Sexual Health

1. Sexual Health • Chlamydia screening uptake increased (2010/11) • Syphilis and genital warts cases increased in number • 15,000 GUM clinic attendances at in RBHT annually. Half aged <25 years • Teenage pregnancy higher in areas with high levels of deprivation • Relatively high teenage repeat abortions • High uptake of antenatal screening (Syphilis, HIV & Hep B) • Number of abortions for all ages reduced (2010/11) • At risk groups • HIV among gay and bisexual men • HIV in people from Sub-Saharan African • Increased risk for STI diagnosis in 16-30 yr olds • Intravenous drug misusers • Commercial sex workers • Commissioning recommendations • Ensure training for staff and multi agency service planning • Tackle stigma and discrimination • Appropriate service provision for high risk groups (MSM and commercial sex workers) • Evaluation of the new outreach nurse post • Ensure continued accessible high quality sexual health and contraception services • Consider continuation of SRE in school age children Gains and key issues Rates of teenage pregnancy have fallen in BW New satellite CASH services have been commissioned Abortion services have been re-commissioned Demise of the healthy schools programme Inequalities in LARC provision Limited implementation of the sexual health LES No data for psychosexual problem & service provision or uptake

2. Tuberculosis • TB infection does not always mean a person can transmit the infection. The infection can be present but quiet • Yearly occurrence in BW over past 3 years is greater than the SE region average • Incidence significantly higher in Reading remained at high levels since 2006 • 40% of all Reading cases in Park, Katesgrove, Abbey and Battle wards (2006-2009). • ↓ trend in BME groups but ↑ trend in White population of TB cases (2006-09) • Although the numbers are small, proportion of children <15 years amongst TB cases ↑ • Risk factors • Proximity to an infectious person • Residence in regions of high TB rates • Poor immunity – e.g. due to HIV, cancer, chronic kidney disease • Substance misuse • International travel • Living or working in a residential care facility • Commissioning recommendations • Strengthen early detection and prevention in new entrants • Strengthen community prevention and control • Adopt neonatal BCG vaccination for newborns of women resident in specific high-risk Reading postcodes • Invest in a networked Health Activist function • Review services for Reading YOI & network with community TB service Gaps and Challenges Lack of multilingual and culturally appropriate information and educational materials Limited staff in the community TB service Limited TB service for the homeless Significant gaps in the provision & poor linkage in services for the offenders’ population especially Reading YOI