Objective: To evaluate the prevalence of sexually transmitted infections (STIs) and mode of presentation in patients originating from Bangladesh and resident in the United Kingdom in comparison with non-Bangladeshi patients attending an inner London genitourinary medicine (GUM) clinic. Methods: A retrospective, cross sectional study with comparator group was carried out at an open access GUM clinic in east London. 104 consecutive newly attending Bangladeshi men were compared with 199 consecutive newly attending non-Bangladeshi men and 115 consecutive newly attending Bangladeshi women were compared with 218 consecutive newly attending non-Bangladeshi women. Any diagnosed sexually transmitted infections, sexual history characteristics, reasons for presentation, and referral patterns were noted. Results: Bangladeshi men (28.8% compared with 7.5%; p<0.0001) and women (42.7% compared with 12.8%; p<0.0001) were more likely to be referred by their general practitioners or other medical services. Bangladeshi men were more likely to present with sexual dysfunction (12.5% compared with 2.5%; p=0.001). The prevalence of STIs was broadly similar across the study groups; however, syphilis was significantly more common in the Bangladeshi men (10.9% compared with 4%; p=0.04) and nongonococcal urethritis (NGU) in the control men (35% compared with 20.2%; p=0.02). Bacterial vaginosis was an infrequent diagnosis in the Bangladeshi women (3.5% compared with 22.4%; p<0.0001). Conclusions: STI prevalence in Bangladeshis attending GUM services is similar to other populations although patterns of presentation and referral do show variation. Bangladeshi men are more likely to access GUM clinics for psychosexual services. The presence of STIs in Bangladeshis particularly those imported from Bangladesh provides an opportunity for HIV transmission between the United Kingdom and Bangladesh.T wenty six per cent of the population of the London borough of Tower Hamlets are of Bangladeshi origin.1 The epidemiology of STIs in the Bangladeshi population is largely unknown and to our knowledge no data exist on STI prevalence in immigrant Bangladeshi communities in the United Kingdom. Studies from Bangladesh suggest variable rates of STIs and HIV prevalence dependent on the population sampled. [2][3][4][5] This study assessed the prevalence of STIs and the mode of presentation in Bangladeshi patients in comparison with the local indigenous population attending an inner London GUM clinic. METHODSA retrospective cross sectional study was performed in 1995. One hundred and four consecutive new male and 115 consecutive new female Bangladeshis were sampled. Controls were the preceding and subsequent newly attending, nonBangladeshi patients, providing a 2:1 ratio.A standardised proforma was used to collect epidemiological data, presenting problems, sexual history, and clinical findings from the case notes. Samples for Neisseria gonorrhoeae, Chlamydia trachomatis, and non-gonococcal urethritis (NGU) were taken in men and additionally Candida albicans, Tr...

The majority of these patients, including those given a diagnosis and/or offered treatment in primary care, had not had a chlamydia test or any other investigations. With the potential "fall out" of patients between primary care and GUM services, this may represent a missed opportunity to detect and appropriately manage sexually transmitted infections.

Implementation of the National Chlamydia Screening Programme in Cornwall commenced in April 2003. Initially, women in community venues were screened using urine samples. However, many of these urine samples were inhibitory to polymerase chain reaction (PCR), resulting in a high recall rate for women in the programme. The decision to switch to self-taken vulvovaginal samples led us to carry out an in-house validation of this sample compared with endocervical samples. Data from 333 women were analysed. Of the endocervical samples, 15.9% were positive compared with 16.8% vulvovaginal samples. This difference between positivity rates in cervical and self-taken vulvovaginal samples is not significant. Equivocal results occurred with 4.7% of the vulvovaginal samples but were not seen with the endocervical samples. Self-taken vulvovaginal samples are acceptable to women, as sensitive as endocervical swabs and more suited to PCR testing with the Roche COBAS Amplicor system than urine samples.

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