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Sexually Transmitted Infections and HIV
  1. B Stanley
  1. Department of Genitourinary Medicine, Cumberland Infirmary, North Cumbria Acute Hospitals NHS Trust, Newtown Road, Carlisle CA2 7HY, UK; b.stanley{at}

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    Edited by Dan Clutterbuck. Pp 209; £34.99 (softcover). London: Elsevier, 2004, ISBN 0-7234-3284-8.

    This pretty, shiny new book slid out of the packaging. I was rather surprised that a book entitled Sexually Transmitted infections and HIV was as small and neat. The preface explained all—a book “intended for those new to the management of sexually transmitted infections and HIV,” and, as such, it succeeds well in its aim.

    The increasing demand on services providing for those concerned that they may have acquired a sexually transmitted infection and emphasis on “near patient treatment” and “one stop shop” provision means that it is likely that patients will attend an increasing variety of clinical services in order to get access to care. This book will be a useful aid in clinics providing contraceptive advice, genitourinary nurse led clinics, and general practice. It is a good introduction to the subject. It is written clearly enough and I have left it with patients who are seeking information.

    The introduction to history taking includes discussion of reactions of the history taker, warning appropriately about the potential for voyeurism. I found no reference to the appropriate behaviour when attempting to examine a man with an erection, but I don’t know of any other book that discusses this either!

    As with all books wishing to provide simple clear advice, some of the advice was over didactic for my taste, and I would have liked references quoted when the text said “there is evidence that.” Specific areas where I thought the book would benefit from additional comment include: differing opinions among genitourinary physicians about appropriate management and review of non-gonococcal urethritis; advice to “avoid sexual intercourse” until after follow up appointment (less relevant as services reduce routine review in order to deal with increasing numbers of patients); reduction in use of centrifuges or potassium hydroxide because of local interpretation of health and safety guidelines; listing of website addresses for STI management (HIV related websites were listed clearly). I suspect a typographical error in the table recommending the duration of treatment with erythromycin used in uncomplicated chlamydial infection, and I would disagree with “blind treatment” for candidiasis in those presumed at low risk of sexually transmitted infection, this is when genital herpes and its appropriate treatment window can be missed.

    There are lots of useful figures and checklists but, because of this, sometimes they are presented in the middle of text relating to other conditions, box illustrations for Pneumocystis and Mycobacterium tuberculosis in HIV were in the middle of text relating to neurology.

    The exposure risk table for blood borne viruses in relation to post-exposure prophylaxis for HIV is very helpful, although it would be worth understanding how it works before needing it in the acute situation.

    “Oooh, this looks nice, nice pictures, is it ours?” was the response from our nurse specialist who spent some time flicking through it making appreciative noises.

    It is a book that will definitely be used in our department.