Sexual health is an important element in the overall physical health and mental health of an individual. Sexual contact can lead to the transmission of sexually transmitted infections (STIs) which, if left untreated, can lead to serious health complications. The public need access to advice from health professionals who are knowledgeable about sexual health and skilled in communication in this area. It is crucial, therefore as healthcare professionals working in both primary care and pharmacy settings, that we stay open, informed and up to date with changes and developments in the field of sexual health.
In the UK, significant advancements have been made in recent years regarding a variety of sexual health-related issues, particularly in relation to the prevention, detection, and treatment of sexually transmitted infections (STI’s). Here we will take a look more closely at some of these positive developments, including the rise in the use of Human Immunodeficiency Virus (HIV) Pre-Exposure Prophylaxis (PrEP), the easier accessibility of sexual health screening through pharmacies and online kits, and the ongoing STI prevention initiatives. Alongside delving into the challenges we still face and the opportunities for improvement in sexual health services.
1. The rise of HIV Pre-Exposure Prophylaxis (PrEP)
One of the most positive developments in sexual health and key aspects of HIV prevention has been the rising use of HIV PrEP. HIV PrEP involves the use of antiretroviral medicines, which greatly lowers the chance of an individual contracting HIV. The introduction of PrEP in the United Kingdom has been a game changer, empowering individuals at risk to take control of their sexual health and minimise HIV transmission.
The PrEP monitoring and evaluation framework, published in March 2022 consists of a series of indicators to inform service improvement in PrEP commissioning and delivery.
UK Health Security Agency (UKHSA), March 2022
Whilst gay, bisexual and other men who have sex with men (GBMSM) are the largest group of individuals accessing HIV PrEP services. It is important that other risk groups are not neglected. Data published by Public Health Scotland showed that last year in Scotland, 42% of all new HIV diagnoses were in heterosexuals, compared to 29% in GBMSM. Healthcare professionals play an important role in promoting PrEP and ensuring that it is available to those who need it.
2. Enhanced access to sexual health screening in primary care and community pharmacy
Accessing sexual health screening services for many may often be seen as a daunting or time-consuming process. Recent advancements, however, have made screening much more accessible and convenient for individuals. Many pharmacies now offer a range of sexual health services, including STI testing. Giving those wanting testing a discreet and easily accessible choice. Furthermore, the availability of online testing kits has transformed the way people access screening. These kits enable individuals to collect samples at home and send them to laboratories for analysis. Providing a convenient and confidential alternative to traditional clinic-based testing.
However, disparities in access do still persist, especially in vulnerable groups. It is important to address these inequalities to ensure that everyone has access to timely diagnosis and treatment. Public health efforts focusing and targeting high-risk populations are needed to provide specialised services and support.
3. Improved availability to contraceptive measures
Correct and consistent condom use remains a major intervention for preventing STIs and unplanned pregnancies. Many areas of the UK have introduced programmes offering free condoms through Condom distribution schemes (CDS).
Contraceptive services have also become more accessible, including the availability of long-acting reversible contraceptives (LARCs) including intrauterine devices (IUDs) and implants. However, improvements still need to be made to make these options more accessible to all. Regardless of geographic location or socioeconomic status.
4. Addressing STI rates
While progress has been made, it is important to acknowledge the ongoing challenges posed by STIs in the UK. Rates of STIs, such as chlamydia, gonorrhoea, and syphilis, remain a worrying concern. Data published by the UKHSA in June 2023 showed there were 392,453 STIs reported in England in 2022. This was a 24% increase from the previous year. This included a 50% increase in gonorrhoea, a 24% increase in chlamydia and a 15% increase in syphilis since 2021.
However, it is crucial to view these statistics in the context of increased testing and improved awareness. The availability of screening through pharmacies and online kits has undoubtedly contributed to the identification and treatment of STIs at an earlier stage.
Yet, these most recent results remain troubling. Particularly when testing rates remain lower than pre COVID-19. Yet the number of STIs diagnosed exceeds the high levels observed prior to the pandemic. The report highlighted there was a 21% increase in chlamydia in young people. This is despite no increase in testing among this group. Furthermore the impact of STIs remains greatest in young people aged 15 to 24 years, GBMSM, and some black ethnic groups. Highlighting the need to address sexual health discussions in these particular risk groups.
5. Sexual Health education and awareness in primary care and community pharmacy
Education and awareness is key. Primary care clinics and community pharmacies should be seen as important hubs for sexual health education to be able to provide information and resources on topics such as safe sex practices, contraception options and STI prevention. This educational outreach can help individuals make informed decisions about their sexual health and can also help to promote more open and inclusive conversations.
However there is still further work to be done in terms of Sexual health education in both primary care, community pharmacy settings and beyond. More comprehensive and inclusive sexual health education programs are needed. With a focus on reaching underserved communities and reducing the stigma surrounding these conversations.
By promoting and educating sexual health, providing preventative services and identifying infections promptly, healthcare professionals can provide appropriate advice, treatment and support. UItimately reducing the spread of STIs within the community. Collaboration between healthcare providers is key. From primary care providers, to pharmacists and specialists, we must work together more closely to ensure comprehensive care for patients, this approach will help to address sexual health issues effectively.
The state of sexual health in the UK has no doubt seen positive developments. The increased uptake of PrEP, enhanced accessibility of screening and contraceptive services and ongoing efforts to address STI rates are all steps in the right direction. However there is still more that needs to be done to improve education and raise awareness of sexual health. In particular, in order to address the concerning rising figures of STI’s in the UK and those most at risk populations.
As healthcare professionals, it is our responsibility to remain up to date with guidance and developments. We must aim to recognise knowledge and service gaps, areas of improvement and to continue to support and promote these positive developments. By taking these steps to ensure that individuals prioritise their sexual health we can help to create a healthier and more informed population.
Wanting to find out more?
Are you interested in finding out more? At Health Academy we have just launched a brand new course aimed at health professionals wishing to deliver introductory level sexual health services in primary care and community pharmacy settings. You can find out more by clicking on the link below.
Introduction to Sexual Health in Primary Care & Community Pharmacy
This introduction to sexual health course is perfect for any health professionals wishing to deliver introductory level sexual health services in their primary care or community pharmacy setting.
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