What is a GUM clinic?
These are sometimes known formally and informally as:
Sexually transmitted infections are diagnosed in other settings- such as clinics for pregnancy terminations, family planning, antenatal care, well women and general practice. However once picked up in these places many will be referred to a GUM clinic for further management. It is only GUM clinics that record routine statistics on sexually transmitted infections. Nearly 1/2 million diagnoses were made in GUM clinics up and down the country in 1996 making them a vital service in controlling the spread of sexual infections.
A recent large scale survey on Sexual Attitudes and Lifestyles of a random sample of the British population found that approximately 1 in 10 men and 1 in 20 women had attended a GUM clinic. The likelihood of attending increased markedly with increasing number of heterosexual partners. One in seven attended who reported more than 5 heterosexual partners in 5 years. More than half of homosexual men with 5 or more partners in 5 years attended a clinic.
A network of clinics was first established following the Venereal Disease Regulations of 1916 when concern about sexually transmitted diseases (STDS) was high. There are now approximately 230 clinics in the UK. Each one has open access and offers free and confidential services and treatment for all sexually transmitted infections (STIs) including HIV. Users are entitled to claim for reasonable travel expenses incurred when making a visit irrespective of income or employment status.
Experience of the range and quality of services will vary considerably across the country.
It might be helpful to check out in advance if the clinic will see you without an appointment. Many do but it will mean just queueing. Upon arrival you will be asked to register. You can give as little or as much information as you like without fear that your confidentiality will be breached. This cannot be overemphasised. Special laws exist to protect personal information held on GUM clinic users. If you use false information it is important use the same details at future visits. Each person is given a card with their own clinic number on which should be brought at each visit. It may be possible in some clinics to request you are seen by someone of a particular gender.
The doctor will ask some questions in order to take a sexual history to help decide what investigations should be done (if any). For example;
Examination & Tests
These will vary according to a persons sex and stated sexual practice so it is important to answer truthfully any question asked if nothing is to be overlooked. If you are unsure why some information is requested or words are used that you dont understand then ask for a clearer explanation. Staff should be sensitive to the fact that many people get embarrassed and fearful about being questioned and examined. Dont be intimidated by anyone or feel you shouldnt complain if you are unhappy with the service. Most clinics are keen to ensure that they offer something of quality.
Tests may include:
Sometimes it is possible to tell straight away the presence of some infections by direct observation and use of a microscope. Other things need to be sent off to a laboratory and may take several days for the results to become known. You may be asked to return for further tests at the end of a specified time period before a full diagnosis can be made. For example HIV and syphilis may takeup to 3 months after infection to show up on a blood test. A full explanation should be given of test results and relevant leaflets supplied to back up any advice given.
Treatment given is free and often dispensed straightaway. A full course of antibiotics should be taken even if the symptoms clear up halfway through. Take note that many infections can be present in people without them even realising.
Most clinics have a health adviser who can spend unhurried amounts of time helping you to better understand what is going on. You may have a lot of personal things you would like to talk through. For example they can help when working out what to do about current or previous partners who may need to be examined or treated. They may ask you for details of partners and whereas this can be really important in helping to control the spread of infections remember that you are under no obligation to give this information. You may however prefer they took on the responsibility to contact partners and you can be assured that this will be undertaken with great tact and discretion without disclosing your identity.
(By Chris Faldon, Health Adviser, Newcastle General Hospital)