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In: Nursing

A patient at an STI clinic is a worried-looking 28-year-old gay man who until a month...

A patient at an STI clinic is a worried-looking 28-year-old gay man who until a month ago was in a long-term mutually monogamous relationship. He became inebriated at a party last night and went home with a new acquaintance. Consensual unprotected sex occurred several times, and the patient was both a top and bottom partner. On awakening the partner was gone. This morning the patient is concerned about STI and HIV risks. His last HIV test, performed 2 weeks ago, was negative. He does not know how to contact the partner from last night, and he asks whether he should have another ELISA or that new “fast test” performed today.

1. Does the patient have cause for concern? Why or why not?

2. What will you tell him about testing today?

3. Is he a candidate for pre-exposure prophylaxis today? Why or why not?

4. Is he a candidate for postexposure prophylaxis today? Why or why not?

5. What other teaching or considerations are needed at this time?

Solutions

Expert Solution

1)Yes, the patient has a reason for concern as the proportion of getting HIV is more in bisexual men than in other individuals.Also, this person does not know the HIV status of the person he slept with that night.

2)Getting tested today might not give accurate results, as antibodies against HIV are formed in the body only after 2-3 weeks of infection.

3)No, this is because his HIV status might have changed today as he had sex with person with unknown HIV status. To start pre exposure prophylaxis, one has to be HIV negative, eventhough he was negative 2 weeks ago,that cannot be considered as he had recent contact with person with unknown HIV status

4)Yes, he is a candidate for post exposure prophylaxis as the risk of getting HIV in MSM(men who have sex with men) is high. Also, he does not know the HIV status of his partner. These two statements fulfils the criteria to start post exposure prophylaxis.

5)Counselling the patient regarding the post exposure prophylaxis.

Advising the patient to have protected sex in the future.

Nightingale answered 2 years ago
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