Background The national sexual health strategy recommends that services should meet the needs of local communities and identifies where service developments are needed most. The financial pressures of the health service and the operational pressures of trying to meet a 48-h target make it difficult to establish targeted outreach projects to reduce the burden of STIs and the uptake of STI/HIV screening and testing in hard to reach groups.
Methods A needs assessment was carried out with relevant partner organisations and an outreach project with sexual health advisors was developed. The needs assessment identified three areas for targeted outreach: brothel services for heterosexual men, sauna for MSM and youth offender services. A health advisor outreach clinic was established and staffed 1–4 times a month. Outcome data from the clinics are presented.
Results The youth offender service clinic was the most successful outreach with 32 patients seen over 17 sessions (23 males and nine females). There were 15 males tested in the sauna over 18 sessions and four female sex workers tested in two clinic sessions. STIs were identified in 20% of all patients seen (two cases of Gonorrhoea, six cases of Chlamydia, two cases of syphilis). The mean percentage of patients seen in the outreach clinics who had never been to the GUM clinic was 71% (75% in brothel, 84% in YOS, 34% from sauna).
Discussion The targeted outreach has revealed a high level of STIs (20%) in the target group as assumed. The targeted outreach service should reduce the rate of STIs by appropriate treatment, partner notification and counselling. Recording of testing has missed out on the recording of educational activities and other health promotion carried out at sessions. Targeted outreach will help to improve access to those who don't normally attend, improve patient care and help reduce STIs in the community.
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