Community clinics can treat sexually transmitted infections

Editor—The House of Commons Public Health Select Committee on Sexual Health recently highlighted the “appalling sexual health crisis” in the United Kingdom and the inability of existing specialist services to meet the demand caused by increasing incidence of sexually transmitted infections.¹,² Recommendations to increase funding to existing hospital based services are to be welcomed, but more innovative solutions should also be considered.

A community based service for the management of uncomplicated genital infections has been running since November 2001 in Lewisham, south east London, an area with high rates of sexually transmitted infections. During the first year 648 infections were treated in 11 community family planning clinics (36 327 client attendances in 2001-2). Chlamydia and chlamydia/non-specific urethritis/non-specific genital infections account for most (70%) of the infections treated.

Demand for the service is growing, and the average number of infections treated weekly has progressively increased from 10 in the first three months to 15 at the end of the first year.

Detailed analysis at the largest clinic has shown that 82% of clients with sexually transmitted infections were treated in the clinic (compared with 52% when clients had to be referred to a specialist clinic),³ and treatment can be verified for 0.43 sexual partners per case of chlamydia treated.

Our experience in Lewisham shows that uncomplicated sexually transmitted infections can be managed in community clinics, which provide an accessible service in a familiar environment. Uptake seems to increase without formally advertising to clients.