SEXUAL HEALTH SERVICES

The 374 clinic: an outreach sexual health clinic for young men

D A Lewis¹, A McDonald², G Thompson² and J S Bingham²

¹ National Institute of Communicable Diseases, South Africa
² Department of Genitourinary Medicine, Lydia Clinic, 1st Floor Lambeth Wing, Guy’s and St Thomas’s Hospital NHS Trust, Lambeth Palace Road, London SE1 7EH, UK

Correspondence to:
Correspondence to:
D A Lewis
Head of STI Reference Centre, National Institute of Communicable Diseases, Private Bag X4, Sandringham 2131, South Africa; david.lewis{at}nhls.ac.za

Objectives: To describe the establishment of a community based walk-in outreach genitourinary medicine clinic, the "374 clinic," in south London to target young men under 25 in an area with high rates of sexually transmitted infections (STIs).

Methods: The outreach clinic was set up within a Brook advisory centre, which already had gained the trust of local young people. Epidemiological, clinical, and laboratory data were obtained retrospectively for the first 24 weeks of the service.

Results: 134 attendances were recorded, including 94 new and 10 rebook events. The age range of the young men seen was 12–27 years (mean 18.2 years), the patients were mainly from black and ethnic minority groups, and all but one were heterosexual. Most men had heard about the clinic by "word of mouth," recommendation by Brook staff or through clinic promotional material. Condoms were used more frequently with non-regular sexual partners than with regular partners. The uptake of screening for gonococcal and chlamydial infections, mostly by urine based molecular techniques, was 98%. The uptake for HIV testing in men aged 16 or more was 72%. An overall STI prevalence rate of 26% was detected in the clinic population, which consisted almost equally of asymptomatic and symptomatic patients. The most prevalent STI was chlamydial infection (12%).

Conclusions: The young men who attended the outreach clinic were happy to undergo both non-invasive urine based testing for gonorrhoea and chlamydia as well as phlebotomy to test for HIV and syphilis. The 374 clinic approach may prove to be a useful model for further outreach services to combat poor sexual health of young men in inner city areas.

Abbreviations: GUM, genitourinary medicine; NSU, non-specific urethritis; STI, sexually transmitted infections

Keywords: outreach clinic; young men; sexual health

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