title: What proportion of sexually transmissible infections and HIV are diagnosed in New South Wales' public sexual health services compared with other services?
abstract: BACKGROUND
  In New South Wales (NSW), publicly funded sexual health services (PFSHSs) target the populations at greatest risk for important sexually transmissible infections (STIs) and so may make a large contribution to the diagnosis of notifiable STIs. We aimed to determine the proportions of STIs diagnosed in PFSHSs and notified to the NSW Ministry of Health in 2009, and describe geographical variations.
  
  
  METHODS
  The number of notifiable STIs (infectious syphilis, gonorrhoea, HIV and chlamydia) diagnosed in 2009 was obtained for each Area Health Service (AHS) and each PFSHS. The proportion of diagnoses made by PFSHSs was calculated at the state and AHS level according to five geographical regions: inner and outer metropolitan, regional, rural and remote.
  
  
  RESULTS
  The overall proportions of diagnoses made by NSW PFSHSs were syphilis, 25%; gonorrhoea, 25%; HIV, 21%; and chlamydia, 14%. Within each zone, the proportions of these STIs were (respectively): (i) inner metropolitan: 32%, 26%, 21% and 13%; (ii) outer metropolitan: 41%, 24%, 43% and 9%; (iii) regional: 62%, 15%, 23% and 10%; (iv) rural: 8%, 29%, <5% and 20%; and (v) remote: <5%, 43%, <5% and 29%. There was considerable variation in proportions of STIs between and within AHSs (<5-100%).
  
  
  CONCLUSIONS
  NSW PFSHSs contribute a large proportion of diagnoses for syphilis, gonorrhoea and HIV, but less so for chlamydia. Across AHSs and zones, there was considerable variation in the proportions. These data support the role of PFSHS in identifying and managing important STIs in high-risk populations.
authors: NSW Sexually Transmitted Infections Programs Unit, PO Box 1614, Sydney, NSW 2001, Australia.
authors: Chris
authors: C
authors: Bourne
authors: Debbie
authors: D
authors: Allen
authors: Katherine
authors: K
authors: Brown
authors: Stephen C
authors: SC
authors: Davies
authors: Anna
authors: A
authors: McNulty
authors: Don E
authors: DE
authors: Smith
authors: David E
authors: DE
authors: Smith
authors: Catherine C
authors: CC
authors: O'Connor
authors: Deborah
authors: D
authors: Couldwell
authors: Eva
authors: E
authors: Jackson
authors: Michale
authors: M
authors: Bolton
authors: Craig
authors: C
authors: Rodgers
authors: Pam
authors: P
authors: Konecny
authors: David J
authors: DJ
authors: Smith
authors: Angela
authors: A
authors: Parker
mesh_terms: D000328:Adult; D003151:Community Health Centers; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000453:epidemiology*; D006801:Humans; D008297:Male; D009517:New South Wales / Q000453:epidemiology; D011320:Primary Health Care; D012749:Sexually Transmitted Diseases / Q000175:diagnosis* / Q000453:epidemiology*