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June 2018 
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Sexual Health & HIV Policy eBulletin
Supporting those working for high quality sexual health, reproductive health and HIV services 

 Welcome 


13 June 2018 (Issue 47)

Welcome to the June issue of the Sexual Health & HIV Policy eBulletin.   It is perhaps not surprising that abortion and the current outdated laws governing it are making headline news across the UK this month. The decisive Irish vote to repeal the 8th amendment, the recent emergency debate in parliament to consider restrictive abortion laws in Northern Ireland and increasing calls for abortion across the UK to be regulated by professional standards rather than criminal law, all bring us closer to securing the abortion law reform that will provide women with equal access to safe, high quality abortion care. 

This month’s eFeature continues on the reproductive health theme with Dr Sue Mann and colleagues from Public Health England (PHE) giving us a preview of a body of work soon to be published, which provides a consensus on the definition and scope of reproductive health and places it firmly in the public health arena. 

Items to look out for in this month’s round-up include: Public Health England’s (PHE) annual data report on STIs and chlamydia screening for 2017, showing that while overall rates of STIs remain stable, trends for individual STIs varied with a decrease in first episode genital warts but over a 20% increase in both gonorrhoea and syphilis diagnoses in the last year; a recent Royal College of Nursing (RCN) report on the impact of funding and service changes on sexual and reproductive health; a new series of policy position statements from Association of Directors of Public Health (ADPH) setting out a life course approach to public health; updated British HIV Association (BHIVA) Standards of Care for people living with HIV and a new HIV self testing programme from Terrence Higgins Trust (THT).

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eFeature


In this month’s eFeature Dr Sue Mann (PHE’s Medical Expert on Sexual & Reproductive Health) and colleagues Monica Davison (Senior Planning Manager) and Alison Hadley (Teenage Pregnancy Advisor) provide some background to the new suite of documents on reproductive health to be published by PHE. The documents will define the scope of reproductive health, provide a national overview of the current status of reproductive health and, through the voices of women around the country, offer a clearer understanding of what women think about their reproductive health, the ways it affects them and the support they need.  This body of work will help set a shared agenda for action across government and provide a starting point for commissioners, providers and policy makers to inform local prioritisation and planning and to improve outcomes on reproductive health across the life course.
>Read PHE's eFeature on reproductive health developments 

Policy development and guidance

Irish referendum on abortion


On the 24 May, nearly two in three Irish voters opted to repeal the Constitution’s 8th amendment, paving the way for a change in law which is expected to allow abortion up to 12 weeks and up to 24 weeks in exceptional circumstances. Medical bodies and campaigners have now turned attention on the restrictive abortion laws in Northern Ireland (NI), calling for the UK government to take action to give Northern Irish women the same access to abortion care as women in the rest of the UK (see item on this in parliamentary section below).  
Read speech by Irish Taiseach, Leo Varadkar
View RCOG position on Northern Ireland
View FSRH position on decriminalisation of abortion in Northern Ireland
Read news release from Royal College of Midwives
Read statement from FPA and APPG on SRH

Home Office review of protest outside abortion clinics


A letter coordinated by Rupa Huq MP and signed by 150 other MPs has been sent to the new Home Secretary, Sajid Javid, urging him to press ahead with a review into protests outside of abortion clinics set up by his predecessor Amber Rudd at the end of last year.  An open letter from 35 women’s advocacy and medical organisations supporting the Back Off campaign also asks him to commit to acting on the review findings, including exploring options such as buffer zones to allow women access to essential healthcare without harassment and intimidation. 
Read the letter from MPs
See the letter from Back Off coalition

Home use of misoprostol


A group of organisations, including Faculty of Sexual and Reproductive Healthcare (FSRH), Royal College of Obstetricians and Gynaecologists (RCOG), Family Planning Association (FPA), British Pregnancy Advisory Service (BPAS) and Humanists UK, have sent an open letter to The Times calling on Jeremy Hunt to allow women in England to take the abortion drug misoprostol at home rather than being required to make multiple trips to a hospital or clinic. The Scottish and Welsh Governments have already announced that they plan to allow home use, although the Society for the Protection of Unborn Children (SPUC) Scotland is currently engaged in a legal challenge claiming the Scottish Governments decision is unlawful.
Read the letter to The Times via Humanists UK website
Get more information on the SPUC Scotland legal challenge

SRH in primary care 


The Royal College of General Practitioners (RCGP), together with RCOG and FSRH, has sent a letter to the Steve Brine, Parliamentary Secretary of State for Public Health and Primary Care. The letter outlines the continuing problems with sexual and reproductive health (SRH) services in primary care and calls for urgent investment and long-term solutions to the current crisis. 
Read the joint letter

RCN report on the impact of SRH funding and service changes in England


This report from the RCN brings together results of a survey with nurses working in sexual and reproductive health.  It highlights significant service and staffing pressures and workforce concerns, including access to education and training and wider issues of recruitment and retention of staff.
Read RCN news release

Download full report

ADPH Policy Positions – A Life Course Approach to Public Health


The ADPH has published a series of new policy position statements setting out a life course approach to public health. These statements explore health and wellbeing at key life stages and cover best start in life, living and working well, healthy ageing and health inequality.
Read policy position on Best Start in Life
Read policy position on Living and Working Well
Read policy position on Healthy Ageing
Read policy position on Health Inequality


Changes to data sharing arrangements between the Home Office and NHS


On 9 May the Government announced amendments to the Memorandum of Understand (MOU) which formalises data sharing arrangements between the Home Office and NHS. The amendments will suspend data sharing for immigration purposes with immediate effect and restrict future sharing to criminal investigations of serious offences only. The Health Select Committee, health sector organisations and charities have all voiced serious concerns about the sharing of patients’ data in this way and have campaigned for the arrangement to stop.  It is hoped that the amended version of the MOU, due to be published by NHS Digital shortly, will reflect well-established ethical, professional and legal standards for confidentiality.
Read BMA statement

Read RCGP statement
Read NAT news release
Read NHS Digital statement

Strategic Direction for Sexual Assault and Abuse Services, 2018-2023


NHS England has recently published its five-year strategy for taking forward services for victims and survivors of sexual assault and abuse.  The strategy focuses on six delivery priorities and makes a commitment to provide care that is better signposted, more joined up and long lasting so that all survivors can access support for as long as they need it. The strategy is backed by investment of £4m per year until 2020/21.
Read NHS England’s news release

View the strategy document

Statutory PSHE Education: meaningful changes supported by busy teachers and school leaders


A new report from a coalition of teaching unions and expert organisations shows how statutory personal, social, health and economic (PSHE) education, including but not limited to relationships and sex education (RSE), can be implemented in a way that brings significant benefits while minimising impact on teacher workload and school funding. The coalition believes this would be the most effective way for government to deliver existing commitments to statutory RSE.
Read the coalition report

RSE to be a statutory part of the Welsh curriculum


The Welsh Government has announced major changes to SRE in Wales following an extensive review on its future place in the Welsh curriculum.  Under the reforms this area of study will become known as Relationships and Sexuality Education (RSE) and will be broadened to include issues such as diversity, gender identity, sexting and online safety. The new RSE programme will be a statutory part Wales’ new curriculum from 2022.
View the news release from Welsh Government
See the Review document


Equally Safe: Scotland’s Strategy to prevent and eradicate violence against women and girls 


The Scottish Government has published an updated strategy to prevent and eradicate violence against women and girls in Scotland. The strategy sets out an understanding of the causes, risk factors and scale of violence against women and girls and highlights the need to prioritise prevention. 
View the strategy document


Parliament

Emergency debate on abortion law in Northern Ireland


An emergency debate on abortion law in Northern Ireland took place in Parliament on 5 June 2018.  The debate, to consider repealing sections of the Offences Against the Person Act of 1861 which continues to criminalise abortion in NI, was secured by Stella Creasy MP with cross-party support, including from key government Ministers. The debate puts mounting pressure on the Government to ensure that action is taken so that modern abortion laws apply equally across the UK.  The debate took place ahead of the UK Supreme Court’s ruling on whether NI’s abortion law violates human rights.
View House of Commons transcript
See press statement from NI Human Rights Commission 


Antimicrobial resistance inquiry 


The Health and Social Care Committee has launched an inquiry into how the Government is responding to the challenge of Antimicrobial resistance (AMR).  Written submissions should be with the Committee by Friday 29 June 2018.
Get more information on the inquiry

Prison healthcare inquiry


The Health and Social Care Committee has also launched an inquiry to explore the effectiveness of prisons and prison healthcare services in meeting the health and social care needs of prisoners.  The Committee are currently considering written submissions.
Find out more about the inquiry

New APPG on Social Media and Young Peoples Mental Health and Wellbeing


A new All-Party Parliamentary group has been established to drive policy change that mitigates the negatives and maximises the positives of social media for young people.  The APPG is chaired by Chris Elmore MP and will be supported by the Royal Society for Public Health (RSPH).  The group will hold an inquiry throughout 2018, drawing evidence from expert stakeholders and young people.
View more information on the new APPG

Service standards & guidelines 

Standards of Care for people living with HIV, 2018


The British HIV Association (BHIVA) has published new Standards of Care for people living with HIV in the UK. The Standards, which update earlier versions in 2007 and 2013, provide information to support high quality care and to inform commissioning decisions to meet the growing need for more efficient and cost-effective services. There are eight quality Standards presented with a rationale, quality statements and measurable and auditable outcomes. Three new sections have been introduced looking at HIV prevention, stigma and well-being and HIV across the life course.
Read news release from BHIVA
View Standards document

NICE Quality Standard on sexual health


The National Institute for Health and Care Excellence (NICE) has started the process for developing a quality standard on sexual health.  The quality standard will cover sexual health across the life course with a focus on reducing sexually transmitted infections (STIs). The consultation on the standard is scheduled for August, with the final published standard expected in February 2019.
Get more information from NICE

Better care, a better future: Implementing our Vision for Sexual and Reproductive Healthcare in Scotland


FSRH has launched a plan of implementation for its vision for sexual and reproductive healthcare in Scotland. Better care, a better future has been developed by the Scottish Committee and highlights practical solutions in seven areas that can help those involved in service planning and delivery to guarantee that standards of care are upheld across the nation and that women and men living in Scotland access high-quality SRH consistently.
Get more information and download the implementation document

Regulatory change for sodium valproate medicines


The Medicines and Healthcare Products Regulatory Agency (MHRA) has recently changed its regulatory position on medicines containing sodium valproate.  Valproate medicines must no longer be used in women or girls of childbearing potential unless a Pregnancy Prevention Programme is in place.
Read more information on implications for practice on FSRH website

Contraception for Women with Eating Disorders


FSRH’s Clinical Effectiveness Unit (CEU) has issued a statement to inform clinicians about issues relating to contraception for women who have eating disorders. The clinical statement outlines the advantages and disadvantages of contraceptive methods for women in this group.
Download the full CEU statement

Evidence, data & research 

STIs and Chlamydia Screening in England: 2017


PHE has released annual STI data for 2017. The data show that rates of new STI diagnoses remained stable in 2017 with 422,147 new diagnoses made at sexual health services. On a national scale, testing rates and clinical attendances continue to increase however there is some regional variability. Trends for individual STIs varied with a decline in diagnoses of genital warts and an increase in diagnoses of gonorrhoea and syphilis during the last year. The report also shows an 8% decline in the number of chlamydia tests in 2017 compared to 2016. Across all STIs, the highest rate of diagnoses continues to be seen in 16-24 year olds. PHE is emphasising the importance of increasing condom use and encourage testing following changes in partners, in order to drive down the transmission of infections. Local government and key sexual health bodies continue to warn of over-stretched services and of the challenges of meeting ever-growing demand with significantly reduced budgets.
Read PHE’s press release
View the 2017 report
Access updated STI data tables
Access updated NCSP data tables
Read response from BASHH
Read response from LGA
Read response from ADPH
Read response from NAT
Read response from THT

Quarterly conceptions to women aged under 18 (Quarter 1, 2017)


Figures for the number of conceptions to women aged under 18 in England and Wales for the first quarter of 2017 were released by the Office of National Statistics (ONS) on 30 May 2018. For England, there has been a 6.6% reduction from a rate of 19.8 per 1,000 women aged 15 to 17 (4,485 conceptions) in the first quarter of 2016 to 18.5 (4,075 conceptions) in the same quarter in 2017. The North East was the only region to show an increase in the quarterly rate compared with the previous year. There is still significant regional variation, with decreases ranging from 12.5% in the East of England to 1.1% in London. 
See Q1 conception data on ONS website
Read LGA press statement

Read FSRH press statement

Good progress but more to do: Teenage pregnancy and young parents


The Local Government Association (LGA), in conjunction with PHE, has published an updated version of their teenage pregnancy briefing for councillors. The briefing sets out the case for why a continued focus is needed, the important links between teenage pregnancy and other council priorities, the international evidence and the ten key factors for effective local action. The briefing includes six case studies illustrating local good practice.
Read LGA/PHE briefing for councillors

Abortion statistics for England and Wales: 2017 


The Department of Health and Social Care (DHSC) has released abortion statistics for England and Wales for 2017.  The total number of abortions has increased by 2.3% since 2016.  The abortion rate in 2017 was highest for women aged 20, although rates in the under 25s have been declining in the past ten years, most significantly in the younger age groups.  Abortion rates for women aged 30 and over continue to show a steady increase. FSRH has responded by highlighting how access to contraceptive information and provision is an essential feature of abortion care across all age groups.
View the 2017 report
Read FSRH press statement

Improving the health and wellbeing of lesbian and bisexual women and other women who have sex with women 


This report from PHE provides an overview of the evidence of health inequalities and barriers to services and support affecting lesbian and bisexual women and other women who have sex with women. It looks at inequalities in physical health outcomes including in the area of sexual and reproductive health. 
Read the report from PHE

Menopause in women living with HIV in England: findings from the PRIME study


The PRIME Study (Positive Transitions through the Menopause), based at UCL’s Institute for Global Health, is one of the largest studies on HIV and the menopause.  Its recent report finds women with HIV in England are not getting the support they need to manage the menopause. It makes a series of policy recommendations aimed at improving the care of women living with HIV in their midlife and beyond.
Read the news release on the PRIME study from UCL
View the full report

Survey of HIV awareness in Scotland


A recent report from the Our Voice Citizen’s Panel for Scotland gives an insight into what participants think about HIV.  It highlights that despite significant advances in treatment and prevention, misconceptions continue to exist that potentially fuel the stigma faced by people living with HIV.
Read a news release from HIV Scotland
Download the Fourth Citizens Panel Survey to see full HIV awareness findings

Reports & other resources

THT’s new HIV self testing programme


Terrence Higgins Trust has launched a programme that will enable men who have sex with men (MSM), trans women and black African people to order free HIV self testing kits. The aim of the programme, which currently has funding for up to 6 months, is to examine the effectiveness of self testing as a method to reduce barriers to HIV testing among groups that are most at risk of contracting HIV.
Read the press release from THT
View self test website


Still got it: sexual health of the over 50s


This new insight briefing from THT explores key issues relating to the sexual health of people aged 50 and over. It focuses on the sex lives of older people, ageism and stigma, sexual health and sex education.
Read the briefing from THT

PHE blog: Supporting sexual health commissioning


This PHE blog is the final in a series exploring each stage of the sexual health commissioning cycle.  It focuses on the last two stages of the cycle: doing and reviewing.
Read the final blog on doing and reviewing
Read the second blog on analysing and planning
Read the first blog on resources to support commissioning

Cervical screening: Computer says ‘no’ report 


This report from Jo’s Cervical Cancer Trust highlights factors affecting accessibility of cervical screening across the UK.  These include complex commissioning arrangements, lack of IT innovation and reduced screening opportunities in sexual health services. According to the report, since 2013 there has been a 52% reduction in samples taken through sexual health services in England and a 42% reduction in Wales. The report, launched at the start of Cervical Screening Awareness Week (11-17 June), calls for an urgent audit to identify where inequalities exist and greater oversight and investment to ensure programmes are fit for purpose and future-proofed.
Read press release from Jo’s Cervical Cancer Trust
View report

RCGP project on menstrual wellbeing


The RCGP has announced its latest round of clinical projects to support frontline GPs and their teams.  It will work in partnership with Endometriosis UK  to develop resources to help primary care clinicians recognise the symptoms of menstrual dysfunction and understand the common causes, investigations and management options.
View more information on RCGP website


Have your say platform for young people


Have your say is Brook’s new platform for young people to say exactly what they want from their sexual health services.  Young people are encouraged to share views on different topics each month.  Topics to date have included long-acting reversible contraception (LARC) and HPV vaccination for boys.
View Have Your Say on Brook website

Curriculum Design Tool for RSE & other SEF resources


The Sex Education Forum (SEF) has recently published a new tool to support educators in designing developmental programmes of RSE which start early in primary school and continue throughout secondary education and beyond. It has also: launched a new course on Teaching Positive Sexual Health for secondary schools; published a blog on what you need to know to teach about STIs and created a quiz to test sexual health and RSE knowledge. 
Download the tool for free from the SEF website

Get more information on the new training course
Read the blog on teaching about STIs
Download the Quiz

Disrespect Nobody teaching resources on preventing abuse in teenage relationships


Teaching materials designed to support the Government’s Disrespect Nobody campaign have been updated by the PSHE Association for 2018. They are designed to help young people understand healthy relationships while also learning about consent, controlling behaviours and abuse.
Find out more about the campaign and download the resources

Petals for Professionals FGM Web App


An FGM web app for professionals who may come into contact with girls and women at risk of female genital mutilation (FGM) has been developed by Coventry University and tested by Coventry City Council and other local authorities.  The Petals for Professionals Web App can be used by nurses, teachers, social workers, police officers and other professionals to access information and tools to help them prevent and safeguard against FGM.  This follow the launch of a Petals for Young People web app launched in 2015.
Read more about the app on Coventry Council website

View the online app

New edition of Anti-HIV drugs booklet


NAM aidsmap has recently updated its booklet Anti-HIV drugs. The booklet is a starting point for anyone who wants to find out about treatments for HIV and includes information on all the antiretroviral drugs that have been licensed in the UK or European Union and are recommended for prescription by BHIVA.
View the new edition on the NAM aidsmap website

New edition of Antiretroviral drugs chart


A new edition of NAM aidsmap’s Antiretroviral drugs chart is now available online. This one-page reference guide lists all the anti-HIV drugs licensed for use in the European Union, with information on formulation, dosing, key side-effects and food restrictions.
View the chart on the NAM aidsmap website

New edition of life expectancy factsheet


HIV-positive people are living increasingly long lives. Many people living with HIV can expect to live as long as people who do not have HIV. NAM aidsmap has recently updated its factsheet Life expectancy for people living with HIV to reflect recent findings from studies on life expectancy.
Download the factsheet from the NAM aidsmap website

News from the 2018 BHIVA/BASHH Conference


The Fourth Joint Conference of BHIVA (British HIV Association) with BASHH (British Association for Sexual Health and HIV) took place in Edinburgh, UK from 17 to 20 April 2018. NAM aidsmap reported from the conference and all the news stories can be found on its conference pages.
View all the conference news

Campaigns & other news 

New It Starts With Me campaign briefing


The summer phase of HIV Prevention England’s (HPE) It Starts With Me campaign will begin on 18 June 2018. The focus of this phase will be on raising awareness on combination prevention and promoting actions on the various ways to prevent HIV: testing, condoms, pre-exposure prophylaxis (PrEP) and treatment.
View the campaign briefing from HPE
Order free HPE resources

Diana, Princess of Wales Lecture on HIV


On 8 June Sir Elton John delivered NAT’s Diana Princess of Wales Lecture on HIV, calling for renewed global action on HIV and the forging of partnerships to harness new technologies for HIV prevention and treatment. The lecture, first launched by NAT in 1999, was delivered in front of an audience of politicians, journalists, health workers and people living with HIV.  
>Read press release from NAT

The Sexual Health & HIV Policy eBulletin was originally developed and published by MEDFASH. 

It continues to be compiled and edited by Helen Christophers on behalf of FSRH and coalition partners. If you have any comments on the eBulletin or eFeature or suggestions for topics you would like to see covered in future eFeatures please get in touch (ebulletineditor@fsrh.org).

You can access previous eBulletins and eFeatures via the links below:
> eBulletin archive (MEDFASH)
> eFeature archive (MEDFASH/FSRH)

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FSRH and coalition partners do not accept responsibility for the content of linked websites/items included in this eBulletin and do not necessarily endorse the views expressed within them.
Copyright © 2018 The Faculty of Sexual and Reproductive Healthcare, All rights reserved.


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This eBulletin has been produced with financial support from:
The M·A·C AIDS Fund Community Grants Program, M·A·C Cosmetics Inc (UK) and Public Health England
Neither The M·A·C AIDS Fund, nor Public Health England have editorial input or control over the content of the eBulletin.