Description of specialty

Genitourinary medicine (GUM) is the medical specialty focused on the screening, diagnosis, management and public health control of sexually transmitted infections including HIV and related conditions. 

Comprehensive sexual health care encompasses needs relating to sexually transmitted infections (STIs) and HIV, contraceptive care, dermatological conditions, and associated general medical, gynaecological and psychosexual issues. The majority of GUM and HIV care is outpatient-based, with HIV services having links to inpatient care facilities. 

Rapid access to diagnosis and treatment of STIs, contact tracing (partner notification) and health promotion and risk reduction messages, are key principles in the prevention of onward STI transmission. Similarly, ease of access to the full range of contraceptive options including emergency contraception and long acting reversible contraception (LARC) is essential to reduce unwanted pregnancies. For this reason many GUM services provide integrated sexual health and contraceptive care in a one-stop shop model of service provision, using a multidisciplinary approach to comprehensive sexual healthcare. 

Sexual ill health disproportionately affects certain population groups including young people, men who have sex with men, and some black and minority ethnic groups. There are well-established links between sexual ill health, levels of social deprivation, drug and alcohol use, risk of domestic violence, and mental health issues. GUM has developed a holistic approach to sexual healthcare, with screening for vulnerability factors, and close working with other health, social care and third sector agencies. 

Two specialist societies provide the specialty with a framework for education, clinical governance and audit. The British Association for Sexual Health and HIV (BASHH) is the national specialist society dealing with all aspects of sexual healthcare and the British HIV Association (BHIVA) represents professionals in HIV care. There is a Joint Specialty Committee for GUM that brings together representatives of the Royal College of Physicians and BASHH to share information and facilitate collaboration.