It's always interesting to see how other countries tackle problems common to us and this recent Anglo-American conference lets us exchange ideas and methods of approach and treatment options on the international stage. JACKY ROGERS reports from New York.

BASHH-ASTDA set out an ambitious programme

The British Association of Sexual Health and HIV (BASHH) and the American Sexually Transmitted Disease Association (ASTDA) met in Brooklyn for a third successful joint conference in May. There were approximately 400 registered delegates, largely from the UK and USA, but also representation from our European and Australian colleagues.

The 40 nurses who attended were all from the UK as far as I could see so it was a missed opportunity for us to meet with American nursing colleagues. I understand they tend to go to the large national conferences held biennially by Central Disease Control (CDC) - in March at the National STD Prevention Conference in Chicago there were 1,300 attending!

There was strong representation by UK nurses in the poster section and poster-viewing sessions were managed in a different way, highlighting areas of work at wine receptions each evening. This proved a good way of enticing delegates to focus on individual pieces of work and an opportunity for nurses to discuss and take questions.

The ambitious conference programme lasted three days from 7am breakfast meetings till finishing at 7pm each evening. Here's a snapshot of the American perspective:

New York City

With a population of 8.1 million, 53 per cent are male and the median age is 36.

  • A large city-operated health care infrastructure is appointed by the mayor and STD clinics are part of the Public Health and Mental Hygiene Department.
  • Each of 10 free "walk-in" STD clinics across the city provide six-to-seven sessions per week for patients over 12 years.
  • Outreach work is complex due to the great diversity of culture and language. One in four New Yorkers was born outside the US.
  • There has been a policy of free unlimited condom provision since 1997.

Prevalence of common STIs in adolescent women

A CDC national study of young women aged 14-19 in the USA who are infected with an STI revealed that African American teenage girls are most severely affected (48 per cent) compared with 20 per cent of young white Americans. This was the first study of its kind.

National Study of Family Growth 2002

Women accessed 51 per cent of all STD and contraceptive services at doctor's offices (not state funded), 20 per cent at community clinics and 16 per cent at family planning clinics. The authors called for greater integration of contraceptive and STD/HIV services.

HPV vaccine

Merck Quadrivalent is the only vaccine currently available in the US. It is being given at 11-12 years at "preventive health care visits". It costs $120 per vaccination in the state system, but 60 per cent of the vaccine programme is through private providers. There is no school-based programme - it's mostly primary care delivery.

Partner notification

See www.inSPOT.org - An STD Internet notification site for partners or "tricks" (a term for prostitute) where people can send an e-card anonymously to partners to tell them they have been exposed to infection. There's also information about the disease and a map of nearest testing facility. This is said to be the preferred method for a lot of people to receive notification, but the authors stressed this will not replace services, telephone contact or notification through the public health department.

PS. Just before we went to press, I was contacted by nurses in Baltimore, North Carolina, and Rochester (New York State). They all run specialist nurse-led sexual health services. So, further news from the USA soon.