NICE says doctors should identify people at high risk of contracting sexually transmitted infections

The National Institute for Health and Clinical Excellence has recommended that health professionals should identify people at high risk of contracting sexually transmitted infections, determined on the basis of their sexual history, and arrange one to one discussions to reduce their risk.

The guidance on sexual health suggests using a wide range of opportunities for assessing risk of infections, including when discussing contraception, pregnancy, or abortion; carrying out a cervical smear test, offering a test for a sexually transmitted infection, or providing travel immunisation; and during routine care or when a new patient registers.

Anyone found to be at high risk of contracting an infection should be referred for one to one structured discussions with a trained practitioner to try to reduce risky behaviour. Patients who are found to have an infection should be helped to get their partners tested and treated.

To reduce teenage pregnancies the guidance advises that midwives and health visitors should regularly visit vulnerable adolescents under 18 who are pregnant or who are already mothers and discuss with them and their partner (where appropriate) how to prevent or be tested for sexually transmitted infections and how to prevent unwanted pregnancies. Where appropriate, young women should be referred to relevant agencies, including services concerned with reintegration into education and work.

Sexual health in the United Kingdom has deteriorated significantly over the past 12 years; rates of infection of chlamydia and HIV have tripled, and that of gonorrhoea has doubled. The UK also has the highest rate of conceptions in under-18s in Europe.

Richard Ma, a GP in London with a special interest in sexual health, said, “Many health professionals have a role to play in helping reduce STIs [sexually transmitted infections] and under-18 pregnancies. With improved training and the use of structured behavioural interventions targeted at the right groups of people, we can make a real difference to the sexual health of the population.

“We know many healthcare professionals and organisations are using innovative ways to tackle these problems; this guidance concentrates on one to one interventions and ensures good practice is implemented across the country, so the public can expect the same high standard of sexual health care wherever they are,” he explained.