Clearance of HPV infection in middle aged men and women after 9 years' follow up.

14/35 (40%) v 1/20 (5%), in those attending the hospital based clinic compared with outreach patients. Interviewees reported that location played an important part in their decision as to which site to attend as 46/55 (83%) attended the clinic that was closest to home or work. Lack of awareness of alternative clinics did not seem to be a significant factor influencing the site attended, as 34/55 (62%) were aware of alternatives. Confidentiality and stigma were not stated as important issues. Demographic and disease data on 209 consecutive attendees at the hospital based clinic and 111 consecutive attendees at the outreach clinic in 2001 were compared (table 1). The data show that outreach patients were more likely to be teenagers, women, African, and first time clinic attendees. STD rates were similar at both sites. These data are similar to those obtained in 1998 although the ethnic mix has changed. It has long been assumed that stigma and confidentiality were the main influences on patient access to GUM services and ever since the Monk report there has been a move towards overcoming these barriers. This study shows that the outreach service attracted a new and very different population, in terms of demographics and GUM experience, but the overriding influence on the patients’ choice of site of care was closeness to home or work. However, outreach services such as this are also relatively time consuming and expensive compared with the larger clinic. These factors should be strongly considered when developing new outreach services.