|Chlamydia||Consider self-collection of samples for testing.|
|Gonorrhoea||Consider self-collection of samples for testing.
If NAAT test result is positive, take swab at relevant site(s) for culture, before treatment. Cultures are the preferred test for samples from non-genital sites.
|Repeat test if patient exposed within previous 12 weeks (window period).|
|Syphilis||If clinical suspicion of syphilis, refer to the syphilis guideline.|
|Hepatitis A||Offer vaccination if susceptible (e.g. MSM sex worker).
Further testing unnecessary after completing vaccination.
|Hepatitis B||Vaccinate if not immune. Vaccination is free in most states/territories for sex workers.
Serological testing after completing vaccination is recommended.
|Hepatitis C||If antibody positive, test for hepatitis C NAAT to determine if patient has chronic hepatitis C.|
|NAAT – Nucleic Acid Amplification Test
MSM – Men who have sex with men
Ask about the best way to contact with results and reminders. Sexual health clinical services, where a Medicare card is not required, are available in major cities.Certificate of sexual health check attendance
A ‘certificate of attendance’ or ‘sexual health check certificate’ may be requested by the patient (NB. working name only can be used, at the patient’s request). This is to certify that the patient attended a clinic for tests for STIs only. It should not include examination findings or results and does not provide evidence that there is no infection. A certificate of attendance may reiterate that some infections may not be detectable for weeks or months after infection, if they become detectable at all (eg. herpes and human papilloma virus (HPV)).Laws
Laws regarding sex work vary between states and territories. Three jurisdictions (ACT, QLD and VIC) have legislation and guidelines which ensure that brothels will only employ sex workers who undergo prescribed tests.MSM sex workers
Provide advice about avoiding oral, vaginal and anal sex until no longer infectious (‘exclusion period’). In some jurisdictions, it is an offence for a sex worker to knowingly work during any period when they are known to be infectious with an STI. Advice may be sought from specialist sexual health clinicians.
‘Provider referral’ may be the preferred method of contact tracing. Advice on provider referral can be sought from the local sexual health clinic or public health unit.
Even if all test results are negative, use the opportunity to:
100% documentation of hepatitis B immunity or vaccination status in current sex workers.