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Community-based sexual health care works: a review of the ACT outreach program.

BACKGROUND
Men who have sex with men, sex workers, youth and university students are at increased risk for sexually transmissible infections (STI) and blood-borne viruses (BBV) and are therefore targets for sexual health services. In recognition of this, a collaborative project offering sexual health care in various outreach settings frequented by these groups was developed.


METHODS
Data collected by clinicians during consultations in five outreach venues (a sex-on-premises venue, a community AIDS organisation, a university campus, brothels and a youth centre) between 2002 and 2005 were analysed.


RESULTS
During 119 clinics (~547 clinician hours), 313 individuals (205 males and 108 females) received education and/or testing. Of those screened, 6.0% (15/249) were positive for chlamydia and 12.7% (9/71) tested positive for hepatitis C (HCV) antibodies. No new cases of hepatitis B (HBV) or HIV were identified and 37.2% (71/191) of patients reported never having been previously tested for HIV. Seroprevalence of hepatitis A and HBV antibodies were 53.8% (91/169) and 52.1% (135/259), respectively. More than half of all four groups reported inconsistent use of condoms and 8.6% reported intravenous drug use.


CONCLUSIONS
Collaborations between agencies to provide outreach services facilitate community-based sexual health education and screening for groups at higher risk of STI and BBV. The database audit showed that through these outreach services cases of chlamydia and HCV that may have remained undetected were identified. The results also highlight the need for continuing hepatitis vaccination, testing, health promotion and education in these populations.