[The Levinsky Walk-in Clinic in Tel Aviv: holistic services to control sexually transmitted diseases in the community].

The Israeli Ministry of Health inaugurated two walk-in community sexually transmitted disease (STD) clinics in 2002. This review focuses on the Levinsky Clinic in Tel Aviv. The clinics were established as a response to the increase in N. gonorrhea morbidity during the late 1990's, especially in the Tel Aviv district and following the rise in trafficking of women into Israel. The target populations were later extended to include other individuals at risk of developing STD, such as prostitutes, drug addicts, men who have sex with men, persons who have multiple sex partners or individuals considering themselves to be at high-risk. The clinic is operated by a multi-professional team, including physicians, nurses, social and community workers, and volunteers. Each patient is interviewed by a nurse or social-worker to stratify her/his risk of acquiring STD. Laboratory tests and physical examinations are performed as indicated. The services are free of charge and the clients have the option to remain anonymous in order to hamper possible barriers in accessing the clinic. The medical and psycho-social services of the Levinsky Clinic are tailored for the target populations. Therefore, some of the services are provided by a mobile unit outreaching the streets, brothels, shelters for trafficked women and refugees, correctional facilities, gay venues and drug trade locations. The staff employs the harm reduction strategy, is sensitive to the status of the individual in the community, and attentive to the influence of the environment over the clients' ability to control their risks of acquiring STD. The staff encourages an open and direct conversation with the clients about sex and sexuality, in a non-judgmental and respectful fashion. Many of those interventions are provided by community workers, who are familiar with the unique social behaviors, language, values and life style of the vulnerable populations, and aware of the limitations in adopting safe sex practices.