When a sexually transmitted disease is suspected, it is important that prompt reliable screening and support services are available to the patient. They should be easily accessible and strictly confidential, providing the patient with the confidence to seek help. The Department of Health has recently published new recommended standards for sexual health services and these apply to all facilities providing NHS-funded sexual health services. Click here for more information on these standards. Prompt diagnosis and treatment of STDs are essential to reduce the levels of infection within the community. The recommended standards for sexual health services state that by 2008 all patients should be able to access STD services within 48 hours of making first contact.

There are a number of different facilities available that provide testing and support for individuals who are or may be infected with an STD. These include genito-urinary medicine (GUM) clinics and sexual health clinics, GP surgeries, drug agencies, antenatal clinics, family planning clinics, well woman clinics and NHS walk-in centres.

GUM clinics

Genito-urinary medicine (GUM) clinics specialise in issues surrounding sexual health and related diseases. They offer a completely confidential service and provide testing, advice and counselling on all types of sexually transmitted diseases (STDs). Some clinics offer a walk-in service but others are by appointment only. The most important factor surrounding the GUM clinic is confidentiality. Special laws are in place to protect disclosure of any personal information given at the clinic without the patient’s consent. This includes disclosure to other health professionals, such as a GP, which means that any results will not appear on the patient’s personal health records.
On first arriving at the clinic, the patient needs to register. It is up to patients’ personal discretion how much, or how little, information they wish to give. False names and addresses can be given, but the same details should be used at every visit. It can also be useful if the clinic has some method of contacting individuals. The laws of complete confidentiality also apply to those under 16 years of age.

Once all the details are registered, the doctor, nurse or sexual health advisor will take a sexual history to try and determine which tests should be performed. The tests performed will depend upon the individual’s sexual history and what type of sex they have had. It is important to stress how critical it is that the patient answers any questions truthfully. The tests carried out may include:

• urine tests
• cervical smear
• swabs from the urethra, vagina, cervix, throat or rectum
• blood tests.