et al.
Sexual Health Sexual Health Society
Publishing on sexual health from the widest perspective

Introduction of screening guidelines for men who have sex with men at an STD clinic, the Melbourne Sexual Health Centre, Australia

Nichole A. Lister A , Anthony Smith B and Christopher K. Fairley A C D
+ Author Affliations
- Author Affliations

A Department of Public Health, The University of Melbourne, VIC 3010, Australia.

B Australian Research Centre in Sex, Health & Society, La Trobe University, 215 Franklin Street, Melbourne, VIC 3000, Australia.

C Melbourne Sexual Health Centre, 580 Swanston Street, Carlton, VIC 3053, Australia.

D Corresponding author. Email:

Sexual Health 2(4) 241-244
Submitted: 9 February 2005  Accepted: 28 June 2005   Published: 16 November 2005


Background: A recent audit indicated that a substantial proportion of men who have sex with men (MSM) were not screened for rectal gonorrhoea and chlamydia at the Melbourne Sexual Health Clinic, Melbourne, Australia. In response, screening guidelines for MSM were introduced at the clinic using a computer reminder. The aim of this study was to evaluate the impact of the guidelines and alert on screening MSM for gonorrhoea and chlamydia. Methods: The medical records of MSM were reviewed for gonorrhoea and chlamydia screening by site (pharyngeal, urethral and rectal), four months before the implementation of the guidelines and alert (July to October 2002), and one year thereafter (beginning November 2002). Results: After the introduction of the guidelines there was a significant increase in rectal chlamydia testing (55% to 67%, P < 0.001), and significant reduction in pharyngeal chlamydia and gonorrhoea testing (65% to 28%, P < 0.001, and 83% to 76%, P = 0.015 respectively). The proportion of tests that were positive by any site did not change (7% to 7%). Conclusions: The introduction of a computer reminder for new guidelines was temporally associated with screening that conformed more closely to clinical guidelines.

Additional keywords: Chlamydia trachomatis, Neisseria gonorrhoeae.


This study was made possible through the support of clinicians and nurse practitioners at the Melbourne Sexual Health Centre (MSHC) with their participation in data collection by responding to the computer reminder. The authors also wish to thank Tim Kuo (IT Officer, MSHC) for help to generate databases of information collected from electronic patient files and the computer reminder, and Claire Wallace for data entry of Ng and Ct testing records from the Microbiological Diagnostic Unit, Melbourne, Australia. Associate Professor Smith is supported by a Senior Research Fellowship from the Victorian Health Promotion Foundation.


[1] Australian College of Sexual Health Physicians (ACSHP). Clinical guidelines for the management of sexually transmissible infections among priority populations. 2003. Available online at: (verified October 2005).

[2] Sexually Transmitted Infections in Gay Men Action Group (STIGMA). Sexually transmitted infection testing guidelines for men who have sex with men. 2002. Available online at: (verified October 2005).

[3] Lister NA,  Smith A,  Read T,  Fairley CK. Testing men who have sex with men for Neisseria gonorrhoea and Chlamydia trachomatis prior to the introduction of guidelines at an STD clinic in Melbourne. Sex Health 2004; 1 47–50.
CrossRef |

[4] Donovan B,  Bodsworth NA,  Rohrsheim R,  McNulty A,  Tapsall JW. Characteristics of homosexually-active men with gonorrhoea during an epidemic in Sydney, Australia. Int J STD AIDS 2001; 12 437–43.
CrossRef | PubMed |

[5] Lister NA,  Smith A,  Tabrizi S,  Hayes P,  Medland NA,  Garland S, et al. Screening for Neisseria gonorrhoeae and Chlamydia trachomatis in men who have sex with men at male-only saunas. Sex Transm Dis 2003; 30 886–9.
PubMed |

[6] Lister NA,  Smith A,  Tabrizi SN,  Garland S,  Hayes P,  Fairley CK. Comprehensive clinical care on-site in male-only saunas: confidential STI/HIV screening outreach clinic. Int J STD AIDS ;

[7] Medland N , Tee B , Ryan N , Azzato F , Rowles S . Very high rate of asymptomatic carriage of Chlamydia trachomatis and Neisseria gonorrhoeae in MSM warrants wide spread testing in clinical environment. [Abstract]. In: 14th Annual Conference Australasian Society for HIV Medicine October 2002, Sydney, Australia. pp. 23–6.

[8] McDowell I,  Newell C,  Rosser W. A randomized trial of computerized reminders for blood pressure screening in primary care. Medicare Care 1989; 27(3): 297–305.

[9] Rosser W,  Hutchinson B,  McDowell I,  Newell C. Use of reminders to increase compliance with tetanus booster vaccination. CMAJ 1992; 146(6): 911–7.
PubMed |

[10] McDowell I,  Newell C,  Rosser W. Comparison of three methods of recalling patients for influenza vaccination. CMAJ 1986; 135(9): 991–7.
PubMed |

[11] Dexter PR,  Perkins S,  Overhage JM,  Maharry K,  Kohler RB,  McDonald CJ. A computerised reminder system to increase the use of preventive care for hospitalised patients. N Engl J Med 2001; 345 965–70.
CrossRef | PubMed |

[12] Koide D,  Ohe K,  Ross-Degnan D,  Kaihara S. Computerised reminders to monitor liver function to improve the use of etretinate. Int J Med Inform 2000; 57 11–9.
CrossRef | PubMed |

[13] National Health and Medical Research Council (NHMRC). When does quality assurance in health care require independent ethical review? 2003. Available online at: (verified October 2005).

Rent Article (via Deepdyve) Export Citation Cited By (7)