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RESEARCH ARTICLE

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: cfairley@unimelb.edu.au

Sexual Health 2(4) 241-244 https://doi.org/10.1071/SH05006
Submitted: 9 February 2005  Accepted: 28 June 2005   Published: 16 November 2005

Abstract

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.


Acknowledgements

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.


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