In the first phase of the National Chlamydia Screening Programme (NCSP), the majority of sites involved offered testing with urine sample. Camden & Islington (C&I) were the first site to offer testing with self-taken vaginal swabs (SVS). SVS are appropriate specimens for diagnosing chlamydia by nucleic acid amplification tests. This study aimed to assess the uptake and acceptability of chlamydia screening using SVS within C&I contraceptive clinics. Data collected from women participating in the NCSP between June 2003 and April 2004 were analysed. Of the 3936 women who accepted screening, 90.4% provided a SVS and only 5.8% accepted the offer of providing a urine sample as an alternative to SVS. Women over 19 years and women from Asian ethnic groups were most likely to decline any screening. No woman stated a reluctance to provide a SVS as a reason for declining screening, confirming the acceptability of SVS for chlamydia screening.

Objective To measure agreement between the client's and the clinician's responses to questions regarding client history as answered on a questionnaire based on the UK Medical Eligibility Criteria for Contraceptive Use (UKMEC) for combined hormonal contraception (CHC).Methods Clients aged 18 years and over, attending a central London community contraceptive clinic requesting a repeat supply of CHC, completed a history questionnaire and an evaluation form. Clinicians then completed their copy of the same questionnaire during the consultation. Percentage agreement and the Kappa statistic were used to assess the level of client-clinician agreement. smoking, the proportion of clients reporting a risk factor was more than the proportion of clinicians reporting a risk factor. No clinically important information relevant to a particular client's use of CHC was missed and none of them would have been wrongly prescribed the CHC based just on their self-completed questionnaires. Most women (97%) were happy with this method of history taking. ResultsConclusions A self-completed history questionnaire is acceptable to women and can potentially replace traditional routine medical history taking for continuing CHC. Women completed the questionnaire with a high degree of reliability. There was complete client-clinician agreement on UKMEC Category 4 criteria. Overall, clients reported more risk factors than clinicians, which increases the safety of the questionnaire. community-based programmes to increase the quality of services and care and to increase women's access to contraceptives. 4 The UK Medical Eligibility Criteria for Contraceptive Use (UKMEC) were developed from the WHO document in 2005. 5 These criteria are classified into four categories, ranging from UKMEC 1 -a condition for which there is no restriction for the use of the contraceptive method (e.g. parity) to UKMEC 4 -a condition which represents an unacceptable health risk if the contraceptive method is used (e.g. thrombosis). History taking and appropriate examination allow clinicians to assess medical eligibility for COC use. The medical and family history should alert the clinician to conditions or risk factors that might be a strong or absolute contraindication to COC use. A woman with multiple risk factors may need to avoid COC use, although individual risk factors would not necessarily contraindicate use. Blood pressure and body mass index (BMI) should be documented for all women before a first prescription of COC 6 and at follow-up.In this article we describe the use of a history questionnaire for established users of combined hormonal contraception (CHC), which includes COCs and the contraceptive patch. The aim of this study was to determine group.bmj.com on May 11, 2018 -Published by

Cervical endometriosis is usually a retrospective finding on histology. We describe the diverse symptomatology of the disease, wherein a suspicion of diagnosis may be raised. A series of five patients with cervical endometriosis confirmed on histology was identified. One patient was asymptomatic but examination revealed a mass arising from the cervix. Two patients presented with persistent postcoital bleeding, one patient with intermenstrual bleeding and one patient with both intermenstrual and postcoital bleeding. All patients were followed up with colposcopy and cervical biopsy. Persistence of symptoms determined the mode of treatment which included surgical management in the form of large loop excision of the transformation zone (LLETZ) biopsy in four patients. Cervical endometriosis is a benign condition which may present with symptoms such as persistent post-coital bleeding or intermenstrual bleeding. Colposcopy and cervical biopsy are pivotal to the diagnosis. This condition can be managed expectantly in asymptomatic patients and persistent symptoms may warrant surgery.

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