Curriculum standards

Clinic management

• Infection control measures required to conduct clinical services in sexual health medicine
• Principles of infection control in clinical practice
• Rationale for provision of clinical services via specialist public sexual health clinics and in primary care

Epidemiology

• Epidemiological basis for prevention strategies
• Epidemiology of sexually transmitted infections (STIs) / HIV at local, national, and international levels
• Epidemiology of STIs / HIV in priority populations
• Priority populations:
  • how and why priority populations may vary over time and location
  • priority populations for different STIs in different contexts and locations
  • process of community engagement with different priority populations
  • rationale for why priority populations require particular attention
  • use epidemiological data to develop and evaluate innovative clinical services for priority populations
• Social determinants of health and how they relate to sexual behaviours, health, and risk, and the complex interplay between components
• Transmission dynamics, including Rₒ = BcD

Evidence

• Describe levels of evidence according to study design, and rank evidence according to consistency, freedom from bias, and methodological rigour
• Differentiate expert opinion from observational evidence, and reconcile dissonant expert opinion with patient values, research evidence, and societal expectations
• Make decisions based on clinical judgement in circumstances where evidence is lacking or conflicting
• Reconcile evidence with contrary patient values and preferences

Health promotion

• Design and implementation of population-based health promotion programs
• Evaluation of health promotion activities
• History and contribution of health promotion approaches to the management at population level
• Importance of the advocacy role of specialists in sexual health medicine in relation to health promotion and public health interventions
• Key strategies and evidence for effectiveness in health promotion interventions
• Prevention frameworks for interventions at a population level:
  • primary
  • secondary
  • tertiary

Partner notification

• Ethical and legal principles
• Rationale and methods of partner notification
• Strategies for resolution of conflicting ethical and legal requirements

Policy

• Fiscal, legislative, and other public policy measures as they relate to sexual health
• Impact of health economics on health service provision, including cost-benefit and cost-effectiveness analyses of testing and treatment regimens

Screening

• Methods for planning, delivery, and evaluation of programs
• Principles of screening as defined by the World Health Organization:
  • early detection and intervention to prevent disease progression
  • ethical and economic aspects
  • management of screening databases
• Strategies and target populations for screening programs:
  • community-wide screening and mass treatment programs to eliminate or significantly reduce infectious disease in specific communities
  • importance of population prevalence in program design
  • opt-out versus opt-in screening
• Use of statistical tests in screening programs

Vaccination

• Efficacy of vaccination for STIs
• Importance of vaccination in reducing basic reproductive rate
• Roll out of vaccination programs through sexual health clinics and other locations and services, including the role of community engagement in program development
• Strategies for targeting priority populations

Epidemiology

• Apply statistical concepts in relation to the use and interpretation of specific screening tests at the individual and population level, such as:
  • likelihood ratios
  • predictive value:
    • negative
    • positive
  • sensitivity
  • specificity

Patient management

• Develop strategies for ongoing engagement with, and management of, individual clients / client groups at higher risk of acquiring and/or transmitting STIs and/or blood-borne viruses (BBVs)
• Negotiate complex and conflicting clinical and contact tracing issues
• Use a variety of approaches in clinical context to promote individual health and wellbeing, including:
  • developing communication skills in negotiating safer sex
  • harm reduction, such as:
    • condoms
    • dams
    • injecting equipment
    • non-occupational post-exposure prophylaxis (nPEP)
    • pre-exposure prophylaxis (PrEP)
    • treatment as prevention
    • vaccination
  • improving health literacy
  • readiness to change models
  • risk assessment
  • tailored information

Public health programs

• Describe disease outbreak management, including identification of the outbreak, stakeholders, interventions, and evaluation
• Design health promotion intervention, including the following components in relation to STIs and BBVs:
  • carry out needs assessments
  • develop program goals, objectives, and strategies
  • evaluate programs – process, impact, and outcome
  • identify and consult with stakeholders
  • implement and monitor programs
  • select strategies to achieve program objectives
• Identify frameworks for intersectoral collaboration and community engagement, and apply to a sexual health promotion initiative
• Procedures, methods, and tools used for health impact assessments
• Use a range of assessment tools to determine health needs and the effect of health promotion activities

Ethical considerations

• Balance individual rights with those of the population in relation to infectious disease
• Consent and issues of consent to investigation and medical treatment
• Consent and issues of consent to sex in local jurisdiction
• Research ethics
• Role of community engagement and involvement in clinic services and research
• Role of human research ethics committees
• Specific issues of consent in young people and people with reduced capacity

Legal considerations

• Legislation in relation to discrimination, both in general and in relation to disability, gender, and sexuality
• Management of individuals who may knowingly place others at risk
• Notification of infectious diseases by laboratories and clinicians in local jurisdictions
• Principles underpinning legislation
• Public health legislation in relation to infectious diseases and STIs, with consideration of issues of discussing status, prevention of transmission, and safer sex, and as it applies to specific groups
• Public health orders in management of risk behaviours
• Recognise the need and role of consultation with public health authorities