The National Sexual Health and HIV Strategy

1. The National Sexual Health and HIV Strategy Cathy Hamlyn Head of Sexual Health and Substance Misuse Department of Health

2. Aims • Reduce HIV and STIs • Reduce prevalence of undiagnosed HIV and STIs • Reduce unintended pregnancy rates • Improve health and social care for people living with HIV. • Reduce stigmaassociated with HIV and STIs

3. Better Prevention • New national safer sex campaign • Targeted local prevention campaigns • More responsive national helplines • Evidence base for HIV/STI prevention • High priority to HIV prevention gay men • African Communities strategic framework • Needle exchange schemes • Sexual health of people living with HIV • Role of service providers in prevention

4. Better Services • Widen the role of primary care • Improve access to GUM services • HIV Standards ( sexual health standards) • Managed clinical networks • One Stop Shops • Chlamydia screening from 2002 • Range of contraceptive services • Abortion address disparities/RCOG • Guidelines/info re counselling and TOP • Expand HIV testing • Increase hepatitis B vaccination

5. Model of Services Level 1 All primary care teams/GU service/family planning clinics Level 2 Primary care teams with extra skills/GUM/family planning Level 3 Specialist services GUM/FP/TOP

6. Levels of Service • Sexual history, STI/HIV testing,pregnancy testing/referral,contraception,assessment of men with STI symptoms,cervical cytology screening, HepB immunisation 1 • IUDs,testing/treatingSTIs,implants,partner notification, invasive testing/men,vasectomy 2 • Sexual health needs assessment, clinical governance, outreach , partner notification co-ordination, specialist contraception, specialist HIV treatment and care 3

7. Commissioning • From April 2002 PCTs to commission • sexual health services. • Specialised services for HIV • treatment at appropriate level. • Local multi-agency group • Sexual health plan in HIMP • Reducing inequalities • User views • Performance Indicators

8. What Does the Strategy Say About Sexual Health Advisers ? • Development of the role of health advisers • Defining the role and responsibilities • Increasing the numbers of sexual health advisers • Improving partner notification • Development of a health advising qualification by 2005

9. Responses to Strategy • Agreement re issues and proposals • Action to achieve change • Lack of cross-Government support • Status of strategy • Need for more joined-up-ness • Medical model ;support;role of LAs • Capacity to reduce stigma • Capacity of PCTs to commission HIV • Concern re mainstreaming • Performance indicators/service standards • Commissioning toolkit • Increasing capacity of services • Service model/clinical govern./HIV testing • Training, training,training!

10. Next Steps • Response to consultation Spring 2002 • Action plan Spring 2002 • Business plan for work cross-Government • Base-line assessment received Mar 2002 • Consider capacity for delivery • Consider mechanisms for local implementation • Priorities for resources Spring 2002

11. National Implementationxxx • Monitoring of HIV investment(May) • Mechanisms for user involvement • Commissioning toolkit (July) • National advisory arrangements (Summer) • Review data availability • Indicators and targets (October) • Set of standards end of 2002/3 • First plans due for implementation April 03

12. Actions-Health Promotion • Evidence on HIV and STI prevention (April) • Contraception and abortion evidence • HIV prejudice advertising campaign • Addressing stigma and discrimination • Pro-HIV testing campaign(Autumn) • Targeted prevention-gay men CHAPS and African Prevention Framework • Health Promotion Toolkit ( August) • Role of Helplines • Sexual Health Public Information review • Role of schools and further education

13. Safer Sex Campaign • Limited radio and TV campaign ( running) • Review of evidence( March) • Information about services • Commission campaign ( June) • Brief local areas of plans ( Summer) • Campaign starts( October) • Evaluation

14. Actions -Services • Model of service description ( May) • Chlamydia screening roll-out ( May) • One Stop Shops pilots (Spring) • Health Advisers action plan ( Spring) • HIV testing briefing ( July) • African Communities Framework( June) • Contraception inc EC,Condoms • Abortion -addressing disparities • GUM waiting times • Managed service networks ( March 03) • Targeted services good practice (2003)

15. Actions-Support • Commission report on support needs of adults living with HIV( September) • Commission report on support needs of children living with HIV( September) • Review Aids Support Grant(October) • Support needs of people with STIs • Skills development for people living with HIV-good practice( late 2002)

16. Supporting Change • Mapping of skills and other professional training July • Training strategy Summer 2002 • Workforce projections • Review Aids Control Act- data requirements Summer 2002 • Research gaps/priorities-literature review

17. Issues and Challenges • Limited resources • NHS reorganisation • Finding a Local lead and champions • Many other priorities in NHS Plan • Primary Care under pressure • Engaging PCTs • Shortage of skilled staff • Existing services under pressure • Need to address access and standards • Need to address inequality • Emotional and Social support

18. How Do We Ensure Effective Implementation • Leadership and Champions • Partnership and Participation • Raising the Profile • Linkage to other agendas • General and Targeted approach • Cross-cutting agenda • Levers-Indicators and targets • Monitoring of progress and outcomes • Guidance, support and direction • A little bit of money helps!