Sexually transmitted infections - factors associated with quality of care among private general practitioners

Objectives. To study the factors associated with quality of sexually transmitted infection (STI) care among private general practitioners in Gauteng. Methods. We analysed 1 194 records of patients attending 26 randomly selected GP practices in the first 3 months of 2000 and 2002, for 3 STI syndromes, namely urethral discharge, pelvic inflammatory disease and genital ulcers. We assessed adherence to nationally accepted STI treatment guidelines and analysed the influence of patient and practice-level variables on effectiveness of STI drug regimens and trends over time. Results. After controlling for syndrome mix, district and time period, appropriate drug treatment for STIs was significantly associated with the client having medical aid (p < 0.001), recent graduation as a medical practitioner (p < 0.001) and male GP gender (p = 0.007). Between 2000 and 2002, STI care improved for clients with medical aids but for not cash clients. Conclusions. There was variation in the quality of prescribing for STIs among GPs and positive trends in this prescribing. There is a need for interventions that address the financial incentives that may hamper quality of STI care for cash clients.