BMJ  2006;332:332-334 (11 February), doi:10.1136/bmj.38726.404120.7C (published 26 January 2006)

Research

Trends in sexually transmitted infections in general practice 1990-2000: population based study using data from the UK general practice research database

Jackie A Cassell, senior clinical research fellow1, Catherine H Mercer, research fellow2, Lorna Sutcliffe, research coordinator1, Irene Petersen, research fellow1, Amir Islam, research fellow1, M Gary Brook, consultant genitourinary physician3, Jonathan D Ross, consultant genitourinary physician4, George R Kinghorn, consultant genitourinary physician5, Ian Simms, senior epidemiological scientist6, Gwenda Hughes, head of research services7, Azeem Majeed, professor of primary care and social medicine1, Judith M Stephenson, reader in epidemiology2, Anne M Johnson, professor of epidemiology1, Andrew C Hayward, senior lecturer in infectious disease epidemiology1

1 Department of Primary Care and Population Sciences, Royal Free and University College Medical School, London NW3 3PF, 2 Centre for Sexual Health and HIV Research, Royal Free and University College Medical School, London WC1E 6AU, 3 Patrick Clements Clinic, Central Middlesex Hospital, London NW10 7NS, 4 Whittall Street Clinic, Birmingham B4 6DH, 5 Royal Hallamshire Hospital, Sheffield S10 2JF, 6 Centre for Infections (Communicable Disease Surveillance Centre), Health Protection Agency, London NW9 5EQ, 7 General Practice Research Database Division, Medicines and Healthcare Regulatory Agency, London SW8 5NQ

Correspondence to: J A Cassell j.cassell{at}pcps.ucl.ac.uk

Abstract

Objective To describe the contribution of primary care to the diagnosis and management of sexually transmitted infections in the United Kingdom, 1990-2000, in the context of increasing incidence of infections in genitourinary medicine clinics.

Design Population based study.

Setting UK primary care.

Participants Patients registered in the UK general practice research database.

Main outcome measures Incidence of diagnosed sexually transmitted infections in primary care and estimation of the proportion of major such infections diagnosed in primary care.

Results An estimated 23.0% of chlamydia cases in women but only 5.3% in men were diagnosed and treated in primary care during 1998-2000, along with 49.2% cases of non-specific urethritis and urethral discharge in men and 5.7% cases of gonorrhoea in women and 2.9% in men. Rates of diagnosis in primary care rose substantially in the late 1990s.

Conclusions A substantial and increasing number of sexually transmitted infections are diagnosed and treated in primary care in the United Kingdom, with sex ratios differing from those in genitourinary medicine clinics. Large numbers of men are treated in primary care for presumptive sexually transmitted infections.


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