Building the bypass—implications of improved access to sexual healthcare: evidence from surveys of patients attending contrasting genitourinary medicine clinics across England in 2004/2005 and 2009. Issue 1 (23rd December 2011)

• Record Type: Journal Article
• Authors: Mercer, Catherine H; Aicken, Catherine R H; Estcourt, Claudia S; Keane, Frances; Brook, Gary; Rait, Greta; White, Peter J; Cassell, Jackie A
• Is Part Of: Sexually transmitted infections. Volume 88:Issue 1(2012)
• Page Start: 9
• Page End: 15
• Publication Date: 2011-12-23
• Subjects: Genitourinary medicine services -- primary care -- general practice -- service delivery -- sexual behaviour -- sexual practices -- risk behaviours -- heterosexuals -- sexual health -- adolescent -- surveillance -- sexual networks -- public health -- GUM services -- service development -- risk profiles -- STD -- STD clinic -- hepatitis -- information technology -- primary care -- screening; Sexually transmitted diseases -- Periodicals; HIV infections -- Periodicals; 616.951005
• DOI: 10.1136/sextrans-2011-050257
• Languages: English
• ISSNs: 1368-4973

Abstract

Abstract : Objective: The objective of this study was to examine changes in patient routes into genitourinary medicine (GUM) clinics since policy changes in England sought to improve access to sexual healthcare. Methods: Cross-sectional patient surveys at contrasting GUM clinics in England in 2004/2005 (seven clinics, 4600 patients) and 2009 (four clinics, 1504 patients). Patients completed a short pen-and-paper questionnaire that was then linked to an extract of their clinical data. Results: Symptoms remained the most common reason patients cited for attending GUM (46% in both surveys), yet the proportion of patients having sexually transmitted infection (STI) diagnosis/es declined between 2004/2005 and 2009: 38%–29% of men and 28%–17% of women. Patients in 2009 waited less time before seeking care: median 7 days (2004/2005) versus 3 days (2009), in line with shorter GUM waiting times (median 7 vs 0 days, respectively). Fewer GUM patients in 2009 first sought care elsewhere (23% vs 39% in 2004/2005), largely from general practice, extending their time to attending GUM by a median of 2 days in 2009 (vs 5 days in 2004/2005). Patients with symptoms in 2009 were less likely than patients in 2004/2005 to report sex since recognising a need to seek care, but this was still reported by 25% of men and 38% of women (vs 44% and 58%, respectively, in 2004/2005). Conclusions: Patient routes to GUM shortened between 2004/2005 and 2009. While GUM patients in 2009 were less likely overall to have STIs diagnosed, perhaps reflecting lower risk behaviour, there remains a substantial proportion of high-risk individuals requiring comprehensive care. Behavioural surveillance across all STI services is therefore essential to monitor and maximise their public health impact.