Introduction of screening guidelines for men who have sex with men at an STD clinic, the Melbourne Sexual Health Centre, Australia.
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.
Lister
Nichole A
NA
Department of Public Health, The University of Melbourne, VIC 3010, Australia.
Smith
Anthony
A
Fairley
Christopher K
CK
D000328:Adult; D002690:Chlamydia Infections / Q000175:diagnosis* / Q000453:epidemiology; D002692:Chlamydia trachomatis / Q000302:isolation & purification; D006069:Gonorrhea / Q000175:diagnosis* / Q000453:epidemiology; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000458:organization & administration*; D008485:Medical Audit / Q000706:statistics & numerical data; D008875:Middle Aged; D009344:Neisseria gonorrhoeae / Q000302:isolation & purification; D012309:Risk-Taking; D012736:Sex Education / Q000379:methods; D014739:Victoria / Q000453:epidemiology