在全科医疗中检测性传播感染：横断面研究。
Testing for sexually transmitted infections in general practice: cross-sectional study.
机构信息
Research Department of Infection and Population Health, University College London, London, UK.
出版信息
BMC Public Health. 2010 Nov 3;10:667. doi: 10.1186/1471-2458-10-667.
BACKGROUND
Primary care is an important provider of sexual health care in England. We sought to explore the extent of testing for chlamydia and HIV in general practice and its relation to associated measures of sexual health in two contrasting geographical settings.
METHODS
We analysed chlamydia and HIV testing data from 64 general practices and one genitourinary medicine (GUM) clinic in Brent (from mid-2003 to mid-2006) and 143 general practices and two GUM clinics in Avon (2004). We examined associations between practice testing status, practice characteristics and hypothesised markers of population need (area level teenage conception rates and Index of Multiple Deprivation, IMD scores).
RESULTS
No HIV or chlamydia testing was done in 19% (12/64) of general practices in Brent, compared to 2.1% (3/143) in Avon. In Brent, the mean age of general practitioners (GPs) in Brent practices that tested for chlamydia or HIV was lower than in those that had not conducted testing. Practices where no HIV testing was done had slightly higher local teenage conception rates (median 23.5 vs. 17.4/1000 women aged 15-44, p = 0.07) and served more deprived areas (median IMD score 27.1 vs. 21.8, p = 0.05). Mean yearly chlamydia and HIV testing rates, in practices that did test were 33.2 and 0.6 (per 1000 patients aged 15-44 years) in Brent, and 34.1 and 10.3 in Avon, respectively. In Brent practices only 20% of chlamydia tests were conducted in patients aged under 25 years, compared with 39% in Avon.
CONCLUSIONS
There are substantial geographical differences in the intensity of chlamydia and HIV testing in general practice. Interventions to facilitate sexually transmitted infection and HIV testing in general practice are needed to improve access to effective sexual health care. The use of routinely-collected laboratory, practice-level and demographic data for monitoring sexual health service provision and informing service planning should be more widely evaluated.
背景
初级保健是英国提供性健康保健的重要提供者。我们试图探索在两个截然不同的地理位置的普通诊所中进行衣原体和 HIV 检测的程度，并将其与相关的性健康措施进行关联。
方法
我们分析了 2003 年中期至 2006 年中期在布伦特（Brent）的 64 家普通诊所和 1 家泌尿科诊所（64 家普通诊所和 1 家泌尿科诊所）以及 2004 年在埃文（Avon）的 143 家普通诊所和 2 家泌尿科诊所的衣原体和 HIV 检测数据。我们检查了实践测试状态，实践特征以及人口需求的假设标志物（地区青少年妊娠率和多重剥夺指数（IMD）分数）之间的关联。
结果
在布伦特（Brent）的 64 家普通诊所中，有 19%（12/64）未进行 HIV 或衣原体检测，而在埃文（Avon）的 143 家普通诊所中，这一比例为 2.1%（3/143）。在布伦特（Brent），进行衣原体或 HIV 检测的布伦特（Brent）实践的普通医生（GP）的平均年龄低于未进行检测的实践。未进行 HIV 检测的实践中，当地青少年怀孕率略高（中位数 23.5 比 17.4/1000 名年龄在 15-44 岁的妇女，p = 0.07），服务范围更广（中位数 IMD 分数 27.1 比 21.8，p = 0.05）。在进行检测的实践中，布伦特（Brent）和埃文（Avon）的每年平均衣原体和 HIV 检测率分别为 33.2 和 0.6（每 1000 名 15-44 岁的患者）和 34.1 和 10.3。在布伦特（Brent）的实践中，只有 20%的衣原体检测是在 25 岁以下的患者中进行的，而在埃文（Avon）中则有 39%。
结论
普通诊所中衣原体和 HIV 检测的强度存在很大的地域差异。需要采取干预措施，促进普通诊所中的性传播感染和 HIV 检测，以改善获得有效性保健的机会。应更广泛地评估使用常规收集的实验室，实践水平和人口统计数据来监测性保健服务的提供情况并为服务计划提供信息。
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