Centre is concerned with the diagnosing and treatment of sexually transmitted infections; counselling of clients, and education. In addition, statistics are kept of the number and type of sexually transmitted infections that are diagnosed. This enables staff to monitor any changing trends in the incidence of these infections in Bermuda which then helps with programme planning. For example, a decision was made three years ago to test all clients for chlamydia infections routinely, since this disease is on the increase, not only in Bermuda, but worldwide.

Clients range in age from 13 to 60, and are of both sexes, the majority being the 20 to 35 age group. In the last two years, there has been an increase in the number of younger clients in the 13-17 age group, some of whom have been diagnosed with serious sexually transmitted infections.

Clients may attend the clinic for a number of reasons: 1. Because they have symptoms of an infection.

2. As a contact of someone diagnosed and treated for an infection.

3. As a referral from a physician for evaluation and treatment. One of the most important aspects for the nurse to consider when interviewing clients in the clinic is to make the client feel comfortable in what may be a stressful situation and reassure them of complete confidentiality.

A routine health history is taken before the client is examined; both male and females are routinely tested for syphilis, gonorrhoea, non-gonoccocal or non-specific urethritis and chlamydia. In addition, female clients are tested for monilia or yeast, trichomonas, and bacterial vaginitis. Clients may have been infected with one or more of these disease and in some instances have no symptoms. This is particularly true of chlamydia. Genital warts and herpes are two viral infections which are treated in the clinic. Once a diagnosis is made, then the appropriate treatment is given. It is the responsibility of the clinic nurses to give education to the client about the infection and also clear instructions regarding medication. The client, too has a responsibility to see that his or her partner attends for evaluation and treatment. To ensure treatment is adequate tests are repeated on completion of medication.

HIV testing which is the test for the virus that causes AIDS is not taken in routine clinic visits for two reason:- 1. The Clinic operates on a "Walk-In'' basis. It is extremely important that these clients are given counselling before commencing the series of tests, that are recommended and after the results are received, regardless of what they are, therefore appointments are made outside the routine clinic hours.

2 Random testing is not recommended because of the length of time of the incubation period which may be as long as 18 months in some people.

Last but not least, education is part of the clinic programme. This may be on an individual basis within the clinic for all clients, and includes not only information on diseases, but discussion on lifestyles and behaviours which may be "at risk'', with recommendation for modification or education within the community, in schools or other groups.

The Clinic staff are always available and pleased to give information about sexually transmitted diseases. Telephone 236-0224 Ext. 236 or 242. -- Jennifer Fox, Communicable Disease, Control Clinic, Department of Health.