Students in Utrecht aren’t travelling to Amsterdam STD clinics

Late January, Student & Starter sent in questions to the municipality board in response to the renovation of ‘sexual health care area Utrecht’. The political party said it had information that more and more students in Utrecht travel to STD walk-in hours in Amsterdam to be tested for sexually transmitted diseases free and anonymously. This was said to happen as a result of long waiting times in Utrecht for free and anonymous check-ups.

In Utrecht, the waiting time at the GGD STD clinic is three days for people who are experiencing symptoms, and a maximum of three weeks for people who don’t have any symptoms. In Amsterdam, the situation is very similar. “We have a system with different types of appointments, in which the waiting time for people with the highest priority is a maximum of five working days. The waiting time for less urgent appointments is currently fifteen working days,” says Arjan Hogewoning, head of the STD clinic for GGD Amsterdam. He says the numbers of Utrecht-based students travelling to Amsterdam aren’t all that high.

“There is a possibility in Amsterdam for young people below 25 years of age, to do a self-test without an appointment. It’s possible students from Utrecht are using this. It would be improper use, because our care is limited to residents of the Amsterdam-Amstelland area. We’re looking into this, but we do think this concerns relatively small groups of people,” Hogewoning continues. The GGD for the Utrecht area agrees: “We incidentally receive reports that people travel to Amsterdam to get tested, but they’re not coming in more often – or less often – than in previous years.”

From own social circle
The signs Student & Starter had received from Utrecht-based students using the STD clinic in Amsterdam mostly come from its own social circle and constituency, says city council member Eva Oosters. “That’s why we sent in our questions, to ask whether the municipality board recognises these signs. A possible next step would be to check whether there’s enough support in the council to study the subject.”

A cause of the long waiting times for less-urgent cases may be that the GGD Utrecht area doesn’t have enough money for STD aid. “The ministry of Health divides the national budget among the regional GGD offices. The Utrecht area is all the way at the bottom of the list. With our 1.5 million euros, we’re nowhere near the 12 million that goes to North Holland,” Student & Starter writes. The budget is hard to re-divide: the division was set in the subsidy regulations for public health – supplementary sexual health care of the Ministry of Health, Welfare, and Sport, and will remain this way until January 2022.

“Re-dividing the budget is only possible if and when the ministry’s regulations are adjusted. There was an evaluation of the subsidy regulations in 2017, and the ministry recently responded to the evaluation report, stating they would not increase the budget,” explains Bas Boogmans, Society & Health doctor for GGD Utrecht area.

Free STD test
To be allowed to use the STD clinics for free, you need to meet a few national criteria. The RIVM states that, to receive a free check-up and treatment (if necessary), you need to be younger than 25, and/or at high risk of getting an STD. That may mean, for instance, that you’re experiencing symptoms that indicate possible STDs, that someone you slept with has warned you about an STD, that you’re a sex worker, or that you’re a man who has sex with other men.

The STD clinics are an addition to general practitioners. People who aren’t experiencing symptoms but would like to get tested, are generally recommended a visit to the general practitioner. “If clients cannot get an appointment within three weeks, we refer them to the GP as well, where they can be helped quickly and properly,” says Bas Boogmans of the GGD Utrecht area. “We feel it wouldn’t be justified to let someone who may have an STD wait for more than two to three weeks.”

However, Student & Starter writes in their letter, many students aren’t registered with a general practitioner in Utrecht yet, which leads to them walking around with (possible) STDs for much longer. Additionally, the STD test at a GP is billed to your deductible, and it’s not anonymous.

Not busier than before
With the renovation of sexual health care in the Utrecht area, the location of the STD clinic has moved, but the number of available appointments hasn’t changed. Early this year, the STD walk-in hours moved from the UMC Utrecht to the GGD locations in the Utrecht City Hall and in Amersfoort.

The GGD isn’t expecting the walk-ins to be busier than before. “We have the same triage. The target groups that are eligible for the walk-ins are the same. Unfortunately it’s still the case that we can’t offer appointments to everyone who wants one,” says Boogmans of the GGD Utrecht area.

Every year, the STD clinic in Utrecht helps around 5,500 people. This number, like the budget, is ten times as high in Amsterdam. Hogewoning for GGD Amsterdam, says: “In 2018, we performed a record number of 51,116 STD consults. This is 10 percent (nearly 4,700 consults) higher than in 2017. Despite this increase, the care needs remain high and the waiting times long.”

Long waiting times at STD clinics are a well-known problem, both in Utrecht and the rest of the country. UMC Utrecht reported this last year when political party GroenLinks alerted the municipality. In May of last year, the city council visited the UMC Utrecht to try to find a solution to the long waiting times.