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Sexually transmissible infection management practices among primary care physicians in Singapore

Roy K. W. Chan A C , Hiok Hee Tan A , Martin T. W. Chio A , Priya Sen A , Kar Woon Ho B and Mee Lian Wong B
+ Author Affiliations
- Author Affiliations

A National Skin Centre, 1 Mandalay Road, 308205, Singapore.

B Department of Community, Occupational and Family Medicine, Faculty of Medicine, National University of Singapore, 16 Medical Drive, 117597, Singapore.

C Corresponding author. Email:

Sexual Health 5(3) 265-271
Submitted: 16 October 2007  Accepted: 31 January 2008   Published: 6 August 2008


Background: Primary care physicians manage a significant number of sexually transmissible infections (STI); however, there has not been a survey to assess the standard of medical care, completeness of notifications, provision of counselling and contact tracing by primary care physicians in Singapore. Methods: An anonymous postal survey was conducted in which 1557 questionnaires were mailed out to general practitioners (GP), and government primary care and emergency department doctors. Results: In all, 736 questionnaires (47.3%) were returned, and the majority of respondents were graduates from the local medical school, worked in solo or group practices and were males. One hundred and thirty doctors (17.7%) indicated they had received training attachments or postings in dermato-venereology departments. Almost one-third (30.8%) had been working as doctors for fewer than 10 years and 87.8% reported that they managed STI in their practice. Almost half did not investigate genital discharge patients, and one-third would still use ciprofloxacin to treat discharges. In the management of ulcers, over half indicated that they would order syphilis serology, and a significant minority would use parenteral penicillin. Most doctors provided history taking, screening for other STI, testing for HIV infection and STI counselling. A small minority of doctors undertook contact tracing, and there was incomplete notification of many STI. Conclusions: Overall medical management of STI by primary care physicians was acceptable. Skills in contact tracing and reminders on disease notification are areas that need particular attention.

Additional keywords: contact tracing, counselling, general practitioners, notification.


The present study was funded by an enabling grant from the National Medical Research Council. We thank Mr Chris Deng for his creation of an Excel data-entry template.


[1] Sen P,  Chio MTW,  Tan HH,  Chan RKW. Rising trends of STIs and HIV infection in Singapore – a review of epidemiology over the last 10 years (1994 to 2003). Ann Acad Med Singapore 2006; 35 229–35.
PubMed |

[2] Department of STI Control. Annual report. Singapore: National Skin Centre 2006

[3] Ministry of Health SingaporeCommunicable Disease Surveillance in Singapore 2006. Singapore: Ministry of Health Singapore; 2007.

[4] Mulvey G,  Temple-Smith MJ,  Keogh LA. Sexually-transmitted diseases – knowledge and practices of general practitioners in Victoria, Australia. Genitourin Med 1997; 73 533–7.
CAS | PubMed |

[5] Freedman E,  Britt H,  Harrison CM,  Mindel A. Sexual health problems managed in Australian general practice: a national, cross sectional survey. Sex Transm Infect 2006; 82 61–6.
Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |

[6] Van Bergen JE,  Kerssens JJ,  Schellevis FG,  Sandfort TG,  Coenen TJ,  Bindels PJ. Prevalence of STI related consultations in general practice: results from the second Dutch National Survey of General Practice. Br J Gen Pract 2006; 56 104–9.
PubMed |

[7] Khandwalla HE,  Luby S,  Rehman S. Knowledge, attitudes and practices regarding sexually transmitted infections among general practitioners and medical specialists in Karachi, Pakistan. Sex Transm Infect 2000; 76 383–5.
Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |

[8] Verhoeven V,  Bovijn K,  Helder A,  Peremans L,  Hermann I,  Van Royen P, et al. Discussing STIs: doctors are from Mars, patients from Venus. Fam Pract 2003; 20 11–15.
Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |

[9] Schneider H,  Chabikuli N,  Blaauw D,  Funani I,  Brugha R. Sexually transmitted infections – factors associated with quality of care among private general practitioners. S Afr Med J 2005; 95 782–5.
CAS | PubMed |

[10] Hansen L,  Barnett J,  Wong T,  Spencer D,  Rekart M. STD and HIV counseling practices of British Columbia primary care physicians. AIDS Patient Care STDS 2005; 19 40–8.
Crossref | GoogleScholarGoogle Scholar | PubMed |