Walk-in GUM clinics reduce delays in STI treatment
A study has aimed to quantify the contribution of delay in accessing GUM clinics to STI transmission.
More than 3,000 consecutive patients attending four GUM clinics were surveyed. The GUM clinics had been selected to represent different types of populations. Patients completed a short questionnaire, which explored access to services and health-seeking behaviour. Sociodemographic data were also obtained, and the questionnaires were linked to routinely collected diagnostic data.
The study found that there appeared to be a median delay of seven days in seeking treatment, irrespective of the clinic used and the patient's social and demographic characteristics. However, clinics operating a walk-in service were associated with marked reductions in patient and provider delay.
The study found that 45% and 58% of symptomatic men and women respectively continued to have sex while awaiting treatment and 4% had sex with at least one new partner without using condoms. About 25% of all men and 31% of all women had already sought or received care in general practice.
The authors suggest that a walk-in service should be available to all populations and that patients attending primary care need clear pathways when referred to GUM clinics. However, we know anecdotally that some patients do not turn up to GUM clinics even if they are referred.
Judging from this and other studies, there is a role for primary care to stop the onward transmission of STIs. GPs could treat infections syndromically; after all, we do it for suspected UTIs all the time.
Mercer CH, Sutcliffe L, Johnson AM et al. How much do delayed healthcare seeking, delayed care provision, and diversion from primary care contribute to the transmission of STIs? Sex Transm Infect 2007;83:400-405Reviewer
Dr Richard Ma
GP principal, North London and staff grade in sexual and reproductive health, Margaret Pyke Centre, London