Basingstoke Contraceptive and Sexual Health (CASH) Service

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Basingstoke Contraceptive and Sexual Health(CASH) Service Rachel Bower, Andrea Grant, Natalie Hilton, Gabriella Howard, Hayley King, Donna Norris-Farmer & Pauline Rachman • CASHAims &Objectives • To modernise sexual health and HIV services in light of the growing prevalence of sexually transmitted infections (STIs) and HIV1 • To promote the location of local sexual health services • To offer sex education, health promotion and contraception to enable people to improve their health • To reduce the teenage conception rate in young women aged 15-17 • Health promotion is said to only be successful if it advocates the best interests of individuals, and society as a whole 2 • Basingstoke CASH Service uses a ‘high-risk’ approach, prioritising people at particular risk in the community, rather than a whole-population approach 2 With thanks to the staff at Basingstoke CASH clinic. • Evidence of need • National Strategy for Sexual Health & HIV1 aims: • • reducing the transmission of HIV and STIs • • reducing the prevalence of undiagnosed HIV and STIs • • reducing unintended pregnancy rates • • improving health and social care for people living with HIV • • reducing the stigma associated with HIV and STIs • The need to develop the evidence base • DOH’sPublicService Agreement5 ‘to reduce the under-18 conception rate by 50 per cent by 2010as part of a broader strategy to improve sexual health’ “In England, and in other developed countries, the burden of sexual illness is borne, in particular, by the most vulnerable in society.” 3 • Bringing sexual health services • into the Internet era • A Cochrane review of sexual health promotion concluded that • computer based interventions: • have a moderate effect in improving people's knowledge about sexual health in comparison to ‘usual practice' leaflet giving • have a small effect on safer-sex intentions • have an effect on sexual behaviour (such as condom use for sexual intercourse) • appeared better than face-to-face interventions at improving sexual health knowledge • However, no studies measured potential harm of computer • based interventions -more research is required to establish • whether they have an effect on outcomes such as STIs and • pregnancy and to assess whether they are cost-effective 11 • Does the service work? • Whilst local media6reported a nationwide decrease in • teenage pregnancies in 2010, there was actually a 7.8% increase in the South East area compared to the previous year7 • CASH service staff identify several barriers to providing • an effective service to young people: • Providing services at times that are accessible • to young adults of school/college age8 • Lack of signposting – the CASH service cannot be • seen to publicly ‘promote’ sex to young people • The service does not have a budget • for targeted advertising in the local area • 49% of young people in the UK reported • that they don’t know where their local • sexual health clinic is9 • Every secondary school in North East Hants is offered a free education and advice session for Year 11 pupils, however the uptake rate is currently approximately 10% • Improved education in schools is vital to improve sexual • health amongst young people10 • CASH is now under the umbrella of Solent NHS • Trust, moving towards a service offered under • “one roof” in place of the previous referral service • 60%‘would not mind’ completing an electronic form regarding their sexual history 78% had no concerns about their sexual health records being stored electronically 77% were ‘very’ or ‘quite’ likely to use an interactive sexual health website12 1 Department of Health (2001) Better prevention, better services, better sexual health – the national strategy for sexual health and HIV. London: The Stationery Office. 2 Scriven, A. (2010) Promoting health, a practical guide. 6th Edition. London: Elsevier. 3 Lloyd, C., Handsley, S., Douglas, J., Earle, S. and Spurr, S. (2007) Policy and practice in promoting public health. Sage: London. 4 www.hampshirecash.org.uk 5 Department of Health (2009) Moving forward: progress and priorities - working together for high quality sexual health: Government response to the Independent Advisory Group's review of the Sexual Health and HIV Strategy. London: The Stationery Office. 6Press Association (2012) Teenage pregnancy rate drops 7.3%. Basingstoke Gazette. Available at: www.basingstokegazette.co.uk/uk_national_news/9558263.Teenage_pregnancy_rate_drops_7_3_/. (Accessed: 12 June 2012) 7Office for National Statistics (2012) Conceptions in England and Wales 2010. Available at: www.ons.gov.uk/ons/rel/vsob1conception-statistics--england-and-wales/2010/2010-conceptions-statistical-bulletin.html#tab-Conceptions-in-England-andWales-2010(Accessed: 12 June 2012). 8UK Youth Parliament (2007) SRE: Are you getting it? Available at http://www.ukyouthparliament.org.uk/wpcontent/uploadsAreYouGettingIt.pdf. (Accessed 12 June 2012) 9FPA and Brook (2012) Joint Statement from FPA and Brook on STI data released on 30 May 2012. Available at www.fpa.org.uk/pressarea/pressreleases/2012/may/joint-statement-from-fpa-and-brook-on-sti-data-released-on-30may-2012. (Accessed 12 June 2012) 10Department of Health (2010) Healthy lives, healthy people: Our strategy for public health in England. Available at: www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/documents/digitalasset/dh_127424.pdf (Accessed: 12 June 2012). 11Bailey, J.V., Murray, E., Rait, G., Mercer, C.H., Morris, R.W., Peacock, R., Cassell, J. and Nazareth, I. (2010) Interactive computer-based interventions for sexual health promotion. Cochrane Database of Systematic Reviews 2010, Issue 9. Art. No.: CD006483. DOI10.1002/14651858.CD006483.pub2. 12 Ross, J. D. C., Copas, A., Stephenson, J., Fellows, L. and Gilleran, G. (2007) Optimizing information technology to improve sexual health-care delivery: public and patient preferences. International Journal of STD and AIDs, 18, pp 440-445. Images:www.hampshirecash.org.uk;blog.jericho.co.nz; www.plannerslounge.com; ww1.prweb.com; images.bigdug.co.uk; images.hayneedle.com; www.zephyrsouthwest.com; www.pvrdirect.co.uk