In this short audit report, Trewinnard and Foley looked at contraception use in women attending a walk-in genitourinary medicine (GUM) clinic at the South Hants Hospital in Southampton, UK. It is known that abortion rates in the UK are rising, especially in the under-20s, and that this is occurring despite an increase in the use of condoms. Women presenting repeatedly for termination of pregnancy usually rely on condoms and have a poor uptake of long-acting reversible contraceptives (LARCs). Many women attending GUM clinics for sexually transmitted infection (STI) screening do so because of unprotected sexual intercourse and therefore are at risk of pregnancy if condoms are their only method of contraception. The audit was carried out as part of a service evaluation assessing provision for the wider sexual health needs for those attending GUM clinics. The audit was carried out prospectively with a questionnaire offered to the female attenders of reproductive age who were sexually active between March and April 2008. A total of 152 women with a mean age of 26 years completed the questionnaire, which appears to be a low response rate as it represented 17% of the women seen during the study. 87.5% reported use of at least one contraceptive method. 64% of women reported using a reliable method of contraception and of these 76% used pills, 14% used a LARC and 3% had been sterilised. 28% were using condoms (which were considered unreliable) and 36% were not using any reliable method. Overall 38% of respondents asked for further contraceptive advice. Of those using an unreliable method, 50% asked for advice; whereas of those using a reliable method, only 28% asked for further advice. Some 15% of women were obtaining contraception from a family planning clinic, 55% obtained contraception from a general practitioner, and the remainder bought condoms or obtained them from GUM clinics. In their discussion the authors reported use of contraception being comparable to women generally in the UK, and that they had a higher percentage (i.e. 28% vs 18%) of women relying on condoms alone compared to the UK population. They put this down to over-reporting due to patients’ perception of health care professionals in the GUM setting. They also noted that many women were willing to ask for further advice and would accept the contraception provision in the GUM setting, and concluded that it would be cost effective to provide a full range of contraception in the GUM setting.
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