This group surveyed sexual health clinics in Australia and New Zealand in 1993, and compared their findings with those of a similar study by Bradford and Philpot a decade earlier. The number of services provided and staff had increased and the complexity of medical conditions had broadened. There was still, however, a marked urban predominance of sexual health clinics, possible underuse of non-medical staff and, most importantly, there were deficiencies in tracing contacts of patients with STDs. Encouragingly, Australia's diagnosis and treatment of STDs complies well with the published guidelines. 7 Sexual health clinics and sexual health physicians do encourage the use of condoms to reduce the probability of transmission, but their greatest potential influence is likely to be on reducing the infectious period.
Contact tracing reduces the duration of infectiousness, particularly among asymptomatic individuals.
It is as critical to the control of STDs as is choosing the right antibiotic. Disturbingly, the study of Marks et al. found that some clinics did not trace contacts, while others did so for only some STDs. Among the majority who did trace contacts, different methods were employed, suggesting that an optimal method has not been clearly established. We should use the inconsistencies identified by Marks et al. to improve our sexual health system. Specifically, we should establish the most efficient method for contact tracing and ensure that it is widely used by all who treat STDs.