A walk-in triage system (WITS) was introduced at Melbourne Sexual Health Centre in August 2001 as a result of the perceived need to increase access to the clinic for clients requiring immediate assessment. An audit of this alteration to clinic operation resulted in a significant increase in the number of new clients attending the clinic who were younger and less likely to report using condoms, substantial increases in the number of investigations ordered for bacterial sexually transmitted infections (STIs) and an increase in the detection of genital herpes and chlamydia. There are a number of possible explanations for these changes other than the change to clinic operation but these are less likely causes for the observed changes. Our findings should complement the other reasons to adopt a WITS system, such as improving access for those most in need and vital to reach if STI rates are to fall.
Partner notification is crucial to the effective control of sexually transmissible infections (STIs) and has not changed substantially over recent years. New technology for communication has been rapidly adopted in our communities but little work has been carried out about its role in contact tracing. Text messaging, emails and the Internet could be useful tools for both provider and patient referral but considerable ethical considerations are involved. Technology is available to help protect the basic tenets of confidentiality and privacy but more thorough exploration of these methods is required to establish efficacy and appropriateness in contact tracing. This research is important if we are to procure an evidence base for future contact tracing strategies rather than allowing these methods to become commonplace at the initiation of our clients.
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