Do Australian sexual health clinics have the capacity to meet demand? A mixed methods survey of directors of sexual health clinics in Australia

Background The study describes the capacity of publicly funded sexual health clinics in Australia and explores the challenges they face. Methods We sent a survey to the directors of publicly funded sexual health clinics across Australia between January and March 2024. The survey asked about how their clinics were managing the current clinical demand. Results Twenty-seven of 35 directors of sexual health clinics responded. These 27 clinics offered a median of 35 (IQR: 20-60) bookings each day, but only a median of 10 (IQR: 2-15) walk-in consultations for symptomatic patients. The average proportion of days that clinics were able to see all patients who presented with symptoms was 70.1% (95% CI 55.4, 84.9) during summer versus 75.4% (95% CI 62.2, 88.5) during winter. For patients without symptoms, the corresponding proportions were 53.3% (95% CI 37.9, 68.8) during summer versus 57.7% (95% CI 41.7, 73.7) during winter. If these percentages were adjusted for the number of consultations that the clinic provided, then the corresponding numbers for symptomatic individuals was 51.0% for summer and 65.2% for winter, and for asymptomatic individuals it was 48.1% and 49.8%, respectively. The catchment population of the clinics for each consultation they provided ranged from as low as 3696 to a maximum of 5 million (median 521,077). Conclusions The high proportion of days on which sexual health clinics were not able to see all patients is likely to delay testing and treatment of individuals at high risk of STIs and impede effective STI control.