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The rate of births to teenagers in the UK is twice that of Germany, three times that of France, and six times that of the Netherlands. The incidences of both gonorrhoea and genital chlamydial infection rose 2.5-fold between 1995 and 2000. A review of cases at a London genitourinary clinic (
) has illustrated some aspects of the problem.
The review included all clients aged 16 years or under attending the clinic during two months (March and October) in 1998. There were 144 females and 18 males (median age 15.4 years, range 12–15.9 years). About half of the females attended because of symptoms of sexually transmitted infection (STI) and almost two thirds had an STI (chlamydia 34, gonorrhoea 13, pelvic inflammatory disease 15, other STI (genital warts, trichomonas vaginalis, herpes simplex, pediculosis pubis) 32). Less than a third of older women attending the clinic had an STI (40% attended as contacts). Twenty-seven teenagers were pregnant and all but one requested termination. Of the 117 non-pregnant females three quarters were not using contraception at the time of attendance and over half had no documentation of contraceptive advice in their notes. Almost half of the teenage females failed to attend for follow up.
Staff at another London genitourinary clinic (
) developed a questionnaire with the help of a focus group of local school teenage pupils. Seven hundred and forty-six questionnaires were distributed to pupils at six schools and a pupil exclusion unit and all were completed. The teenagers wanted more frequent clinics, after-school and on Saturdays, and walk-in rather than appointment. Many (37%) would prefer a waiting area solely for young people and only 20% would go in the first place to their general practitioner. Staff sensitivity and confidentiality were important to them.
Sexual health services for teenagers need to be sensitive to their needs and to provide contraceptive advice.