COVID-19: Sexual Health, HIV and PAC service guide

April 2020

Scope

This information provides guidance on the management of Sexual Health, HIV and PAC patients in Western Devon provided by Sexual health in Plymouth during the Covid-19 pandemic. The information is based on national guidance from the BASHH, BHIVA and FRSH which includes regularly updated resources for patients and health care professionals.

National guidance

FSRH Position: Essential SRH Services during COVID-19 March 2020

British Association for Sexual Health and HIV: COVID-19 Resources

British HIV Association: Coronavirus (COVID-19) and HIV - BHIVA Statements

Conditions with specific guidance

Human Immunodeficiency Virus (HIV)

In summary:

  1. People with a CD4 count less than 50 or opportunistic illness in last 6 months: follow shielding advice for extremely vulnerable;
  2. People with CD4 less than 200, detectable viral load or not on ART: follow social distancing advice stringently;
  3. People with CD4 greater than 200 and undetectable on ART: follow general population advice (i.e. social distancing).

Contraception

Provision of information regarding management of Long-acting reversible contraceptives (LARCs) (intrauterine contraceptive device(IUD)/ intrauterine system (IUS)/implant) which expire during this period (FSRH guidance)

Encourage 12-month prescription for existing cop/pop users - electronic prescriptions straight to pharmacies

QuickStart and Bridge with POP (no need for face to face ) for anyone with new request for contraception

Switch Depot users to Sayana Press (provided available) and give them 4x (12-month supply)

PAC

Home medical termination of pregnancy (MTOP) available for those suitable after telephone assessment and short clinic visit for ultrasound (US) scan if required

Local anaesthetic and general anaesthetic termination of pregnancy (TOP) currently still available but may be subject to restrictions during COVID-19.

Routine referrals

All new routine referrals will be clinically triaged and will either be added to a waiting list or, if appropriate, A&G will be given.

Please ensure that a practice-based system is in place to check daily for returning referrals with A&G.

Prior to making a routine referral, please ensure that any appropriate Policy or CRG has been reviewed and that all the suggested investigations and management options have been considered.

Existing new and follow-up routine appointments have been cancelled and changed to telephone / video consultation where appropriate.

Urgent advice

Please call 01752 431124 option 6 for advice on Sexual Health, HIV or PAC: Monday - Friday, 08:30- 16:30.

Urgent HIV, Sexual Health or PAC issues include:
  • new HIV, syphilis and gonorrhoea diagnosis,
  • suspected pelvic inflammatory disease, syphilis, HIV seroconversion or gonorrhoea,
  • sexual health review after sexual assault (use SARC for forensic examinations),
  • PEPSE,
  • emergency IUD fit/problems,
  • request for termination of pregnancy.

Patients can self-refer using the same telephone number and choose the appropriate option

Risk factors for face-to-face review will be decided on case by case basis.

There is an on-call HIV consultant out of hours contactable via Derriford switchboard telephone: 01752 202082

Advice & Guidance/Telephone services

Advice and Guidance / telephone consultation services aim to maintain operation for non-urgent patients

Patientsknowbest web based EPR will be used for transfer of images or video consultations. Mobile messaging is routinely used.

Patients will be assessed by telephone and managed with home testing/sampling as needed.

Need for face-to-face review will be decided on case by case basis.

Courier or pick up service for medication

Patients will be encouraged to attend pharmacies for guided self-management where appropriate

Western Contact information

Pathway Group

This guideline has been signed off on behalf of the NHS Devon Clinical Commissioning Group

Last updated: 04-05-2020

 

Home > Refer-CV19 CRGs > Western CRGs > COVID-19: Sexual Health, HIV and PAC service guide

 

  • First line
  • Second line
  • Specialist
  • Hospital