Staff training in integrated sexual health services
- Centre for Sexual and Reproductive Health Research, Department of Public Health and Policy, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK
- Correspondence to: Roslyn Kane, Centre for Sexual and Reproductive Health Research, Department of Public Health and Policy, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK;
Coordination of family planning and GUM services has the potential to boost the effectiveness of both
The move towards integration of family planning and genitourinary medicine (GUM) services (that is, the reorganisation of the two specialties, strategically and in terms of setting, in a more client centred approach) has recently been gathering momentum in the United Kingdom. Providers of family planning services are increasingly being urged to adopt a broader remit in respect of their clients’ needs for STI and HIV prevention and treatment,1 as are providers of STI services in respect of their clients’ contraceptive needs. Although fully integrated sexual health services are still comparatively rare, a growing number of family planning services provide STI diagnosis and treatment and a growing number of GUM clinics provide contraceptive services.2,3 The trend may be accelerated as a result of the government’s sexual health strategy,4 in England. The systematic evaluation of three pilot “one stop shops” is likely to provide more robust evidence on the acceptability and effectiveness of integrated services which, if favourable, could provide the impetus to further expansion.
In theory, the case for an integrated approach to sexual health service provision is compelling. Control of fertility and of sexually transmitted infection share common characteristics. The choice of contraceptive method may have implications for transmission of infectious agents and the presence of infection has consequences for fertility. The two services also share potential clients. Studies of GUM clinic attenders have shown a high proportion to be at risk of pregnancy5–9 and studies of family planning clinics attenders show sizeable proportions to be at risk of infection.7,10,11 There is also evidence that service users prefer a one stop service providing coordinated sexual health care.7,12,13 Advocates of integration claim that …