CHLAMYDIA TESTING IN COMMUNITY CLINICS - A FOCUS FOR ACCURATE SEXUAL HEALTH-CARE

As judged by testing women in community clinics at the time of their c ervical smear; a substantial number of chlamydial infections exists in Liverpool but the vast majority of these infections would have been m issed by current practice which relies on patients complaining of symp toms. One hundred and sixty four women who spontaneously reported symp toms or with risk factors for sexually transmitted diseases were refer red directly from the community clinics to the department of Genitouri nary Medicine (GUM) for investigation. One thousand one hundred and se venty women aged between 16 and 25 years were screened for chlamydial infection in the clinics. Of these, 295 (25 percent) eventually admitt ed to having symptoms suggestive of infection during the consultation and had a chlamydia positive rate (7.1 per cent) equal to that in the women referred directly to GUM. The overall positive rate for those sc reened was 4.9 per cent. In those without symptoms or signs, selection on one or more of six parameters identified a significantly higher ch lamydia positive rate (9.3 per cent) than in the remainder of the grou p (3.2 per cent) and women using the male condom alone for contracepti on had the lowest positive rate (2.5 per cent). There was a substantia l delay in some women reaching the department of GUM for treatment One case of gonorrhoea was found during the study. Offering a community c linic test for chlamydia has provided a focus for discussing reproduct ive health with both the women themselves and their health care provid ers and purchasers.