Genitourinary medicine clinic and general practitioner contact: what do patients want?

Abstract

Mode of referral and concerns about the implications of HIV testing affect patient preference on information sharing. A significant proportion of patients still want GUM visits to be anonymous and a policy of sharing GUM data on common IT systems may deter patient attendance.

Increased electronic information sharing by sexual health services: Confidentiality and consent

“…Similar to a previous study with UK GUM clinic patients, 8 46 per cent of respondents in this study disagreed with other hospital medical staff accessing their sexual health test results and 49 per cent agreed that the SHS could replace the current separate SHS code on laboratory forms with NHI numbers. This indicates that the inclusion of all SHS laboratory results in regional repositories may cause a barrier to attending the SHS, given the 21 per cent of respondents who said that they would stop attending the SHS if NHI numbers were used.…”

“…Referred patients, however, were more likely to agree to a discharge letter to their GP (35% compared with 25%), although at a slightly lower level than previous studies, 8,23 indicating that the concerns of patients attending sexual health clinics may not be limited to a provincial SHS in New Zealand. The SHS receives referrals (both formal written and informal verbal) from many different health professionals, so a respondent may have been referred to the SHS by a non-GP referrer, which may account for our slightly lower figure but warrants further investigation.…”

“…7 In New Zealand, sexual health care is mainly provided by free sexual health clinics and family planning and youth clinics and general practitioners (GPs) with varying levels of fee subsidy. 7 However, information sharing with other health providers has been a major concern for patients attending SHS, 8–10 where the sensitive nature of relevant information is potentially stigmatising – contracting an STI is often perceived as due to ‘amoral’ or ‘deviant’ behaviours – that people with STIs are somehow socially and morally unacceptable, and thus, people with STIs can be subjected to embarrassment, discrimination, criminalisation and abuse. 11–13 Thus, patients may limit disclosure of information that is essential for correct treatment or be deterred from attending for care.…”

“…11–13 Thus, patients may limit disclosure of information that is essential for correct treatment or be deterred from attending for care. 8 –15 Most SHS currently use their own sexual health code numbers, a similar practice to that of sexual health and genitourinary medicine (GUM) clinics in the United Kingdom, 8 to keep patients’ records and test results separate from hospital and regional databases, thus maintaining a confidential service for SHS patients. 16…”

Otitis media: prevention instead of prescription

“…These factors included heterosexual orientation, initial GP referral, and not considering HIV testing to have negative implications for future mortgage and life insurance applications. 6 Two factors have been reported to us that impair the ability of non-genitourinary practitioners, both in primary care and other specialist care settings, to perform HIV testing. The first is pre-test counselling.…”