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SA’s central STI clinic limits service, citing overwhelming demand

UPDATED | Heterosexual people over the age of 25 have been excluded from South Australia’s state-wide sexual health clinic for the first time, amid overwhelming demand for the service and the closure of other STI clinics.

Nov 29, 2018, updated Nov 29, 2018
The clinic operates out of a non-descript building on North Terrace. Photo: InDaily / Tony Lewis

The clinic operates out of a non-descript building on North Terrace. Photo: InDaily / Tony Lewis

The Adelaide Sexual Health Centre on North Terrace – otherwise known as Clinic 275 – has limited its testing and treatment services to people within “priority groups”, who are at a higher risk of sexually transmitted infections, for the first time in its history.

Heterosexual people over the age of 25, without known STI symptoms and who don’t fall into higher-risk groups, have been turned away from the service, advised to consult a GP or to attend the not-for-profit sexual health service Shine SA instead. (The most common STIs – chlamydia and gonorrhoea – are often asymptomatic.)

The clinic cites increased demand as the reason for limiting its services.

InDaily understands about 30 people have been turned away from Clinic 275 each week since the policy was changed in September.

The clinic had already reduced its hours of service earlier this year.

Clinic 275 has been under pressure from increased demand since it began providing the HIV prevention drug PrEP in late 2016.

SA Health declared an outbreak of syphilis in Adelaide earlier this month, just days before Shine SA announced it would be closing two of its four sexual health clinics, blaming State Government funding cuts.

Thereafter, more than 350 South Australian doctors signed an open letter to Health Minister Stephen Wade warning the funding cuts would likely lead to increased STI contraction and transmission in the state’s population.

And a motion by Greens MLC Tammy Franks, condemning the funding cuts, passed the Legislative Council yesterday.

She told InDaily this morning that sexual health services in SA have been losing public funding since 2012.

“We’ve got rising STIs, we have got syphilis in a capital city … (the situation is) extraordinary and we shouldn’t be seeing this in the 21st century,” she said.

A spokesperson for the Central Adelaide Local Health Network told InDaily Clinic 275 provides a “highly specialised service to complex cases”.

“It’s imperative that the centre prioritises members of the community that are most at risk,” the CALHN spokesperson said.

“In line with similar clinics interstate, the decision was made in September to refer heterosexual people over 25 with Medicare who are experiencing no symptoms to other services.”

However, SA Health sources told InDaily the clinic had never excluded heterosexuals over 25 as a matter of policy, and that the clinic was forced to take the decision because of funding constraints.

The number of STI diagnoses recorded in South Australia has been steadily rising over the past decade.

STI diagnoses have been steadily rising over the past decade. Data: SA Health epidemiological reports. Graph: Bension Siebert / Nicky Capurso

Clinic 275 now tests and treats people from the following “priority groups”:

  • Men who have sex with men.
  • People who identify as trans or gender diverse.
  • Sex workers and their clients.
  • Aboriginal and Torres Strait Islander people, migrants and people from culturally and linguistically diverse backgrounds.
  • People under 25 years of age.
  • People with a recently diagnosed sexual partner.
  • People without a medicare card.
  • People requiring PEP – an emergency medication for recent HIV exposure.
  • People with known STI symptoms.

InDaily asked CALHN about Clinic 275’s funding levels, but the department was unable to provide any information on the clinic’s funding before deadline.

The spokesperson said the clinic has the equivalent of about 23 full-time staff.

Wade told InDaily SA Health’s total funding to Shine SA had increased by $750,000 since the 2012 financial year.

“The State Government does not accept that SHINE SA needs to cut services,” he said.

“Similar services interstate are operating more efficiently and we think Shine SA can derive more revenue from Medicare to fund its services.

“For SHINE SA to announce it will close half its clinics in response to a 9 per cent reduction in funding doesn’t make sense.”

He said a significant portion of a $4.5 million annual grant funding contract with Shine SA is to provide education and training in clinical sexual health services to GPs.

“This is so GPs across South Australia are supported to provide sexual health services to their communities, whether that be prescribing contraception, inserting IUDs, or testing for STIs,” he added.

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