A tale of 2 cities: a comparison of demographic details, source of referral, spectrum of infection and contraceptive practice in patients under 16 years attending genitourinary medicine clinics in London and Swansea

Sexually transmitted infections (STIs) in young people are increasing, with children aged less than 16 years being particularly vulnerable. We compared the demographic details, spectrum of infection, contraceptive practice and source of referral in patients aged less than 16 years attending 2 genitourinary clinics, one in Swansea and the other in London. In the London population, children aged less than 16 years represented 0.7% of the total new attendances compared with 1.4% in Swansea. The female to male ratio was almost 4:1 in both clinics with most infections confined to female attenders. In females the incidence of chlamydial infection, genital warts and anaerobic (bacterial) vaginosis was 5.5%, 19% and 8%, respectively in London compared with 27%, 32% and 36% in Swansea. Seventy-two per cent of patients attending the clinic in London were self referred compared with 40% in Swansea. Contraceptive practice was also markedly different in the 2 populations, and over one-third of children in both clinics used no contraception. The high incidence of STIs in both populations and low use of contraception has serious implications for the sexual health of young people and emphasizes the need for effective sexual health education at an early age.