Meeting demand for comprehensive sexual health needs: the experience within a primary care setting in the UK
D Lee, K Ewer, A Vaughan, C Linnard
The Alma Clinic, Winton Health Centre, Bournemouth, Dorset, United Kingdom
Background The UK is experiencing a sexual health crisis, with demand for care outstripping supply. The workload of Genito-Urinary Medicine (GUM) services has doubled in the past 10 years.1 New ways of delivering sexual health care are being developed and investigated. The "One Stop" sexual health clinic model has much to commend it. This paper looks at one Family Planning Clinic, set in Primary Care, that has been developed into a combined service.
Objective To evaluate the transition from a dedicated, sessional, primary care, family planning clinic, to a combined sexual health clinic, by documenting the diagnoses of sexually transmitted infections (STIs) .
Design A prospective data collection study .
Setting A Primary Care, combined Sexual Health Clinic, offering Family Planning and/or STI screening, testing and treatment.
Participants All patients seen for STI screening/ testing in the first 6 months, 1st January - 30th June 2005.
Outcome measures Uptake of STI screening / testing, and numbers of positive STI diagnoses.
Results 98 patients were screened for STIs during this period. 82 female, median age 25 (range 16 - 54) and 16 men, median age 22 (range 18 - 51). 29 (30%) were diagnosed with an STI; Chlamydia 12 (12%); gonorrhoea 1(1%) - referred to secondary care GUM service; herpes simplex 1(1%); hepatitis C 1(1%) - referred to a hepatologist; genital warts 7(7%) and pelvic inflammatory disease (PID) 7 (7%). 2/3 underwent HIV screening, none proved positive. 4 were immunised against hepatitis B. All these "STI" patients also had their contraceptive needs addressed.
Conclusions 30% patients attending this "One Stop" clinic in Primary Care, were diagnosed with an STI. This high prevalence demonstrates that offering STI testing, within this Family Planning population, is highly appropriate, efficient and beneficial. Conversely, Family Planning requirements for STI patients, may also be met opportunistically, using this combined approach.
Reference
Department of Health. Better prevention. Better services. Better sexual health. The National Strategy for Sexual Health & HIV. London: Department of Health, 2001.