malignant conditions 356
premalignant conditions 354–355
aetiology 278
diagnosis 282
epidemiology and transmission 279
and HIV 289b
and male condoms 406b
pregnancy and neonatal infection 286–288
terminology 278
ulceration, causes of 281b
anogenital infections and gonorrhoea 139, 147
anogenital squamous cell carcinoma 292t
anogenital ulceration 87f, 87b
aetiology 292
clinical features 294
epidemiology and natural history 293
HIV 304b
human papilloma virus types in lesions 292t, 302–303b, 304b
frequently asked questions 297–299b, 302–303b
sexual partners 301
treatment algorithm 298f, 299f
pregnancy and infection in neonates and children 101, 296
relative frequency of location of 294t
transmission 293
anorectal stimulation 50
anorectal syndrome 249
anterior uveitis 517
antibiotics
and genital candidiasis 236
and oral contraceptives 414b
sexual assault management 108b
sexually acquired reactive arthritis 210
antibodies and anogenital herpes 282
antifungals 490
antiretroviral drugs
for HIV during pregnancy and labour 655
and hormonal contraception 414b
antiviral management and anogenital herpes 284, 285
arousal with body fluids 50
arthralgia 597
gonococcal 143
HIV-associated 597
psoriatic 598
reactive 598
septic 599 see also sexually acquired reactive arthritis
assisted conception 654
Atopobium vaginae 215
attendance confirmation 7
atypia 358
availability of services 6
azoles and genital candidiasis 242b
B
bacillary angiomatosis 554–555
bacillary dysentery 264
bacteria 264
aerobic 215
anaerobic 215
bacterial infection and HIV 489, 524b, 554–555, 565, 567b
bacterial pneumonia 527
bacterial vaginosis (BV) 65, 94, 213–224
altered vaginal discharge 85f
anaerobic and G. vaginalis -associated balanitis/balanoposthitis 224
-associated organisms in pelvic inflammatory disease 171
associations 217
children 115
clinical features 217
complications 218
HIV 224b
microscopy accuracy 75t
pregnancy 98
bacteriuria, asymptomatic 270
balanitis and balanoposthitis 83f, 224, 241
Bancroftian filariasis 253
Bartholinitis and Bartholin’s cyst and abscess 142, 153, 380
biliary tract disease 505
biological false-positive reactions and syphilis 125b
bone marrow infiltration 604–605
bone mineral dysfunction 579
boric acid 243
breastfeeding 147, 158, 222, 338
HIV 658
Brucella spp. 194
Brugia malayi 194
bullous impetigo 554
C
Caesarean section and anogenital herpes 288
Campylobacter infection 264
Candida spp. 66
candidal endophthalmitis 520
candidal oesophagitis 493
candidiasis 94
accuracy of microscopy 75t
altered vaginal discharge 85f
epidemiological treatment for contacts 91t
pregnancy 98
pseudomembranous 489–490 see also genital candidiasis
candour, professional duty of 31
capacity 19
cardiovascular disease 593
cardiovascular disorders see HIV: cardiovascular disorders
catheterized patients and urinary tract infection 270
cellular response and HIV primary infection 481
cerebral toxoplasmosis (Toxoplasma gondii) 543
cerebrospinal fluid examination and syphilis 127–128, 128t
cerebrovascular disease 549
cervical cytology technique and guidance 360b
chlamydia 153
classification 361t
clinical features 359
diagnosis 362
glandular intra-epithelial (CGIN) 358, 362, 363
HIV and cervical carcinoma 364
intra-epithelial (CIN) 358, 361t, 362, 363
invasive cervical carcinoma 358, 362
management 363
pregnancy 364
primary prevention 363
risk factors 359
cervical polyp 380
cervix, histology of the normal 358
chancroid 87f, 91t, 94, 246–247
chaperones and intimate examinations 32, 32b
children 48
assessment for risk 23b
bacterial vaginosis 115
chlamydia 114
gonorrhoea 114
herpes 114
HIV 114
protection issues 21
sexual assault 110–115, 110–115b
sexual exploitation 24–25, 25b, 26b
sexually transmitted infections 111
trichomoniasis 115 see also infant; neonates/neonatal; prepubertal infection
Chlamydia trachomatis 64, 86f, 94, 149–159
aetiology 150
children 114
complications 153
epidemiological treatment for contacts 91t
epidemiology and transmission 151
lymphogranuloma venereum 248
and male condoms 406b
nucleic acid amplification test 64, 107–108t, 156
pelvic inflammatory disease 171
point of care tests 76
pregnancy and the neonate 98, 154–155
sexually acquired reactive arthritis 203
cholangiopathy, HIV-associated 505
circumcision and anogenital herpes 285
cisgender 42
Clinical Commissioning Groups 60
clinical psychology and vulval pain syndromes 371
clitoridectomy 29b
coagulation disorders 606
coliform enteric bacteria and epididymitis 194
colposcopy 362
coming out 44
competence (of children) 20–21
computed tomography angiography and syphilis 128
condoms and anogenital herpes 285
congenital infection and syphilis 119, 123–124, 124b, 129, 132
conjunctival infection/conjunctivitis
gonococcal 147
sexually acquired reactive arthritis 205
conjunctival microvasculopathy 515
conjunctival squamous cell carcinoma 516
connective tissue/autoimmune diseases 567b
forensic assessment for sexual assault 109
contact dermatitis 348
cautions and contraindications 417–427t, 416
coitus interruptus (‘withdrawal’) 408
combined hormonal contraceptives including combined pill, vaginal ring, and patch 417–427t, 384–386, 385b, 386t, 415
copper intra-uterine device 417–427t, 400–401, 401t, 410
depot medroxyprogesterone acetate 417–427t, 415
diaphragms and caps 402
efficacy 383t
female condom 403
female sterilization 411, 412b, 414
fertility awareness methods 407
and genital candidiasis 236
intra-uterine devices 415
lactational amenorrhoea method 408
levonorgestrel intra-uterine system 417–427t, 397–398, 399t, 409
male sterilization: vasectomy 413, 413b, 414
progestogen-only pill 417–427t, 388–389, 389t, 390b, 409, 415
spermicides 404
transgender/non-binary people 46
UK Medical eligibility criteria for contraceptive use guidelines 417–427t
ulipristal acetate emergency contraception 409–410
core (HIV structure) 458
co-receptors 462
court appearances 37
cowperitis and abscess 141
Coxsackie virus B 194
Criminal Law (Consolidation) (Scotland) Act 1995: 27–28
criminalization of HIV transmission 35
cryotherapy 298f, 299f, 300–301, 613
cryptococcosis 556
cryptosporidiosis: Cryptosporidium spp. 265, 495–496
cystitis 271
Cystoisospora belli (formerly Isospora belli ) 497
cystoisosporiasis 497
cytomegalovirus (CMV) 94, 194, 264, 326
oesophagitis 494
pneumonitis 537
D
Data Protection Act 1998: 34
death 36
death certificates 36
deinfibulation 29b
demographic risk factors 48–49
dermatological disorders see HIV: dermatological disorders
dermatological infection and sexually acquired reactive arthritis 206, 211
dermatophytosis 556
desensitization and genital candidiasis 243
diabetes mellitus and genital candidiasis 236
diarrhoea and travellers with HIV 662
diffuse idiopathic lymphocytic syndrome (DILS) 597
dilated cardiomyopathy 591
disability 6
disseminated gonococcal infection (DGI) 142, 147
distal symmetric polyneuropathy 548
distressed patient 48
doctors 4
donovanosis see granuloma inguinale
drug/drugs
-associated cardiovascular disorders 593
-facilitated sexual assault 102
reactions and dermatological disorders in HIV 562
resistance and genital candidiasis 241
resistance testing 648
side effects in HIV management 640–641
toxicity and neuropathy 547
use of during sex 51
dyskaryosis 358
dysphagia investigations 493
dysuria 272
E
Ebola 327
ecthyma 554
ectopic pregnancy 174
ectopic sebaceous glands (Fordyce spots) 346
eczema 558
ejaculation
1–2 hours before coitus 438–439
ejaculatory pain 440
elderly patients and urinary tract infection 271
electronic technology 34
emotional implications of Kaposi’s sarcoma 612
Encephalitazoon intestinalis 496
endemic treponematoses 255–258
endemic syphilis (bejel, dichuchwa) 258
management 258
pinta 257
yaws (framboesia, pian, buba) 257
endocrine disturbances in HIV 572, 573–575
endometritis 153
causes of diarrhoea 500b
chronic diarrhoea evaluation in HIV 499f
cystoisosporiasis 497
microsporidiosis 496
shigellosis 498
Enterocytozoon bieneusi 496
entry inhibitors 630t
envelope (HIV structure) 458
enzyme immunoassay (EIA)
eosinophilic pustular foliculitis 559
epidemiological studies 31
epidermal naevi 346
epidermoid cysts 346
epididymal cysts 379
clinical features 196
complications 196
epidemiological treatment for contacts 91t
investigations 197
management 200
episcleritis 205
epispadias 378
Epstein–Barr virus (EBV) 94, 324, 324b, 610
erectile dysfunction 436–438, 437t
erythema 348
nodosum 206
erythrasma 347
erythroderma 562
Escherichia coli 194
ethical, medico-legal, and sociocultural issues 15–39
confidentiality 17
death 36
electronic technology 34
female genital mutilation 29–30
HIV-infected healthcare workers 36
intimate examinations and chaperones 32
partner notification issues 35
statements and court appearances 37
evidence and sexual assault 109
excoriation 348
expressed prostatic secretions (EPS) 186b
extra-mammary Paget’s disease 354
eye disorders see HIV: eye disorders
eyelashes and pediculosis 344
F
factitious illness 431
Fanconi’s syndrome 641
female genital mutilation 29–30, 29b
female to male (FtM) 43
females see women
fertility treatment 654
filarial organisms 194
Fitz–Hugh–Curtis syndrome see perihepatitis
fixed drug eruption 349
5-fluorouracil 5% cream 300–301
focal neurological signs and symptoms 541b
folliculitis 554
food and water for travellers with HIV 662
foreign bodies 274b
forensic assessment/testing and sexual assault 104, 109
Fraser Ruling (Gillick competence) 20, 21
free treatment 59
fungal infection 194, 489–490, 524b, 535–536, 555–556, 565, 567b
G
gabapentin 370t
Gardnerella vaginalis 215
gastrointestinal disorders see HIV: gastrointestinal disorders
gastrointestinal disturbance 640
sexual health 46
gender dysphoria 43
gender expression 43
gender non-conforming 43
Gender Recognition Act 2004: 45
gender role 43
general examination 55
genetic susceptibility and HIV disease progression 463
genital allergic contact hypersensitivity 348b
aetiology 234
chronic mucocutaneous 238b
diagnosis 239
epidemiology and transmission 235
and HIV 244b
predisposing factors 236
standard antimycotics 242b see also vulvo-vaginal candidiasis, recurrent
genital infections
chlamydia 158
epididymo-orchitis 194
and gonorrhoea 147 see also mucopurulent cervicitis; non-gonococcal urethritis; tropical genital and sexually acquired infections
genital lesions and sexually acquired reactive arthritis 206
genital lumps and bumps 89f
genital reassignment/reconstructive surgery 44–45
genital stimulation using mouth 50
genotyping 648
giant condyloma of Buschke and Lowenstein 294
giardiasis: Giardia duodenalis 265
glans penis material 74
gonococcal dermatitis 142
accuracy of microscopy 75t
aetiology 138
children 114
clinical features 140–142, 140t
epidemiological treatment for contacts 91t
epidemiology and transmission 139
and HIV infection 148
infectivity and clearance rates 139b
and male condoms 406b
point of care tests 76
pregnancy and the neonate 98, 143–144 see also Neisseria gonorrhoeae
Gram-negative diplococci (GNDC) 73, 74
Gram-stained smear 71
cervical 73
urethral 74
from urine 74
vaginal 73f
granuloma inguinale 95, 251–252
anogenital ulceration 87f
and epidemiological treatment for contacts 91t
granulomatous diseases 567b
granulomatous orchitis 195
group B β-haemolytic streptococci 79
Guinea worm infestation 253
H
haemangioma 346
haematological disorders 604–606
haematospermia 183b
haemoglobin 273
Haemophilus ducreyi 246
Haemophilus influenzae 97
Haemophilus parainfluenzae 194
hair follicles, prominent 346
head and neck carcinoma 292t
headaches and HIV 541b
health advisers (HAs) 5, 5b, 9–11
healthcare workers, HIV-infected 36
Helicobacter pylori infection 264
hepatitis A virus (HAV) 95
epidemiological treatment for contacts 91t
vaccination 478
hepatitis B virus (HBV) 95
co-infection with HIV 509–510, 510b, 610, 623, 655
epidemiological treatment for contacts 91t
immunization and sexual assault management 107t
and male condoms 406b
vaccination 478
hepatitis C virus (HCV) 95
co-infection with HIV 511–512, 511b, 512b, 610, 623, 655
immunization and sexual assault management 107t
pregnancy 99
hepatocellular carcinoma (HCC) 619
hepatotoxicity 640
herbal treatment and anogenital herpes 285
herpes simplex virus (HSV) 65–66, 95
anal 501
anogenital ulceration 87f, 87b
children 114
pregnancy 99 see also anogenital herpes
herpes zoster (shingles) 547
herpes zoster ophthalmicus 515
hidradenitis-like plaques 554
hidradenitis suppurativa 351
high-grade squamous intraepithelial lesions of the genital tract 354–355
histoplasmosis 556
HIV 96
anogenital herpes 289b
anogenital warts 304b
-associated wasting syndrome 580
bacterial vaginosis 224b
cervical carcinoma 364
children 114
chlamydia 159
clinical indicator conditions 471b
clinical staging 466–467, 466t, 467t
desensitization schedule for trimethoprim–sulfamethoxazole 650t
diagnosis and assessment 469–478
endocrine disturbances 572
epidemiological treatment for contacts 91t
epididymo-orchitis 200b
genital candidiasis 244b
gonorrhoea 148
hepatitis virus co-infection 507–512
-infected healthcare workers 36
and male condoms 406b
metabolic disorders 572, 576–579
Molluscum contagiosum 308
natural history of untreated infection 468, 468f
pelvic inflammatory disease 179
point of care tests 77
-positive women and contraception 414–415
post-test counselling 476, 476b
pregnancy 99
prophylaxis and sexual assault management 107t, 108b
prostatitis/chronic pelvic pain syndrome 191b
psychological aspects 430, 441b
scabies 335
sexually acquired reactive arthritis 212b
and syphilis co-infection 135
testing
infants 657
and risk assessment 471–475, 471b, 472–474b, 473t, 474t
transgender/non-binary people 46
transmission, criminalization of 35
and trichomoniasis 232b
HIV: cardiovascular disorders 589–593
cardiac neoplasia 592
cardiovascular disease 593
dilated cardiomyopathy 591
drug-associated disorders 593
endocarditis 591
myocarditis 590
pericardial effusion 590
pulmonary hypertension 592
venous thrombosis 592
HIV: dermatological disorders 471b, 551–562
drug reactions 562
inflammatory conditions 558
pruritic follicular and papular eruptions 559
scabies 557
biological implications of types and subtypes 452
history 450
origin 451
risk factors and transmission routes 454, 454t
anterior segment of eye 517
neuro-ophthalmic manifestations 521
ocular surface and adnexa 515–516
posterior segment of eye 518–520
HIV: gastrointestinal disorders 485–506
biliary tract disease 505
pancreatic diseases 503 see also enteric diseases; oral diseases
HIV: malignancies 609–619, 624
anal carcinoma 618
hepatocellular carcinoma 619
Hodgkin’s disease 617
invasive cervical carcinoma 617
leiomyosarcoma 618
lung cancer 618
multicentric Castleman’s disease 617
non-Hodgkin’s lymphoma 614–616
adherence 626
antiretroviral drug–drug interactions 643, 644t
antiretroviral side effects 640–641
characteristics of commonly used antiretrovirals 630t
chronic infection 623
entry inhibitors 630t
HIV life cycle and points of drug action 628f
immune reconstitution 642
initial treatment 625
integrase inhibitors 630t
monitoring and follow-up 633–637, 634t
non-nucleoside reverse transcriptase inhibitor 630t
nucleoside/nucleotide reverse transcriptase inhibitor 630t
opportunistic infections 623
pharmacokinetic boosters 630t
primary infection 623
prognosis according to CD4 cell count and viral load 624f
prophylaxis against infections 650–651, 650t
protease inhibitor 630t
recommended first-line antiretroviral regimens 629t
stopping antiretroviral therapy 639
switching antiretroviral therapy 639
virological failure 649
HIV: musculoskeletal disorders 595–601
immunity pathogenesis 596
infections 599
inflammatory arthropathies 597–598
muscle disease 601
neoplasia 600
osteopenia and osteoporosis 600
rheumatic disease 601
HIV: neurological disorders 539–549
autonomic neuropathy 545
cerebrovascular disease 549
meningitis 544
neoplastic disease 549
neurosyphilis 549
peripheral nerve disease 547–548
spinal cord disease 546
symptom complexes 541b
factors influencing disease progression 463
genetic organization 459, 459t
receptors 462
binding/attachment 460
fusion 460
integration 460
maturation 461
proviral transcription and translation 461
reverse transcription 460
budding 461
antenatal management 656
antiretroviral treatment 655
infant feeding 658
labour and delivery 656
monitoring 655
neonates 657
pre-conception 654
screening 655 see also contraception
post-exposure prophylaxis 445–446, 445b, 446b
pre-exposure prophylaxis 446, 447, 447b
treatment as 623
HIV: primary infection 479–484
clinical features of acute seroconversion illness 482, 483t
immune responses 481
management 484
prevalence of acute seroconversion illness 482
HIV: pyrexia of unknown origin 563–570
aetiology 565
management 568
Mycobacterium avium complex 569
visceral leishmaniasis 570
acute renal failure and HIV seroconversion 585
assessment 582
drugs and renal disease 586, 587t
end-stage renal disease 588
HIV-associated nephropathy 583
immune-mediated renal disease 584
interstitial nephritis 585
thrombotic microangiopathy 585
HIV: respiratory disorders 524–525
bacterial pneumonia 527
chest X–ray appearances 526t
cytomegalovirus pneumonitis 537
mediastinal and hilar lymphadenopathy 537
pneumocystis pneumonia 528–530
pulmonary aspergillosis 535–536
pulmonary cryptococcosis 535
pulmonary vascular disease 537–538
spectrum of illnesses 524b
HIV: reticulo-endothelial disorders 471b, 603–607
haematological disorders 604–606
persistent generalized lymphadenopathy 607, 607b
diarrhoea 662
food and water 662
planning 660
Hodgkin’s disease 617
hormonal factors and genital candidiasis 236
human herpes virus-8 (HHV8) 95, 329, 610
human papilloma virus (HPV) 96
anogenital and male condoms 406b
and anogenital warts 292t, 304b
DNA triage 360
human T-cell lymphotropic virus 1 (HTLV-1) 328
-associated myelopathy 546
humoral response and HIV primary infection 481
hypernatraemia 578
hypersensitivity and condoms 405
hypersensitivity and dermatoses 348
hypersensitivity and drug reactions 527, 560, 628–629, 631, 638, 640
hypersensitivity and genital candidiasis 237–238, 241
hypersensitivity and scabies 335, 343
hypertrophic osteoarthropathy 597–598
hyphae 239
hypochondriasis 431
hyponatraemia 578
hyporeninaemic hypoaldosteronism 578
hypospadias 378
I
idiopathic calcinosis of the scrotum with multiple nodules 346
imiquimod 5% cream 298f, 299f, 299–300
immature patients 21
immune-mediated renal disease 584
immune reconstitution syndrome 534, 642
immune recovery inflammatory response (IRIS) 601, 642
immune-recovery uveitis 517
immunity, impaired and genital candidiasis 236
immunity pathogenesis in HIV 596
indecent exposure 27
indecent/sexual assault 27
infant
feeding and HIV in pregnancy 658
pneumonia 159
serology 129
infectious mononucleosis-like illness 482
infertility and pelvic inflammatory disease 174
infibulation 29b
inflammatory arthropathies 597–598
inflammatory conditions and HIV-related dermatological disorders 558
inflammatory demyelinating neuropathy (Guillain–Barré syndrome) 548
influenza
prophylaxis 651
vaccination 478
inherited diseases 567b
integrase inhibitors (INIs) 630t, 646t
integrated sexual health services 2–3
interpreters 6
interstitial nephritis 585
intestinal problems and sexual problems 435
intimate examinations and chaperones 32, 32b
intra-epithelial neoplasia 292t, 354–355, 502
invasive cervical carcinoma (ICC) 358, 617
investigations and microscopy 63–80
accuracy of microscopy 75t
chancroid 247
commensals and confounders 79–80
genital candidiasis 239
microscope 69
rapid point of care tests 76–78, 76b
routine female microscopy 73
routine male microscopy 74
sexual assault investigation 107t
slide preparation 70b
trichomoniasis 229
iridocyclitis 517
iritis (acute anterior uveitis) 205
irritant dermatitis 348
ivermectin 338
J
Jarisch–Herxheimer reaction 131–132, 133
K
Kaposi’s sarcoma (KS) 490–491, 600, 611–613
and cardiac neoplasia 592
and HIV-related dermatological disorders 560
and HIV-related eye disorders 515–516 see also human herpes virus-8 (HHV8)
keratitis, infectious 517
keratoderma blennorrhagica (KB) 206
Klebsiella (Calymmatobacterium ) granulomatosis 251
Klebsiella spp. 194
L
larva migrans, cutaneous 253
laryngeal papilloma 292t
Lassa virus 327
lasting power of attorney 36
leg weakness 541b
leiomyosarcoma 618
Leishmania spp. 570
leishmaniasis 253
leptothrix 79
leucocyte esterase 273
leukaemia/lymphoma, adult T-cell 328
lichen sclerosus (LS) 350
linear gingival erythema 489
lipid profiles 633
liposomal chemotherapy 613
Lipschutz ulcers 352
liquid-based cytology 360, 360b
living wills 36
Local Authorities commission 60
low-grade squamous intraepithelial lesions of the genital tract 354–355
lung cancer 618
lymphadenopathy, mediastinal and hilar 537
lymphocele 378
lymphogranuloma venereum (LGV) 87f, 91t, 96, 248–250
lymphomas 491, 560–561, 614–616
M
macular rash 121b
malaria prophylaxis 651
malassezia furfur folliculitis 559
malathion 0.5% aqueous lotion 338
male to female (MtF) 43
males see men
malignancies see HIV: malignancies
malignant conditions and anogenital dermatoses 356
management 59
Marburg haemorrhagic fever virus 327
matrix (HIV structure) 458
measles prophylaxis 651
mechanical aids (sexual problems) 437–438
medical transition 44
melanocytic naevi (moles) 346
men
anogenital warts treatment 299f
complications and gonorrhoea 141
general examination 56–57, 57f
genital candidiasis 238
genital infection and chlamydia 152
genital infection and gonorrhoea 140
microscopy, routine 74
non-gonococcal urethritis 162, 163, 164, 165–167
trichomoniasis, clinical features of 228
urinary tract infection 272
urogenital infection and sexually acquired reactive arthritis 205
aseptic 544
cryptococcal 544
gonococcal 148
Mental Capacity Act 2005: 18–19
metabolic disorders in HIV 572, 576–579
microscopy see investigations and microscopy
microsporidiosis 496
mitochondrial toxicity 640
Molluscum contagiosum 96, 305–308, 516
aetiology and epidemiology 306
clinical features 306
diagnosis 307
management 307
mononeuritis multiplex 547
Moraxella catarrhalis 97
morbilliform (erythematous maculopapular) drug eruption 562
mucopurulent cervicitis 91t, 161–167
clinical features 163
diagnosis 164
management 167
mucosal melanosis (genital lentiginosis) 346
mucous membrane lesions and secondary syphilis 120
Mullerian duct anomalies 380
multicentric Castleman’s disease 617
mumps 194
Munchausen’s syndrome 431
muscle disease 601
musculoskeletal disorders see HIV: musculoskeletal disorders
musculoskeletal infection and sexually acquired reactive arthritis 205
mycobacterial infection 555, 565
Mycobacterium avium complex (MAC) 534
prophylaxis 651
Mycobacterium leprae 194
Mycobacterium tuberculosis 171, 191, 194
Mycoplasma genitalium 66, 165b
epidemiological treatment for contacts 91t
pelvic inflammatory disease 171
sexually acquired reactive arthritis 203
mycoses 191
myelopathy (tropical spastic paraparesis) 328, 546
myiasis 253
myocarditis 590
N
Nabothian follicles 346
nail pigmentation 562
nails 206
National Health Service Act 1977: 38
necrotizing periodontal diseases 489
necrotizing stomatitis 489
necrotizing ulcerative periodontitis 489
laboratory detection 146
pelvic inflammatory disease 171
sexual assault investigation 107t, 108
sexually acquired reactive arthritis 203
Neisseria meningitidis 79, 97, 194
nematodes 266
neonates/neonatal
anogenital warts 296
group B β-haemolytic streptococci 374–375
sepsis 148
syphilis 132
vulvovaginitis 227
neoplasia 490–491, 524b, 549, 560–561, 565, 567b, 592, 600 see also intra-epithelial neoplasia
nephropathy, HIV-associated (HIVAN) 583
neuritis 547
neuro-cognitive disorder, HIV-associated 542
neurological disorders see HIV: neurological disorders
neurological manifestations 482
neuro-psychiatric side effects 641
neuroses associated with sexual health 431
neurosyphilis 122, 127–128, 128t, 131, 549
neutropenia 605
NHS England 60
NHS Trusts and Primary Care Trusts (Sexually Transmitted Diseases) Directions 2000: 38
nitrate reductase 273
Nocardia spp. 194
nodular regenerative hyperplasia 504–505
sexual health 46
non-gonococcal urethritis (NGU) 96, 161–167
diagnosis 164
epidemiological treatment for contacts 91t
and sexually acquired reactive arthritis 203
non-Hodgkin’s lymphoma (NHL) 592, 600, 614–616
non-nucleoside reverse transcriptase inhibitors (NNRTIs) 630t, 646t
nucleic acid amplification tests (NAATs) 156
nucleoside/nucleotide reverse transcriptase inhibitors (NRTIs) 630t, 646t
nurse specialists/practitioners 5
O
occupational exposure to infection 31
oesophageal diseases 493–494, 493b
oesophagitis, candidal 493
Offences against the Person Act 35
onchocerciasis 253
onychomycosis 556
ophthalmia neonatorum 143, 148, 154, 159
ophthalmic infection and sexually acquired reactive arthritis 205, 210
opportunist mycobacterial infections 534
bacterial diseases 489
differential diagnosis of oral–pharyngeal ulcers 492b
differential diagnosis of white lesions in oral cavity 487b
parotid gland enlargement 492
salivary gland disease 491–492
oral hairy leukoplakia (OHL) and HIV 488
oral lesions
and Kaposi’s sarcoma 611
and sexually acquired reactive arthritis 206
oral–pharyngeal ulcers 492b
oral pigmentation 562
oral ulcers and cytomegalovirus 488
oral warts and human papilloma virus (HPV) types in lesions 292t
orchitis see epididymo-orchitis
orgasmic dysfunction 434
osteomyelitis 599
osteonecrosis (avascular necrosis) 598
osteopenia 600
osteoporosis 600
ovarian function 574
P
paclitaxel and Kaposi’s sarcoma 613
pancreatic diseases 503
pancreatic function 575
pancreatitis 503
papular lesions 121b
paralysis 122
paraphilia 51
paraphimosis 378
parasitic infection 191, 524b, 565, 567b
parotid gland enlargement 492
partner notification 9–11, 10t, 35
bacterial vaginosis 222
chancroid 247
chlamydia 159
epididymo-orchitis 200
gonorrhoea 148
granuloma inguinale (Donovanosis) 252
lymphogranuloma venereum 250
mucopurulent cervicitis 167
non-gonococcal urethritis 167
pediculosis 344
pelvic inflammatory disease 179
scabies 338
syphilis 134
pearly penile papules 346
aetiology 341
clinical features 343
diagnosis 344
epidemiological treatment for contacts 91t
epidemiology 343
management 344
transmission 343
pelvic floor exercises 437–438
pelvic inflammatory disease 169–179
aetiology 171
chlamydia 153
clinical features 173
complications and sequelae 174
epidemiological treatment for contacts 91t
gonorrhoea 142
investigations 175
pelvic pain syndrome, chronic see prostatitis/chronic pelvic pain syndrome
pelvic problems and sexual problems 435
pemphigus vulgaris 353
penicillin allergy 133
penicilliosis 556
prophylaxis 651
penile ulceration 562
peri-appendicitis 174
pericardial effusion 590
perihepatitis (Fitz-Hugh–Curtis syndrome) 142, 153, 174
periodontal disease 489
peripheral nerve disease 547–548
peripheral sensation, altered 541b
peri-urethral cellulitis and abscess 141
permethrin 5% cream 338
persistent generalized lymphadenopathy 607, 607b
Peyronie’s disease 378
pharmacokinetic boosters 630t
pharmacy arrangements 59
pharyngeal infection 139, 141, 147, 153, 158, 489–490
pharynx 58
phenotyping 648
phimosis 378
phobias 431
phosphodiesterase-5 inhibitors 436–437
physiotherapy and vulval pain syndromes 371
piercings 51
pigmentary changes 346
pinta 257
pituitary function 573
plasma cell balanitis (of Zoon) 350
pneumococcal vaccination 478
pneumocystis pneumonia 478, 528–530, 565
podophyllotoxin 298f, 299f, 299–300
point of care tests (POCTs), rapid 76–78, 76b
polio prophylaxis 651
polymerase chain reaction (PCR)
chancroid 247
trichomoniasis 229
polymorphonuclear leucocytes (PMNLs) 73, 74
post-exposure prophylaxis 651
neonates 657
post-mortem testing for sexually transmitted blood-borne infections 31
potassium 578
pregabalin 371t
bacterial vaginosis 222
cervical neoplasia 364
granuloma inguinale (Donovanosis) 252
hepatitis A virus 311
pelvic inflammatory disease 179
scabies 338
sexually acquired reactive arthritis 211
streptococcal infections 374–375
test 72b
trichomoniasis 228
urinary tract infection 270 see also HIV: pregnancy
premalignant conditions and anogenital dermatoses 354–355
prepubertal infection 141, 148, 153, 158–159
priapism 379
procaine benzylpenicillin 131b, 133
proctocolitis and enteric sexually acquired infections 259–266
infections not usually sexually transmitted 264–266
infections usually sexually transmitted 263
no infection demonstrable 263
sexually transmitted causes and clinical features 261–262
progressive lumbosacral polyradiculopathy 548
progressive multifocal leukoencephalopathy (PML) 543
progressive outer retinal necrosis (PORN) 519–520
prostatitis/chronic pelvic pain syndrome 141, 153, 174, 181–191
acute bacterial prostatitis 183
asymptomatic inflammatory prostatitis 191
chronic bacterial prostatitis 185
Chronic Prostatitis Symptom Index 188b
expressed prostatic secretions 186b
and HIV 191b
prostatic massage 186b
sexually transmitted infections 191
symptoms 182t
protease inhibitors (PIs) 630t, 646t
protein 273
Proteus spp. 194
transgender/non-binary people 46
pruritic follicular and papular eruptions 559
pseudohyphae and/or spores 239
Pseudomonas aeruginosa 194
psychological factors 430
HIV 441b
psychosexual therapy
chronic prostatitis/chronic pelvic pain syndrome 190
vulval pain syndromes 371
Public Health (Control of Diseases) Act 1984: 39
Public Health (Infectious Diseases) Regulations 1988: 39
public interest 17
Public Interest Disclosure Act 1998: 36
pulmonary aspergillosis 535–536
pulmonary cryptococcosis 535
pulmonary hypertension 592
pulmonary vascular disease 537–538
pyelonephritis 270
pyoderma gangrenosum 353
pyrexia of unknown origin see HIV: pyrexia of unknown origin
pyuria with no or low bacterial counts 274b
R
rash 641
recall 9
recording consultations 34
rectal infection 141, 152–153, 158
referrals 6
regulatory proteins 459t
renal disorders see HIV: renal disorders
renal impairment 641
respiratory disorders see HIV: respiratory disorders
respiratory secretions/lung tissue and pneumocystis pneumonia 528
respiratory tract infection and chlamydia 154
respiratory tract organisms 97
reticulo-endothelial disorders see HIV: reticulo-endothelial disorders
retinal microvasculopathy 518
retinal necrosis, acute 519
review 59
rheumatic disease 601
routine examination 54
S
sadomasochism 51
‘safer sex’ 50
salivary gland disease 491–492
sarcoidosis 195
aetiology 332
clinical features 335
diagnosis 337
distribution 336f
epidemiological treatment for contacts 91t
epidemiology 334
HIV 335
incognito 335
management 338
transmission 334
scalded skin syndrome 554
scalp abscess 148
Schistosoma haematobium 194
schistosomiasis 253
scrotal mass/pain 198b
seborrhoeic dermatitis 348–349, 558
seborrhoeic keratosis 346
seizures 541b
sensate focus 434
sensation reduction (premature ejaculation) 438–439
seroconversion, acute (retroviral syndrome) 553
transgender/non-binary people 46
sex and genital candidiasis 237
sex toys 51
sexual activity and abuse (children) 22
sexual activity, causing person to engage in without consent 27
sexual assault 48
forensic assessment 109
management 105–108, 105b, 106b, 107t, 108b
by penetration 27
sexual contacts, management of 91t, 92t see also partner notification
sexual desire/arousal, low 434
sexual health commissioning 60–61
sexual health in primary care 60–61
Sexual Offences Act 1967: 28–38
Sexual Offences Act 2003: 22, 27–28, 38–39
Sexual Offences (Northern Ireland) Order 2008: 27–28
sexual practice, types of 50–51
sexual problems 432
classification 433
sexuality and relationship 50
sexually acquired reactive arthritis 201–212
aetiology 203
associations 204
causes of acute painful swollen joints 209b
chlamydia 153
diagnosis 208
management 210
natural history 207
pregnancy 99
sexually acquired viral hepatitis 309–322
hepatitis A virus 311–312, 316b, 322t
hepatitis B virus 313–317, 315t, 316t, 316b, 322t
hepatitis C virus 318–321, 319t, 320t, 322t
shigellosis 498
sicca syndrome 515
sinecatechins 10–15% extract of green tea leaf 299–300
skin
lesions and Kaposi’s sarcoma 611
rash, drug-related 641
samples 71
tags (achrocordon) 346
warts 292t
social implications of Kaposi’s sarcoma 612
social transition 44
sodium and water 578
special situations 48
specialized roles of GUM 4
specific antitreponemal immunoglobulin M (IgM) detection 126t, 127
specific genitourinary situations 81–115
anogenital ulceration 87f, 87b
balanitis and balanoposthitis 83f
child sexual assault 110–115, 110–115b
genital lumps and bumps 89f
proctitis 90f
sexual contacts, management of 91t, 92t
urethritis, symptoms suggesting 82
vaginal discharge, altered 85–86, 85f, 86f
vulval irritation/discomfort/pain 84f see also sexual assault
spectinomycin 148b
spermatic granuloma 195
spermatoceles 379
spinal cord disease 546
squeeze technique (premature ejaculation) 438–439
examination of women 55f, 55–56
general examination 55
management and review 59
routine examination 54
sexual health commissioning and sexual health in primary care 60–61
sexual practice, types of 50–51
staphylococcal skin infection 554
Staphylococcus aureus 376, 554
statements and court appearances 37
Stevens–Johnson syndrome (SJS) 353, 562
stop/start (premature ejaculation) 438–439
streptococcal infections 97, 374–375
Streptococcus agalactiae 79, 374–375
Streptococcus pneumonia 194
Streptococcus pyogenes 374
Strongyloides stercoralis 266
structural proteins, major 459t
sub-preputial material 74
symmetrical polyarthritis, acute 597
synthetic prostaglandin E1 agent 437–438
accuracy of microscopy 75t
aetiology 118
anogenital ulceration 87f
biopsy 128
co-infection with HIV 135
congenital infection 119, 123–124, 124b, 129, 132
diagnosis and investigations 125–129
management 130
endemic (bejel, dichuchwa) 258
epidemiological treatment for contacts 91t
epidemiology and transmission 118
follow-up 134
management 130
and male condoms 406b
natural history 118
pregnancy 100, 123–124, 124b, 131–132
primary 120
sexual assault investigation 107t see also neurosyphilis
T
T-cell leukaemia/lymphoma, adult 328
tabes dorsalis 122
termination of pregnancy and bacterial vaginosis 223
test results 8
testicular cancer 199t
testicular torsion 199t
testing in error 31
testosterone (IM or transdermal) 434, 437–438
thrombocytopenia 605
thrombotic microangiopathy 585
thrombotic thrombocytopenic purpura 605
thyroid disease 573
toxic epidermal necrolysis 562
toxoplasma retinochoroiditis 520
toxoplasmosis 478
prophylaxis 650
sexual health 46
transsexual 43
travel
expenses, reimbursement of 8 see also HIV: travel
treatment 59
Treponema pallidum 70b, 118, 127, 194
triage 6
trichloroacetic acid (TCA) 298f, 299f, 300–301
accuracy of microscopy 75t
aetiology 226
altered vaginal discharge 85f
bacterial vaginosis 217
children 115
clinical features 228
diagnosis 229
epidemiological treatment for contacts 91t
epidemiology and transmission 227
and HIV 232b
and male condoms 406b
pregnancy 100
trimethoprim–sulfamethoxazole desensitization schedule 650t
tropical genital and sexually acquired infections 245–253
anogenital ulceration 87f
granuloma inguinale (Donovanosis) 251–252
lymphogranuloma venereum 248–250
tuberculosis 478, 489, 531–533, 624
tubo-ovarian and pelvic abscess 174
tubular necrosis, acute 582
tumours and possible HIV infection 471b
U
ulcerative conditions and anogenital dermatoses 352–353
Ureaplasma urealyticum 194, 203
urethral caruncle 380
urethral channels (accessory) 379
urethral material 74
urethral strictures and fistulae 141
urethral syndrome 271
urethritis, symptoms suggesting 82
urinalysis 72
urinary problems and sexual problems 435
urinary tract infection (UTI) 82, 267–276
aetiology 268
diagnosis 273
epididymo-orchitis 194
men 272
pregnancy 100
pyuria with no or low bacterial counts 274b
urine
inspection 71
pregnancy test 72b
urogenital infection and sexually acquired reactive arthritis 205
urology referral 276
uterine problems and sexual problems 435
uveitis
anterior 517
immune-recovery 517
V
vaccination and HIV 478, 638, 638t, 661, 661t
neonates 657
vacuolar myelopathy 546
vaginal bleeding
cervical neoplasia 359
transgender/non-binary people 46
vaginal discharge 71, 85f, 86f
vaginal stenosis, transgender/non-binary people 46
vaginismus 435
bacillary dysentery 264
contraception 417–427t, 384–385
leptothrix 79
neonate 143
non-specific see bacterial vaginosis
Staphylococcus aureus 376
streptococcal infections 374
transgender/non-binary people 46
urinary tract infections, recurrent 269
varicella zoster virus (VZV) 478, 488, 553–554
prophylaxis 651
varicocele 379
vasculitis 567b
Venereal Diseases Act 1917: 38
Venereal Diseases Regulations 1916: 38
venous thrombosis 592
viral infections
viral load and HIV 633
viruses
and proctocolitis and enteric sexually acquired infections 264
and prostatitis 191
and respiratory illnesses in HIV 524b
visceral leishmaniasis 570
vitiligo 346
vulval irritation/discomfort/pain 84f
aetiology 367
clinical features 367
management 368–371, 370t, 371t
prognosis 372
vulval papillae 346
vulvo-vaginal candidiasis, recurrent 237, 239, 242
vulvo-vaginal problems and sexual problems 434
vulvo-vaginitis, acute 237, 241
W
warts see anogenital warts
wasting syndrome, HIV-associated 580
women
anogenital warts treatment 298f
general examination 55f, 55–56
genital anomalies 380
genital candidiasis 237
genital infection and chlamydia 152
genital infection and gonorrhoea 140
gonorrhoea 142
microscopy, routine 73
mucopurulent cervicitis 162, 163, 164, 167
trichomoniasis 228
urinary tract infection 269–271
urogenital infection and sexually acquired reactive arthritis 205
Wuchereria bancrofti 194
Wuchereria pacifica 194
Y
yaws 257
yeast infections 194
Z
Zika 327