The Public Health and Social Research Unit have produced a Sexual Health Needs Assessment for West Sussex.
Good sexual health is an intrinsic part of good overall physical, mental and emotional health. Most adults in West Sussex are sexually active. Sexual health is an important public health matter. Poor sexual health can, significantly, add to the burden of disease in the local population with diagnosed, and undiagnosed, sexually transmitted infections (STIs). We know that while everyone who is sexually active risks exposure to a STI, there are some groups at a higher risk, these are:
- men who have sex with men;
- younger adults;
- people from black and ethnic minority groups;
- people in prisons and immigration removal centres (IRCs).
There is also an association between STIs and deprivation.
Sexual health should not be isolated from other issues. Decisions sexually active people make cannot be separated from other aspects of their health and wider wellbeing, especially their mental and emotional wellbeing. This means that effective links and pathways between services are important. This includes services tackling substance misuse, mental health and those that support vulnerable young people and adults, including young people in care and people with learning disabilities.
This needs assessment examines sexual health needs of the West Sussex population and the current population-level sexual health outcomes.
It recommends the following:
- A sexual health strategy group should be established (led by WSCC Public Health) to:
- increase the communication between services across the county, includ- ing services for vulnerable groups, and communication with partner and third sector organisations and service users and service user groups.
- identify emerging issues and risks across the system.
- actively engage with wider stakeholders on the issues of sexual health.
- Expand performance indicators and monitoring relating to service user experience and views. Currently data sharing is good between the commissioned provider and local authority. Data are used to monitor performance and identify demand fluctuation and trends. This should also include service user views and experiences. Where surveys are undertaken by the provider, content could be shared and discussed with commissioners on an annual basis.
- Recommendations relating to young people:
- Increase detection for chlamydia to meet recommended Public Health England target
- Ensure that clinic hours continue to meet the needs of young people.
- Maintain outreach efforts that promote and normalise the service so that young people in need of treatment and advice know where to access this.
- Monitor the effectiveness of the pilot fast-track pathway for Children Looked After.
- Outreach to higher risk groups and links to other services:
- There are increasing pressures on the local health and care system, including to budgets and workforce; but it is important that higher risk groups, including outreach to those groups, are prioritised, and barriers to service access addressed.
- Treatment pathways should be developed (where absent) and reviewed annually between services including those for higher risk and vulnerable groups, such as children leaving care, adults with learning disabilities, and people known to substance misuse services.
- Of note there is a considerable overlap between people most at risk of poor sexual health and harmful drug and alcohol activity. The opportunities for closer, and joint, working, needs to be developed and prioritised by the relevant local authority commissioners. Some co-commissioning of services should be considered.
- Recommendations relating to HIV:
- Advocate for the use of PReP which is a cost-effective means of protecting against the acquisition and the onward transmission of HIV.
- Maintain testing coverage to increase the chance of timely diagnosis and to remind those presenting at clinics that HIV remains a key issue in their sexual health.
- Sustain efforts to ensure early diagnoses and treatment and sustained access to treatment and services that promote good health and wellbeing and work to ensure the viral load remains low or undetectable.
- Continue to pursue late diagnoses with the same urgency, treating all cases as a critical incident.
- Follow the UNAIDS 90:90:90 strategy implemented in England by PHE. This focusses on achieving the 90:90:90 target, which has implications for both minimising onward transmission and maximising quality of life for people living with HIV.
- Ensure support for outreach work on HIV, especially for harder to find cases such as ethnic minorities and cases of heterosexual transmission.