Knowledge of genital Chlamydia trachomatis infection in family planning clinic attenders.

The purpose of this study was to determine the level of awareness of genital Chlamydia infection and level of knowledge related to this infection in family planning (FP) clinic attenders. Clients attending FP clinics during a 3 month study period were invited to complete an anonymous self-administered questionnaire. Five hundred and sixteen questionnaires from female attenders were analysed. Results showed that 54% of respondents had heard of Chlamydia. Subjective knowledge assessment for Chlamydia was low compared to that for other infections. Mean knowledge scores relating to genital chlamydial infection were low. There was no significant age-related trend in knowledge scores. The implications of these findings are discussed in relation to increased Chlamydia screening activity in FP clinics.

What if the audit commission visited you?

Readers will be familiar with high profile media items, like the Audit Commission investigating national public institutions, and publicising rigorous critiques of their 'value for money'. Family planning (FP) services may be interested to learn that the Audit Commission also perform 'district audits' (nothing to do with 'clinical audit') and that these can analyse broader concerns to do with quality of patient care and acceptability of services, not just efficiency. 'Out of the blue' our service was the focus of such a district audit conducted over just 3 weeks. We were asked what areas, apart from 'value for money', we would like investigated. We were keen to measure if our efforts of collaboration with Primary Care and other agencies had been effective. We learned that there is a national system (DATIS) to compare each FP service's expenditure per thousand patients. We also learned that being the subject of such an investigation need not be a threatening experience, and can be an opportunity to review quality of care and demonstrate our cost effectiveness. This account is the report of the district audit team of our service and our attempts at collaboration.

Auditing the introduction of a new product to a family planning service.

The audit aimed to develop a questionnaire to monitor how a new method od contraception is offered in service by identifying local demand and assessing levels of awareness of and interest in a new product (Mirena(R)) The audit also aimed to establish those suitable for Mirena and the numbers of Mirena fitted and characteristics of recipients.

PIP: The National Coordinating Unit for Clinical Audit in Family Planning relies on pilot sites throughout the UK to develop informational materials about new products. Described in this paper is an audit conducted in Chesterfield Community Services (North Derbyshire Community Health Trust) in 1996 with the aim of developing a questionnaire for identifying local awareness of and demand for the Mirena IUD. Family planning staff completed questionnaires for 57 new patients or women requesting a change in contraceptive method. Of the 49 women who identified their current method of contraception, 29 were using condoms, 14 were on the pill, and 2 were IUD users. 41 consultations (72%) included a discussion of Mirena; in the remaining 16 cases, the women had decided on a method prior to consultation. 21 women had heard of the Mirena IUD before their visit to the clinic and 18 expressed an interest in it. Only 7 women actually obtained a Mirena IUD; in 1 other case, the device was not available at the clinic. Another 7 women opted for a copper IUD. The mean age of Mirena acceptors (32.9 years) was significantly higher than the mean age of the sample (28.2 years). Of concern is the possibility that women who want Mirena will be directed toward less expensive IUDs in greater supply in UK clinics. It is recommended that a protocol be established for cases in which Mirena is preferred and suitable, but no supply is available.

AIDS prevention--a strategy.

Even if we could prevent more infections with the human immunodeficiency virus (HIV) today, we know from the numbers of "well" seropositive people in the world that a sharp rise in the number of AIDS patients and deaths is inevitable in the coming years. This article describes how one London Health Region (population 3.5 million) intends to prevent the further spread of the disease. It includes guidance to health authorities on where to care for people who need hospital treatment, the role of out-patient services, the need for screening and means of developing better care outside hospital. It examines the implications for haemophiliacs and for intravenous drug users and highlights the importance of sound, effective health education for health service staff and for the population as a whole.

Knowledge, attitudes, and behaviour of health professionals in relation to AIDS.

KIE: A sample of physicians, nurses, and dentists working within the South East Thames Region of England, chosen because they were at risk of acquiring AIDS from patients or were in decision making positions, was surveyed to ascertain health professional knowledge and attitudes concerning the disease. Questions were asked about HIV antibody tests, patient informed consent before testing, compulsory screening of high-risk groups, refusal of hospital admission under the Public Health (Infectious Diseases) Act, screening of various population groups before hospital admission, and the need for special precautions or referral of HIV-positive patients to special units. The study revealed that clinicians tend to be unduly eager to test patients and that they sometimes test without first informing and counseling the patient. The author recommends staff education at all levels.^ieng