The government has finally issued its long awaited draft proposals to modernise sexual health and HIV services and tackle the rising prevalence of sexually transmitted infections in England.
The national strategy for sexual health and HIV will be accompanied by a new national safer sex information campaign in 2002 and spending of £47.5m in the next two years.
The move coincides with publication of the latest figures from the Public Health Laboratory Service, which show that the upward trend in sexually transmitted infections since 1995 continues unabated, with large and increasing numbers of new diagnoses in teenage girls and in men who have sex with men.
The strategy focuses on more integrated care, including piloting “one-stop shops” for young people, improved and targeted access to information on sexual health, particularly for vulnerable groups, and the levelling out of current inequities in service provision.
Services will have to meet new standards on access, advertising, and signposting of service provision, and all primary care trusts should have a single point of access to services in place by 2006.
A key element of the strategy is a reduction in the number of newly acquired HIV and gonorrhoea infections by 25% by the end of 2007, including increasing the uptake of HIV testing to 60% of people offered it. Screening for chlamydia will begin in 2002, but initially only among selected groups of women. All gay and bisexual men attending genitourinary clinics will be offered hepatitis B vaccination at their first visit.
Cases of gonorrhoea in England and Wales rose by 27% from 1999 to 2000 and are now at their highest level for over a decade. Attendances at genitourinary clinics have doubled over the past 10 years to more than one million. New diagnoses of HIV were the highest on record last year.
Speaking at the launch last week, the deputy chief medical officer, Sheila Adam, acknowledged the strategy as “ambitious.” But she said, “This is the first comprehensive look at a range of measures aimed at reducing sexually transmitted infections.”
Sex education in schools is not part of the strategy, but Dr Adams said that this was already under way with the teenage pregnancy strategy and the Department for Education's sex and relationship education guidance issued last year.
“It's too early to say if this is working,” she said. Professor Michael Adler, who jointly led the development of the strategy with Dr Adam, said, “The level of school education can't be good enough if we are faced with such levels of ignorance [among young people], but the strategy is about recognising that.”
Anne Weyman, chief executive of the Family Planning Association, welcomed the strategy, but said, “I'm concerned that there are no targets in relation to areas other than HIV.” (See p 243)
The House of Commons all party parliamentary group on AIDS has called on the government to introduce a new anti- discrimination and anti-stigma strategy on AIDS and HIV. See www.appg-aids.org.uk
Figure.
A B DOWSETT/SPL
Cases of gonorrhea are at their highest for over a decade (Neisseria gonorrhoeae (shown in red is the causative organism)