Joint strategic needs assessment
Sexual Health and HIV (2019)
This is an online synopsis of the topic which shows the executive summary and key contacts sections. To view the full document, please download it.
| Topic title | Sexual Health and HIV (2019) |
|---|---|
| Topic owner | Nottingham & Nottinghamshire Sexual Health Strategic Advisory Group (SHSAG) |
| Topic author(s) | Matthew Osborne - Nottinghamshire County Council Uzmah Bhatti - Nottingham City Council |
| Topic quality reviewed | 9th October 2018 |
| Topic endorsed by | Nottingham & Nottinghamshire Sexual Health Strategic Advisory Group (SHSAG) |
| Topic approved by | Health and Wellbeing Board January 2019 |
| Current version | January 2019 |
| Replaces version | 2015 |
| Linked JSNA topics |
Executive summary
Introduction
The previous Nottinghamshire Sexual JSNA Chapter was refreshed in 2015 and amended in July 2017. It has been two and a half years since the local authority commissioned sexual health services in 2016 and this chapter has been refreshed to look at the sexual health landscape to understand current and future demands, trends and pressures.
This JSNA chapter has been endorsed by the Nottinghamshire/Nottingham Sexual Health Strategic Advisory Group (SHSAG). The chapter will be used to refresh the Sexual Health Framework for Action which aims to provide a clear and ambitious plan for improving the sexual health and wellbeing of the people of Nottinghamshire.
Definitions and overall approach
Sexual health is defined by the World Health Organisation as: ‘a state of physical, mental and social well-being in relation to sexuality; it is not merely the absence of disease, dysfunction or infirmity. Sexual health requires a positive and respectful approach to sexuality and sexual relationships, as well as the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination and violence. For sexual health to be attained and maintained, the sexual rights of all persons must be respected, protected and fulfilled’.[i]
This JSNA chapter was produced in collaboration with Nottingham City Public Health. This chapter focuses on Nottinghamshire and considers the need, evidence of effective interventions and current service provision for:
- sexually transmitted infections, including HIV,
- contraception,
- terminations of pregnancy,
This chapter identifies unmet needs and knowledge gaps and reflects on potential future changes in sexual health. A series of recommendation are made for stakeholders across the sexual health system to consider.
This chapter does not focus on domestic abuse, teenage pregnancy, sexual violence or gynaecology as they are covered in other published documents. Further information can be found on the Nottinghamshire Insight website. A summary of the responses to the preceding assessment can be found in appendix 1.
Nottinghamshire County is similar to the rest of the country when considering key sexual health outcomes. In Nottinghamshire there has been a slight increase in new diagnoses of STIs, similar to the rise seen nationally. The chlamydia detection remains low compared to the rest of the country although the most up to date data indicates that Nottinghamshire is beginning to improve. Nottinghamshire is performing well in relation to the rate of Longer Action Reversible Contraception (LARC) prescribed but there are local differences in demand and provision.
Unmet needs and service gaps
The following unmet needs and service gaps have been identified:
- There are differences in sexually transmitted infection patterns in terms of gender, age and locality.
- Men, especially young white men, are less likely to access sexual health services.
- Variation in chlamydia detection rates across the district suggests that there is a need to improve access to testing in different localities.
- Access to and effective use of contraception,
These are explored in more detail in section 8 of this JSNA chapter.
Recommendations for consideration by commissioners
The recommendations below are summarised from section 10 and identify key changes needed to address the sexual health needs of people in Nottinghamshire County.
Recommendation |
Lead organisation |
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| SHSAG | Local Authority | Providers | Others | ||
|---|---|---|---|---|---|
Sexual Health Promotion |
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| 1. |
Consider more robust planning and evaluation around communications for sexual health campaigns. |
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| 2. |
Consult with the community to understand the views of citizens and barriers for those who use (and do not use) sexual health services, especially those from identified at risk groups. |
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| 3. |
Consider further assessments/audits including engagement with specific sexual health needs of some at risk groups such as young offenders, sex workers, MSM and LGBT Q+ communities. |
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| 4. |
Support stakeholders to prepare Nottinghamshire schools for the implementation of statutory RSE in September 2020. |
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Prevention of poor sexual health outcomes |
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| 5. |
Work with a range of partners and stakeholders from within the health care system with the aim of addressing the pressures in the sexual health system in order for citizens to continue to receive the right care in the right place at the right time. |
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| 6. |
Develop a further understanding of factors contributing to reinfections and how behaviour change can be encouraged via sexual health services and health promotion routes. |
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| 7. |
Investigate the differences in sexual health outcomes within the districts of Nottinghamshire to understand the potential causes and implement interventions where appropriate. |
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| 8. |
Continue efforts to improve Nottinghamshire’s chlamydia detection rate to regional and national averages, with the aspiration of achieving the PHOF target. |
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| 9. |
Investigate what is driving the drop in HIV testing coverage and uptake within Nottinghamshire. |
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| 10. |
Consider auditing Locally Commissioned Public Health Services (LARC/EHC) across Nottinghamshire to enhance understanding of demand, provision and potential unmet needs. |
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Sexual health treatment |
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| 11. |
Consider reviewing and refining service user satisfaction data collection methods to understand how people use sexual health services and what services people want. |
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| 12. |
Consider a service evaluation of the online chlamydia testing service to understand who is using it, the cost effectiveness of the service and anticipated future demand. |
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| 13. |
Understand and plan for issues on the sexual health horizon such as testing for M. Gen, roll out of PrEP and increased service demand. |
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| 14. |
Ensure that MSM are tested regularly and in line with the current guidance. |
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[i]Department of Health. (2013) A Framework for Sexual Health Improvement in England. Available at: https://www.gov.uk/government/publications/a-framework-for-sexual-health-improvement-in-england [Accessed 16.07.18]
Key contacts
Matthew Osborne, Public Health and Commissioning Manager
matthew.osborne@nottscc.gov.uk
Nick Romilly, Senior Public Health and Commissioning Manager
This is an online synopsis of the topic which shows the executive summary and key contacts sections. To view the full document, please download it.