Sexually transmissible infection management practices among primary care physicians in Singapore

Abstract

Background: Primary care physicians manage a significant number of sexually transmissible infections (STI); however, there has not been a survey to assess the standard of medical care, completeness of notifications, provision of counselling and contact tracing by primary care physicians in Singapore. Methods: An anonymous postal survey was conducted in which 1557 questionnaires were mailed out to general practitioners (GP), and government primary care and emergency department doctors. Results: In all, 736 questionnaires (47.3%) were returned, and the majority of respondents were graduates from the local medical school, worked in solo or group practices and were males. One hundred and thirty doctors (17.7%) indicated they had received training attachments or postings in dermato-venereology departments. Almost one-third (30.8%) had been working as doctors for fewer than 10 years and 87.8% reported that they managed STI in their practice. Almost half did not investigate genital discharge patients, and one-third would still use ciprofloxacin to treat discharges. In the management of ulcers, over half indicated that they would order syphilis serology, and a significant minority would use parenteral penicillin. Most doctors provided history taking, screening for other STI, testing for HIV infection and STI counselling. A small minority of doctors undertook contact tracing, and there was incomplete notification of many STI. Conclusions: Overall medical management of STI by primary care physicians was acceptable. Skills in contact tracing and reminders on disease notification are areas that need particular attention.