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<h3><!--mstheme--><font color="#003366"><a name="What">What</a> is a GUM clinic?<!--mstheme--></font></h3>
<p>These are sometimes known formally and informally as:</p>
<!--mstheme--></font><!--msthemelist--><table border="0" cellpadding="0" cellspacing="0" width="100%">
<!--msthemelist--><tr><td valign="baseline" width="42"><img src="_themes/shastd2/shasbul3.gif" width="35" height="24" hspace="3"></td><td valign="top" width="100%"><!--mstheme--><font face="verdana, arial, helvetica">STD clinics<!--mstheme--></font><!--msthemelist--></td></tr>
<!--msthemelist--><tr><td valign="baseline" width="42"><img src="_themes/shastd2/shasbul3.gif" width="35" height="24" hspace="3"></td><td valign="top" width="100%"><!--mstheme--><font face="verdana, arial, helvetica">‘Special’ clinics<!--mstheme--></font><!--msthemelist--></td></tr>
<!--msthemelist--><tr><td valign="baseline" width="42"><img src="_themes/shastd2/shasbul3.gif" width="35" height="24" hspace="3"></td><td valign="top" width="100%"><!--mstheme--><font face="verdana, arial, helvetica">VD clinics<!--mstheme--></font><!--msthemelist--></td></tr>
<!--msthemelist--><tr><td valign="baseline" width="42"><img src="_themes/shastd2/shasbul3.gif" width="35" height="24" hspace="3"></td><td valign="top" width="100%"><!--mstheme--><font face="verdana, arial, helvetica">Sexual Health clinics<!--mstheme--></font><!--msthemelist--></td></tr>
<!--msthemelist--><tr><td valign="baseline" width="42"><img src="_themes/shastd2/shasbul3.gif" width="35" height="24" hspace="3"></td><td valign="top" width="100%"><!--mstheme--><font face="verdana, arial, helvetica">‘Clap’ clinics<!--mstheme--></font><!--msthemelist--></td></tr>
<!--msthemelist--></table><!--mstheme--><font face="verdana, arial, helvetica">
<p align="JUSTIFY">Sexually transmitted infections are diagnosed in other settings- such
as clinics for pregnancy terminations, family planning, antenatal care, well women and
general practice. However once picked up in these places many will be referred to a GUM
clinic for further management. It is only GUM clinics that record routine statistics on
sexually transmitted infections. Nearly 1/2 million diagnoses were made in GUM clinics up
and down the country in 1996 making them a vital service in controlling the spread of
sexual infections. </p>
<p align="JUSTIFY">A recent large scale survey on ‘Sexual Attitudes and
Lifestyles’ of a random sample of the British population found that approximately 1
in 10 men and 1 in 20 women had attended a GUM clinic. The likelihood of attending
increased markedly with increasing number of heterosexual partners. One in seven attended
who reported more than 5 heterosexual partners in 5 years. More than half of homosexual
men with 5 or more partners in 5 years attended a clinic. </p>
<p align="JUSTIFY">A network of clinics was first established following the Venereal
Disease Regulations of 1916 when concern about sexually transmitted diseases (STD’S)
was high. There are now approximately 230 clinics in the UK. Each one has open access and
offers free and confidential services and treatment for all sexually transmitted
infections (STI’s) including HIV. Users are entitled to claim for reasonable travel
expenses incurred when making a visit irrespective of income or employment status.</p>
<p align="JUSTIFY">Experience of the range and quality of services will vary considerably
across the country. </p>
<p align="right"> <a href="clinics/clinics">GUM clinic locations</a>.</p>
<h3><!--mstheme--><font color="#003366">Registration<!--mstheme--></font></h3>
<p align="JUSTIFY">It might be helpful to check out in advance if the clinic will see you
without an appointment. Many do but it will mean just queueing. Upon arrival you will be
asked to register. You can give as little or as much information as you like without fear
that your confidentiality will be breached. This cannot be overemphasised. Special laws
exist to protect personal information held on GUM clinic users. If you use false
information it is important use the same details at future visits. Each person is given a
card with their own clinic number on which should be brought at each visit. It may be
possible in some clinics to request you are seen by someone of a particular gender.</p>
<h3><!--mstheme--><font color="#003366">Interview<!--mstheme--></font></h3>
<p align="JUSTIFY">The doctor will ask some questions in order to take a ‘sexual
history’ to help decide what investigations should be done (if any). For example;</p>
<!--mstheme--></font><!--msthemelist--><table border="0" cellpadding="0" cellspacing="0" width="100%">
<!--msthemelist--><tr><td valign="baseline" width="42"><img src="_themes/shastd2/shasbul3.gif" width="35" height="24" hspace="3"></td><td valign="top" width="100%"><!--mstheme--><font face="verdana, arial, helvetica">What are you worried about?<!--mstheme--></font><!--msthemelist--></td></tr>
<!--msthemelist--><tr><td valign="baseline" width="42"><img src="_themes/shastd2/shasbul3.gif" width="35" height="24" hspace="3"></td><td valign="top" width="100%"><!--mstheme--><font face="verdana, arial, helvetica">How many people have you had sex with recently?<!--mstheme--></font><!--msthemelist--></td></tr>
<!--msthemelist--><tr><td valign="baseline" width="42"><img src="_themes/shastd2/shasbul3.gif" width="35" height="24" hspace="3"></td><td valign="top" width="100%"><!--mstheme--><font face="verdana, arial, helvetica">What type of sex was it?<!--mstheme--></font><!--msthemelist--></td></tr>
<!--msthemelist--><tr><td valign="baseline" width="42"><img src="_themes/shastd2/shasbul3.gif" width="35" height="24" hspace="3"></td><td valign="top" width="100%"><!--mstheme--><font face="verdana, arial, helvetica">Were your partners male or female?<!--mstheme--></font><!--msthemelist--></td></tr>
<!--msthemelist--><tr><td valign="baseline" width="42"><img src="_themes/shastd2/shasbul3.gif" width="35" height="24" hspace="3"></td><td valign="top" width="100%"><!--mstheme--><font face="verdana, arial, helvetica">Have you had an STD in the past?<!--mstheme--></font><!--msthemelist--></td></tr>
<!--msthemelist--><tr><td valign="baseline" width="42"><img src="_themes/shastd2/shasbul3.gif" width="35" height="24" hspace="3"></td><td valign="top" width="100%"><!--mstheme--><font face="verdana, arial, helvetica">Are you on any medication?<!--mstheme--></font><!--msthemelist--></td></tr>
<!--msthemelist--><tr><td valign="baseline" width="42"><img src="_themes/shastd2/shasbul3.gif" width="35" height="24" hspace="3"></td><td valign="top" width="100%"><!--mstheme--><font face="verdana, arial, helvetica">Do you suffer any allergies?<!--mstheme--></font><!--msthemelist--></td></tr>
<!--msthemelist--></table><!--mstheme--><font face="verdana, arial, helvetica">
<h3><!--mstheme--><font color="#003366">Examination & Tests<!--mstheme--></font></h3>
<p align="JUSTIFY">These will vary according to a persons sex and stated sexual practice
so it is important to answer truthfully any question asked if nothing is to be overlooked.
If you are unsure why some information is requested or words are used that you don’t
understand then ask for a clearer explanation. Staff should be sensitive to the fact that
many people get embarrassed and fearful about being questioned and examined. Don’t be
intimidated by anyone or feel you shouldn’t complain if you are unhappy with the
service. Most clinics are keen to ensure that they offer something of quality. </p>
<h4 align="JUSTIFY"><!--mstheme--><font color="#003366">Tests may include:<!--mstheme--></font></h4>
<!--mstheme--></font><!--msthemelist--><table border="0" cellpadding="0" cellspacing="0" width="100%">
<!--msthemelist--><tr><td valign="baseline" width="42"><img src="_themes/shastd2/shasbul3.gif" width="35" height="24" hspace="3"></td><td valign="top" width="100%"><!--mstheme--><font face="verdana, arial, helvetica">Urine test (best not to go to the toilet for 2 hours before tests)<!--mstheme--></font><!--msthemelist--></td></tr>
<!--msthemelist--><tr><td valign="baseline" width="42"><img src="_themes/shastd2/shasbul3.gif" width="35" height="24" hspace="3"></td><td valign="top" width="100%"><!--mstheme--><font face="verdana, arial, helvetica">Cervical smear<!--mstheme--></font><!--msthemelist--></td></tr>
<!--msthemelist--><tr><td valign="baseline" width="42"><img src="_themes/shastd2/shasbul3.gif" width="35" height="24" hspace="3"></td><td valign="top" width="100%"><!--mstheme--><font face="verdana, arial, helvetica">Swabs (ie some like tiny cotton buds used) from urethra (entrance of water pipe),
vagina, cervix (neck of womb), throat and rectum (back passage). Honestly you’ll not
see an umbrella-like instrument anywhere! Something called a speculum is used to hold open
the vagina and the doctor or nurse may insert gloved fingers at the same time. Asmall tube
called a proctoscope may in some cases be inserted into the rectum.<!--mstheme--></font><!--msthemelist--></td></tr>
<!--msthemelist--><tr><td valign="baseline" width="42"><img src="_themes/shastd2/shasbul3.gif" width="35" height="24" hspace="3"></td><td valign="top" width="100%"><!--mstheme--><font face="verdana, arial, helvetica">Blood test for syphilis<!--mstheme--></font><!--msthemelist--></td></tr>
<!--msthemelist--><tr><td valign="baseline" width="42"><img src="_themes/shastd2/shasbul3.gif" width="35" height="24" hspace="3"></td><td valign="top" width="100%"><!--mstheme--><font face="verdana, arial, helvetica">HIV tests are only done with a persons consent and therefore are not routinely
performed.<!--mstheme--></font><!--msthemelist--></td></tr>
<!--msthemelist--></table><!--mstheme--><font face="verdana, arial, helvetica">
<h3><!--mstheme--><font color="#003366">Diagnosis<!--mstheme--></font></h3>
<p align="JUSTIFY">Sometimes it is possible to tell straight away the presence of some
infections by direct observation and use of a microscope. Other things need to be sent off
to a laboratory and may take several days for the results to become known. You may be
asked to return for further tests at the end of a specified time period before a full
diagnosis can be made. For example <a href="sti/hivaids">HIV</a> and <a href="sti/syphilis">syphilis</a> may takeup to 3 months after infection to show up on
a blood test. A full explanation should be given of test results and relevant leaflets
supplied to back up any advice given.</p>
<h3 align="JUSTIFY"><!--mstheme--><font color="#003366">Treatment<!--mstheme--></font></h3>
<p align="JUSTIFY"><a href="medications/medicati">Treatment</a> given is free and
often dispensed straightaway. A full course of antibiotics should be taken even if the
symptoms clear up halfway through. Take note that many infections can be present in people
without them even realising.</p>
<h3 align="JUSTIFY"><!--mstheme--><font color="#003366">Health Adviser<!--mstheme--></font></h3>
<p align="JUSTIFY">Most clinics have a health adviser who can spend unhurried amounts of
time helping you to better understand what is going on. You may have a lot of personal
things you would like to talk through. For example they can help when working out what to
do about current or previous <a href="professional_interest/partner">partners</a> who may need to be
examined or treated. They may ask you for details of partners and whereas this can be
really important in helping to control the spread of infections remember that you are
under no obligation to give this information. You may however prefer they took on the
responsibility to contact partners and you can be assured that this will be undertaken
with great tact and discretion without disclosing your identity.</p>
<p align="JUSTIFY">(By Chris Faldon, Health Adviser, Newcastle General Hospital) </p>
<p align="JUSTIFY"><a href="#What"></a>
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