Objective To follow a series of 100 women attending for fitting of the levonorgestrelreleasing intrauterine system (LNG IUS) registered at a single urban general practice serving the students of the local universities and higher education colleges. Methods This was a prospective observational study. A questionnaire was completed by the fitter in discussion with the patient at the time of attendance for IUS fitting. Follow up was by telephone at 6 weeks, 6 months and 9-12 months after fitting. Results The age range of women within the series was 18-38 years. 97 women were nulliparous. 37 women selected the IUS as their preferred method of contraception. 12 women chose the IUS primarily for non-contraceptive reasons. 75 women still had the IUS at 12 months' follow up with 11 lost to follow up at this point. No pregnancies or perforations were reported. Conclusions The IUS is an acceptable form of contraception in young women, including nulliparous women, and should be offered alongside other methods as first line without restriction when offering contraceptive options to this age group.

Background: A young people's clinic has been running at the Archway Sexual Health Clinic since 1997. This offers a weekly walk-in service to both young men and women under 20 years old. Objectives: To review the audit data of over 7 years' experience from the dedicated young people's clinic at the Archway Sexual Health Clinic, the ''Arch.'' Methods: These data were collected by retrospective notes review of a consecutive series of all male attendees over a 7 year period from 1997 to the end of 2003 with collection of data in Microsoft Excel database. Results: These figures show an overall increase in attendee numbers, but also a relative rise in the numbers of young men using the service. A high number of bacterial sexually transmitted infections were detected. In 2001 and 2003 respectively, 14.5% and 17.8% of the young men using the service were diagnosed with Chlamydia trachomatis. A user survey aimed to identify factors that may be encouraging the young men to access the service. Conclusions: Responding to the views of young men using the service has played a part in service development. Initiatives at the ''Arch'' such as the condom policy and choice of gender of staff may be factors encouraging increasing attendances. Continuing to work with other agencies to develop ways to engage young men are recommended. Word of mouth recommendation cannot be underestimated in publicising the service.

Sexual assault in the UK is common. The British Crime Survey (2000) estimated that 61 000 women in England and Wales had been raped in the preceding year and found that this is the crime that women fear most. 1 Most women and virtually all men who have been sexually assaulted keep their painful experience to themselves and do not disclose it to police or healthcare services. 2 Those vulnerable individuals miss out on the prevention and treatment of sequelae such as sexually transmitted infections, genital injuries and other trauma, unwanted pregnancies, and psychological morbidity-while their assailants avoid prosecution and may go on to assault others. Even when sexual assault is reported to the police, conviction rates are low. In the year 2002, the police recorded 9723 female rapes. Only 2651 assailants were proceeded against and a mere 572 cases ended in a conviction. 3 Service improvements that encourage complainants of sexual assault to seek help for themselves and provide the forensic evidence needed by the prosecution to secure a conviction are therefore clearly desirable.

No abstract