McCarthy G A, Cockell A P, Kell P D, Beevor A S, Boag F C
John Hunter Clinic, St Stephen's Clinic, London.
Genitourin Med. 1992 Dec;68(6):386-9. doi: 10.1136/sti.68.6.386.
To evaluate a multidisciplinary women-only clinic (WOC) providing HIV testing, HIV follow-up, genitourinary screening and a substance misuse service. The clinic is designed to attract women who are at risk of acquiring sexually transmitted infections, including HIV, yet are not using existing medical services.
A questionnaire survey and review of the case notes of women attending the WOC during the first seven months (April to October 1991) and comparison with a mixed-sex, daytime genitourinary clinic (John Hunter Clinic), and a HIV out-patients clinic (Kobler Centre) all within St Stephen's Clinic.
One hundred and twenty-nine women attended the WOC over the seven month period and 113 completed a questionnaire. The main reasons for attendance included a preference to be seen by a female doctor and staff, the presence of female patients in the waiting area, and the greater convenience of an evening clinic. In the absence of the WOC over half the patients (56%) indicated that they would not have attended a genitourinary medicine (GUM) clinic. The WOC attracted significantly more new patients than in the JHC (31.5% vs 15% p < 0.001). One hundred and four women (81%) were screened for genitourinary infection. Compared with the JHC there were significantly more cases of genital warts (33.9% vs 16.1% p < 0.001) and candidosis (41.5% vs 22.3% p < 0.001). A greater number of HIV tests were also performed (19% vs 9% p < 0.01). Sixteen (12.4%) women were HIV positive. Their attendance record at both first appointment (88% vs 64% p < 0.05) and subsequent follow-up appointments (81% vs 43% p < 0.05) was significantly higher than a comparable group of women seen by the same doctor (FB) in the Kobler Centre. The women also saw the health adviser more frequently. Although the number of injecting drug users was small (eight), all women currently injecting drugs entered a detoxification programme.
The WOC has become an established and popular service at St Stephen's. Women not previously using medical services are attending. The multidisciplinary nature of the clinic encourages a wider use of medical and paramedical services. Attendance record for HIV positive women has improved significantly. Whether these factors will lead to improved standards of sexual health will require a longer period of audit. Seventy-nine per cent of women indicated they would use a family planning service if available. An integrated family planning clinic was introduced after the audit period.
评估一家仅面向女性的多学科诊所（WOC），该诊所提供艾滋病毒检测、艾滋病毒随访、泌尿生殖系统筛查以及药物滥用服务。该诊所旨在吸引有感染包括艾滋病毒在内的性传播感染风险但未使用现有医疗服务的女性。
对在最初七个月（1991年4月至10月）期间就诊于WOC的女性进行问卷调查并查阅病例记录，并与圣斯蒂芬诊所内的一家男女混合的日间泌尿生殖诊所（约翰·亨特诊所）以及一家艾滋病毒门诊诊所（科布勒中心）进行比较。
在七个月期间，有129名女性就诊于WOC，其中113名完成了问卷调查。就诊的主要原因包括更倾向于由女医生和女工作人员看病、候诊区有女性患者以及夜间诊所更便利。若没有WOC，超过一半的患者（56%）表示她们不会去泌尿生殖医学（GUM）诊所就诊。WOC吸引的新患者明显多于约翰·亨特诊所（31.5%对15%，p<0.001）。104名女性（81%）接受了泌尿生殖系统感染筛查。与约翰·亨特诊所相比，尖锐湿疣病例显著更多（33.9%对16.1%，p<0.001），念珠菌病病例也显著更多（41.5%对22.3%，p<0.001）。进行的艾滋病毒检测数量也更多（19%对9%，p<0.01）。16名（12.4%）女性艾滋病毒呈阳性。她们在首次预约就诊（88%对64%，p<0.05）和后续随访预约就诊（81%对43%，p<0.05）时的就诊记录明显高于在科布勒中心由同一位医生（FB）诊治的一组类似女性。这些女性看健康顾问也更频繁。尽管注射吸毒者数量较少（8名），但所有目前注射毒品的女性都进入了戒毒项目。
WOC已成为圣斯蒂芬诊所一项既定且受欢迎的服务。以前未使用医疗服务的女性开始就诊。诊所的多学科性质鼓励更广泛地使用医疗和辅助医疗服务。艾滋病毒呈阳性女性的就诊记录有显著改善。这些因素是否会导致性健康标准提高还需要更长时间的审计。79%的女性表示如果有计划生育服务，她们会使用。在审计期之后引入了一家综合计划生育诊所。
