Treating sexually transmitted infections in primary care: a missed opportunity?

Objectives: To explore patterns of primary care attendance, barriers to the use of primary care, and views on services in a population of first time genitourinary medicine (GUM) clinic attenders. Method: A cross sectional survey of new patients attending a mainly walk-in outer London GUM clinic, in which responses were linked to clinical data. Results: 40.5% of all patients and 39.9% of those with an STI had already seen a GP for their current problem. This did not vary with age or symptom status. Duration of symptoms was highly significantly longer in patients who had attended a GP than in patients who attended a GUM clinic in the first instance. When patients who had not seen a GP were asked the reason for this, a third of responses cited the convenience of a GUM clinic or difficulty in accessing primary care services, while only 3% cited embarrassment and only 2% examination or gender issues. Conclusion: Many patients initially attend GP services for STIs, and primary care is therefore already an important setting with potential for STI control. However, delay in treatment through attendance at primary care, and barriers in access to primary care, need to be addressed in the planning of future services.