Abstract

BackgroundRisky drinking is associated with risky sexual experiences, however the relationship between alcohol and sex is complex. The aim of the study was to assess the feasibility of delivering alcohol screening and brief interventions in genitourinary medicine (GUM) clinics. The objectives were to; understand the levels of alcohol use amongst patients; report on the number of alcohol interventions delivered; and to analyse the relationship between alcohol use with demographic data as well as diagnosed sexually transmitted infections (STIs) to see if there were any associations.MethodsAll new patients attending GUM between April 2012 and March 2013 self-completed the Alcohol Use Disorder Identification Test (AUDIT) prior to their clinical consultation. Where appropriate (scoring 8+ on AUDIT) the clinician would deliver up to 2–3 min of alcohol brief intervention. Descriptive statistics, t-tests, ANOVA and logistic regression were carried out as appropriate.ResultsAUDIT scores were available for 90% of all new patients (3058/3390) with an average mean score of 7.75. Of those who drank alcohol, 44% were categorised as being AUDIT positive, including 2% who had a score indicative of probable alcohol dependence (20+). 55 % (n = 638) of patients who screened positive on the AUDIT received a brief intervention whilst 24% (n = 674) of drinkers were diagnosed with a STI. Logistic regression modelling revealed that males, younger age groups and those of ‘white’ ethnicity were more likely to score positive on AUDIT. Patients classified as non-students, living in deprivation quintiles one to four and categorised as probable alcohol dependence on the AUDIT were more likely to be diagnosed with an STI.ConclusionIt is possible to embed alcohol screening into routine practice within sexual health services however further work is required to embed brief interventions particularly amongst increasing risk drinkers. If resources are limited, services may consider more targeted rather than universal alcohol screening to specific population groups. The study was undertaken in one GUM service in the North East of England and therefore findings may not be generalizable. The study did not assess efficacy of alcohol brief intervention in this setting.

Highlights

  • In the United Kingdom (UK), the costs related to alcohol are €25bn (£21 bn) a year for health, welfare, employment, and criminal justice sectors as a consequence of alcohol attributable disease, injury, and violence [1]

  • Alcohol Use Disorders Identification Tool (AUDIT) scores Full AUDIT scores were recorded for 90% of patients (n = 3058). 7% reported that they did not drink alcohol (7% males and 11% females)

  • Of those patients who drank alcohol, 44% were categorised as being AUDIT positive (53% (n = 686) males, 35% (n = 526) females) including 2% being categorised as having a score indicative of probable alcohol dependence (3% (n = 43) males, 2% (n = 26) females)

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Summary

Introduction

In the United Kingdom (UK), the costs related to alcohol are €25bn (£21 bn) a year for health, welfare, employment, and criminal justice sectors as a consequence of alcohol attributable disease, injury, and violence [1]. The aim of the study was to assess the feasibility of delivering alcohol screening and brief interventions in genitourinary medicine (GUM) clinics. All members of staff working in the local genitourinary medicine (GUM) clinics were trained on how to complete the AUDIT and in the delivery of BI (including brief advice and extended BI). This training was based on training previously used in primary care and accident and emergency departments in England [29, 30]. The service compromised of two clinics; one of the clinics was located within a large university city and the second clinic was located within a market town serving a large rural area.

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