GPs, STDs and life insurance.

We sought to ascertain general practitioners' (GPs) views on their patients' attendances at genitourinary medicine (GUM) departments regarding methods of referral, record keeping and supplying of information to insurance companies. A questionnaire was sent to 429 local GPs of whom 294 (68%) responded. A written means of referral was less likely for HIV than for sexually transmitted disease (STD) (P < 0.001), and in turn less likely for STD than for other genital problems (P < 0.02). The percentage of GPs who did not keep a record of referrals were: For HIV testing--29%; STDs--13%; and for other genital problems--8%. Whilst 48% of GPs did not feel obliged to divulge lifestyle information on a patient, 21% would feel it necessary to confirm that a patient had suffered from an STD if the 'source' on a cytology smear was shown to be that of a GUM department. Only 23 GPs (8%) felt they had sufficient knowledge as to the use to which the information they supplied to insurance companies was put. Many GPs acknowledged that their practice, with reference to patient attendance at a GUM department, was influenced by life insurance considerations. Bearing in mind the current policy of The Association of British Insurers which recommends that all applicants for life insurance be asked to declare any previous STD and counselling/testing for HIV, we make several suggestions which may aid GPs in this difficult area.