2016年英国男男性行为者性健康护理国家指南。

2016 United Kingdom national guideline on the sexual health care of men who have sex with men.

作者信息

Clutterbuck Dan, Asboe David, Barber Tristan, Emerson Carol, Field Nigel, Gibson Stuart, Hughes Gwenda, Jones Rachael, Murchie Martin, Nori Achyuta V, Rayment Michael, Sullivan Ann

机构信息

1 NHS Lothian, Edinburgh, UK.

2 Chelsea and Westminster Healthcare NHS Foundation Trust, London, UK.

出版信息

Int J STD AIDS. 2018 Jan 1:956462417746897. doi: 10.1177/0956462417746897.

Abstract

This guideline is intended for use in UK Genitourinary medicine clinics and sexual health services but is likely to be of relevance in all sexual health settings, including general practice and Contraception and Sexual Health (CASH) services, where men who have sex with men (MSM) seek sexual health care or where addressing the sexual health needs of MSM may have public health benefits. For the purposes of this document, MSM includes all gay, bisexual and all other males who have sex with other males and both cis and trans men. This document does not provide guidance on the treatment of particular conditions where this is covered in other British Association for Sexual Health and HIV (BASHH) Guidelines but outlines best practice in multiple aspects of the sexual health care of MSM. Where prevention of sexually transmitted infections including HIV can be addressed as an integral part of clinical care, this is consistent with the concept of combination prevention and is included. The document is designed primarily to provide guidance on the direct clinical care of MSM but also makes reference to the design and delivery of services with the aim of supporting clinicians and commissioners in providing effective services. Methodology This document was produced in accordance with the guidance set out in the BASHH CEG's document 'Framework for guideline development and assessment' published in 2010 at http://www.bashh.org/guidelines and with reference to the Agree II instrument. Following the production of the updated framework in April 2015, the GRADE system for assessing evidence was adopted and the draft recommendations were regraded. Search strategy (see also Appendix 1) Ovid Medline 1946 to December 2014, Medline daily update, Embase 1974 to December 2014, Pubmed NeLH Guidelines Database, Cochrane library from 2000 to December 2014. Search language English only. The search for Section 3 was conducted on PubMed to December 2014. Priority was given to peer-reviewed papers published in scientific journals, although for many issues evidence includes conference abstracts listed on the Embase database. In addition, for 'Identification of problematic recreational drug and alcohol use' section and 'Sexual problems and dysfunctions in MSM' section, searches included PsycINFO. Methods Article titles and abstracts were reviewed and if relevant the full text article was obtained. Priority was given to randomised controlled trial and systematic review evidence, and recommendations made and graded on the basis of best available evidence. Piloting and feedback The first draft of the guideline was circulated to the writing group and to a small group of relevant experts, third sector partners and patient representatives who were invited to comment on the whole document and specifically on particular sections. The revised draft was reviewed by the CEG and then reviewed by the BASHH patient/public panel and posted on the BASHH website for public consultation. The final draft was piloted before publication. Guideline update The guidelines will be reviewed and revised in five years' time, 2022.

摘要

本指南旨在供英国泌尿生殖医学诊所和性健康服务机构使用,但在所有性健康环境中可能都具有相关性,包括全科医疗以及避孕与性健康(CASH)服务机构,即男男性行为者(MSM)寻求性健康护理的场所,或者满足MSM性健康需求可能具有公共卫生益处的场所。就本文件而言,MSM包括所有男同性恋者、双性恋者以及所有其他与男性发生性行为的男性,包括顺性别男性和跨性别男性。本文件未就其他英国性健康与艾滋病协会(BASHH)指南中涵盖的特定病症的治疗提供指导,而是概述了MSM性健康护理多个方面的最佳实践。在预防包括艾滋病毒在内的性传播感染可作为临床护理的一个组成部分加以解决的情况下,这与综合预防的概念相一致,并已纳入其中。该文件主要旨在为MSM的直接临床护理提供指导,但也提及了服务的设计与提供,目的是支持临床医生和服务提供者提供有效的服务。

方法

本文件是根据BASHH CEG于2010年在http://www.bashh.org/guidelines上发布的“指南制定与评估框架”文件中规定的指导方针,并参考AGREE II工具编写而成。在2015年4月更新框架之后,采用了评估证据的GRADE系统,并对建议草案进行了重新分级。

检索策略(另见附录1)

Ovid Medline数据库,检索时间为1946年至2014年12月,Medline每日更新;Embase数据库,检索时间为1974年至2014年12月;Pubmed NeLH指南数据库;Cochrane图书馆,检索时间为2000年至2014年12月。检索语言仅为英语。第3节的检索在PubMed上进行,截至2014年12月。优先检索科学期刊上发表的同行评审论文,不过对于许多问题,证据包括Embase数据库中列出的会议摘要。此外,对于“识别有问题的娱乐性药物和酒精使用”部分以及“MSM中的性问题和性功能障碍”部分,检索还包括PsycINFO数据库。

方法

对文章标题和摘要进行了审查,如有相关则获取全文。优先考虑随机对照试验和系统评价证据,并根据现有最佳证据提出建议并分级。

试行与反馈

指南初稿分发给了编写小组以及一小群相关专家、第三部门合作伙伴和患者代表,邀请他们对整个文件,特别是特定部分发表意见。修订草案由CEG进行了审查,然后由BASHH患者/公众小组进行了审查,并发布在BASHH网站上供公众咨询。最终草案在发布前进行了试行。

指南更新

本指南将于2022年,即五年后进行审查和修订。

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