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Letters

STI testing in emergency contraceptive consultations

Eugene YH Yeung, Eleanor Comben, Charlotte McGarry and Rebecca Warrington
British Journal of General Practice 2015; 65 (631): 63-64. DOI: https://doi.org/10.3399/bjgp15X683449
Eugene YH Yeung
College of Medical and Dental Sciences, University of Birmingham, Birmingham and Lion Health Medical Centre, Stourbridge. E-mail:
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  • For correspondence: eugeneyh@gmail.com
Eleanor Comben
College of Medical and Dental Sciences, University of Birmingham, Birmingham and Lion Health Medical Centre, Stourbridge. E-mail:
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  • For correspondence: eugeneyh@gmail.com
Charlotte McGarry
College of Medical and Dental Sciences, University of Birmingham, Birmingham and Lion Health Medical Centre, Stourbridge. E-mail:
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  • For correspondence: eugeneyh@gmail.com
Rebecca Warrington
College of Medical and Dental Sciences, University of Birmingham, Birmingham and Lion Health Medical Centre, Stourbridge. E-mail:
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We recently read the Faculty of Sexual and Reproductive Healthcare (FSRH) Clinical Guidance (2012) that recommends 100% of women attending for emergency contraceptive have a discussion regarding future contraception, and are offered the opportunity for sexually transmitted infection (STI) testing, including HIV.1 The FSRH recommends STI testing because studies showed up to 9.1% of women aged <25 years presenting for emergency contraceptive had Chlamydia trachomatis.2,3 The Quality of Outcomes Framework (QOF) also recommends that 50–90% of women receiving emergency hormonal contraception are offered information about long-acting reversible methods of contraception.4 However, QOF does not mention about STI testing.

We conducted an audit in our general practice investigating whether women attending for emergency contraception were offered STI testing and information regarding future contraception. From November 2012 to November 2014, we identified 34 consultations in which women were given levonorgestrel, ulipristal, or copper coil for emergency contraception. Future contraception advice was given in 31 (91%) of the consultations, but STI testing was offered in only eight (24%) of them (Table 1). Only five of the eight patients accepted the STI testing, but were all tested for Chlamydia only.

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Table 1.

Number of women being offered future contraceptive advice and STI testing

The 24% of women being offered STI testing in our general practice was much lower than the 71% of women being offered STI testing in a genitourinary medicine clinic in Edinburgh.5 The low proportion in our study may be due to STI testing not being monitored by QOF. In contrast, while being monitored by QOF, the proportion of women being offered future contraceptive advice was significantly higher than that of STI testing. Our study was limited by the low number of women attending for emergency contraceptives in our practice. To validate our findings, we encourage other general practices to conduct similar studies to investigate the proportion of women attending for emergency contraceptive being offered STI testing. Furthermore, we would like to ask the Royal College of General Practitioners to raise awareness of offering STI testing to women presenting for emergency contraception. Finally, we would like to ask QOF to consider adding STI testing in its monitoring parameters.

  • © British Journal of General Practice 2015

REFERENCES

  1. 1.↵
    1. Faculty of Sexual & Reproductive Healthcare
    (2012) Emergency Contraception. http://www.fsrh.org/pdfs/CEUguidanceEmergencyContraception11.pdf (accessed 7 Jan 2015).
  2. 2.↵
    1. Kettle H,
    2. Cay S,
    3. Brown A,
    4. Glasier A
    (2002) Screening for Chlamydia trachomatis infection is indicated for women under 30 using emergency contraception. Contraception 66(4):251–253.
    OpenUrlCrossRefPubMed
  3. 3.↵
    1. Brabin L,
    2. Thomas G,
    3. Hopkins M,
    4. et al.
    (2009) Delivery of chlamydia screening to young women requesting emergency hormonal contraception at pharmacies in Manchester, UK: a prospective study. BMC Womens Health 9:7.
    OpenUrlCrossRefPubMed
  4. 4.↵
    1. Health & Social Care Information Centre
    (March, 2014) 2014/15 General Medical Services (GMS) contract Quality and Outcomes Framework (QOF) guidance for GMS contract 2014/15, NHS England Gateway reference: 01264. http://www.hscic.gov.uk/media/14019/QOF-Guidance-GMS-Contract-2014-15/pdf/QOF_guidance_GMS_contract_2014_15.pdf (accessed 7 Jan 2015).
  5. 5.↵
    1. Goodall L
    (2012) Emergency contraception prescribing in a GUM clinic: missed opportunities for improving sexual and reproductive health. J Fam Plann Reprod Health Care 38(2):140.
    OpenUrlFREE Full Text
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British Journal of General Practice: 65 (631)
British Journal of General Practice
Vol. 65, Issue 631
February 2015
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STI testing in emergency contraceptive consultations
Eugene YH Yeung, Eleanor Comben, Charlotte McGarry, Rebecca Warrington
British Journal of General Practice 2015; 65 (631): 63-64. DOI: 10.3399/bjgp15X683449

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STI testing in emergency contraceptive consultations
Eugene YH Yeung, Eleanor Comben, Charlotte McGarry, Rebecca Warrington
British Journal of General Practice 2015; 65 (631): 63-64. DOI: 10.3399/bjgp15X683449
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