Evaluation of sexual health services within Australia and New Zealand.

ABSTRACT

OBJECTIVE: To examine and compare specialised services for patients with sexually transmitted diseases (STDs) in Australia and New Zealand. DESIGN: Postal questionnaire survey. PARTICIPANTS AND SETTING: All STD facilities in Australia and New Zealand in 1993. MAIN OUTCOME MEASURES: Patient numbers and demography; staffing levels; the role of nurses; diagnostic and treatment protocols; contact-tracing policies; and the availability of specialist medical services and community and education programs. RESULTS: 83 of 100 clinics responded; 52 were urban, 21 rural, and nine remote. 95% were open to men and women. Staffing levels were similar in Australia and New Zealand and there was considerable consistency in diagnostic techniques and treatment among clinics. Australian clinics more often used ciprofloxacin or ceftriaxone as the treatment of first choice for gonorrhoea; New Zealand clinics were more likely to test for Chlamydia using direct immunofluorescence; and Australian clinics were more likely to test for hepatitis A and offer hepatitis B vaccination to a broader range of patients. 88% of clinics always traced contacts for gonorrhoea, 86% for syphilis and 77% for Chlamydia. 98% of clinics offered HIV test counselling, and 78% STD health education. CONCLUSIONS: The number of sexual health services has increased over the past decade. Other improvements include most clinics being open to both men and women, and consistency in the diagnosis, treatment and contact tracing of STDs. However, given the lack of adequate comparative data and the variable quality of national surveillance data, it is difficult to determine whether current facilities are meeting service needs.