Introduction of Screening Guidelines for Men Who Have Sex With Men at an STD Clinic, the Melbourne Sexual Health Centre, Australia

A recent audit found that a considerable proportion of men who have sex with men (MSM) were not tested for chlamydia and rectal gonorrhea at the Melbourne Sexual Health Clinic. In response, the clinic instituted screening guidelines for MSM that use a computer reminder. The authors of the current study evaluated the impact of the guidelines and alert on screening MSM for gonorrhea and chlamydia.

From July to October 2002, four months prior to the implementation of the guidelines and reminder, the medical records of MSM were reviewed for chlamydia and gonorrhea testing by site (pharyngeal, urethral, and rectal). The records were then reviewed for one year thereafter, beginning in November 2002.

A significant increase in rectal chlamydia testing (55 percent to 67 percent, P<0.001) was seen after the guidelines were introduced, and a significant reduction was seen for pharyngeal chlamydia and gonorrhea testing (65 percent to 28 percent, P<0.001, and 83 percent to 76 percent, P=0.015, respectively). There was no change in the proportion of tests that were positive in any site (7 percent to 7 percent).

"The introduction of a computer reminder for new guidelines was temporarily associated with screening that conformed more closely to clinical guidelines," the authors concluded.

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