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SEXUAL HEALTH STRATEGY An Update

SEXUAL HEALTH STRATEGY An Update. Nick Payne Sexual Health Team, Department of Health, London. National Survey of Sexual Attitudes and Lifestyles. Daily Star. Sexual Behaviour Changes. Age of first intercourse reduced in last 10 years

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SEXUAL HEALTH STRATEGY An Update

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  1. SEXUAL HEALTH STRATEGYAn Update Nick Payne Sexual Health Team, Department of Health, London

  2. National Survey of Sexual Attitudes and Lifestyles Daily Star

  3. Sexual Behaviour Changes • Age of first intercourse reduced in last 10 years • Increase in unprotected sex - associated with alcohol and binge drinking • Number of lifetime partners increasedin the last 10 years • Concurrent relationships increased • Condom usage increased, but offset by number of sexual partners • 44% of HIV+ men have sex with new partners in the last month of whom 40% reported no or inconsistent condom use.

  4. Consequences of Poor Sexual Health • Part of physical and mental health and well-being • Inequality , poverty and social exclusion • Infertility,ectopic pregnancy, premature delivery • Chronic conditions e.g.Cancer, hepatitis • Unintended pregnancies/abortion • HIV • Stigma and discrimination

  5. New diagnoses of selected STIs/HIV in GUM clinicsEngland, Wales & Northern Ireland

  6. November 2004 Public Health White Paper - Choosing Health

  7. Summary of Sexual Health Topics in Public Health White Paper • A new national STI advertising/media campaign. • New capital and revenue funding for modernisation of the whole range of NHS sexual health services. • A national chlamydia screening programme, covering all of England by March 2007.

  8. Audit of contraceptive service provision in early 2005 and investment centrally to meet gaps in local services. • National review of treatment services to provide advice and support on service modernisation for both commissioners and service providers. • By 2008 everyone referred to a GUM clinic should be able to have an appointment within 48 hours.

  9. Funding announced -over 3 years • Advertising Campaign £50m • Treatment Services (Capital and Revenue) £130m • Chlamydia Screening £80m • Contraceptive Services £40m

  10. New national campaign • Targeting younger men and women • Risks of unprotected sex in terms of STIs and unintended pregnancies • Promoting benefits of condoms • Engaging support of stakeholders

  11. Chlamydia screening • Accelerated roll-out of national screening programme by March 2007, backed by £80 million investment • Piloting screening in pharmacies across London and Cornwall

  12. ContraceptiveServices Audit • Comprehensive audit of contraceptive service provision will include specialist providers, general practice, outreach services etc • Audit should be used at local level to support service development and identify gaps • Investment of £40 million to improve services in line with results of audit

  13. Newer DoHInitiatives • GUM Development Pilots • GUM Services Review • Cost-effectiveness of Sexual Health Services

  14. Northumberland North Cumbria North of Tees Warrington Salford & Manchester GUM Development Pilots Telford & Wrekin Swindon Weston & Bristol Waltham Forest West Dorset

  15. GUM Development Pilots • Ten in England • Invitations for Local Bids • BASHH involved with Department of Health in prioritising • Each gets about £250,000 over 2 years • What general lessons can we learn?

  16. Main Issues arisingfrom GUMDevelopment Pilots • Recruitment and staffing • Accommodation

  17. GUM Services Review

  18. GUM Services Review • Being conducted for DoH by MEDFASH – Medical Foundation for AIDS and Sexual Health • Pre-visit questionnaire • Aim to visit all ~ 200 GUM Clinics in England • Local Sexual Health Economy also part of Review Process • Results should inform investment

  19. Health Economics of Interventions in Sexual Health • Limited literature • Not well presented to NHS – especially with Finance and Commissioning Leads • Some interventions are cost-saving, others are very cost-effective • Consensus meeting • Dissemination of “Solid Facts”

  20. The Economic Case for Investment • Average lifetime treatment costs of each HIV +ve patient £180,000 • Each case HIV infection prevented saves £1/2-1 million in terms of individual health benefits and treatment costs • Cost of infertility due to chlamydia - 20% + of infertility treated by IVF

  21. Example of Results

  22. National Survey of Sexual Attitudes and Lifestyles The Times

  23. END

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