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5 August 2021
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 Sexual Health, Reproductive Health & HIV Policy eBulletin
Supporting those working for high quality sexual health, reproductive health and HIV services 

 Welcome 


5 August 2021  (Issue 66)

Welcome to the August edition of the Sexual Health, Reproductive Health & HIV Policy eBulletin. If you haven’t already, it is worth taking a look at new research released last week by National AIDS Trust and Fast-Track Cities London demonstrating how public knowledge and attitudes has failed to keep up with developments in HIV. The research, which surveyed 3,000 people, shows how HIV remains a highly stigmatised and often misunderstood health condition.  Even after 40 years of the HIV epidemic many respondents were confused about how HIV is transmitted, the developments in treatment, and what this means for HIV in 2021. HIV testing also remains high on the sector agenda this month with a recent report from The All-Party Parliamentary Group on HIV & AIDS calling for opt-out testing to be adopted across healthcare settings.  The report sets out a series of recommendations on increasing and normalising HIV testing across the UK.  It builds on the work of the English HIV Commission and highlights what still needs to be done across the four nations to achieve zero HIV transmissions by 2030.

Other items to look out for this month include: a new tool from PHE estimating the ROI of contraceptive provision in maternity services and long acting contraception (LARC) in primary care; the development of a new reproductive health indicator set; the reclassification of progestogen-only pills to a pharmacy medicine available to purchase without a prescription; a new good practice guide from LGBT Foundation and NHS England on implementing effective sexual orientation and trans status monitoring; upcoming changes to the vaccine supplied for the HPV immunisation programme and a new survey by the Higher Education Policy Institute and Brook on students’ experience of relationships, sex and sexual health.

The HIV prevention drug PrEP (pre-exposure prophylaxis) is now available via local authority-commissioned sexual health services and £23 million funding has been made available in 2021/22 to cover the costs of delivering it. In this month’s eFeature Richard Angell, Campaigns Director at Terrence Higgins Trust, looks at what local areas can do to improve provision, ensure a more equitable delivery of PrEP and bring PrEP closer to the communities who need it. 

***Date for the diary!***  
Brook's Sexual Health Week will take place from 13-19 September.  This year’s theme is Consent: Do You Get It? See campaigns round-up for more information 

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eFeature


Bringing PrEP closer to communities 

Commissioning services to deliver the HIV prevention drug PrEP has been in the hands of local councils since the Government first published details of the PrEP grant determination in September 2020. In this month’s eFeature, Richard Angell, Campaigns Director at Terrence Higgins Trust, looks at the story of PrEP to date, highlighting current inequalities in PrEP provision that need to be addressed and identifying key opportunities for councils to bring PrEP closer to communities through improved education and access.
>Read full eFeature by Richard Angell 
 

Policy development and guidance

PHE priorities for 2021/22


Health Minister Jo Churchill MP has recently confirmed the health promotion priorities that Public Health England (PHE) should deliver on this year, until its responsibilities are formally transferred to other parts of the public health system. Action on sexual and reproductive health include publishing evidence on the impact of reconfigured sexual health, HIV and hepatitis services in response to COVID-19 and supporting the Department of Health and Social Care’s (DHSC) development of the Government’s Sexual and Reproductive Health Strategy and the Government’s HIV Action Plan.
See letter from Minister

PHE women’s reproductive health programme: progress, products and next steps 


This document provides an update on progress to date against main workstreams within PHE's reproductive health programme, with signposts and links to new resources and guidance for providers, commissioners, and policy makers. This includes a new set of reproductive health indicators and a new tool estimating the return on investment of contraception provision in maternity services and the provision of long acting reversible contraception (LARC) in primary care.
See main update document
Read about the new indicator set development
See extended contraception ROI tool

Progestogen-only pills reclassified to a pharmacy medicine 


The Medicines and Healthcare products Regulatory Agency (MHRA) announced on 8 July that progesterone-only contraceptive pills will be available for the first time from pharmacies without prescription, increasing choice for women in the ways in which they can access contraception.  The move has been widely welcomed by leading SRH bodies including Royal College of Obstetricians and Gynaecologists (RCOG) and Faculty of Sexual and Reproductive Healthcare (FSRH), who are also calling for these pills to be available to everyone for free in community pharmacies, as well as the reclassification of other contraceptives moving forward.
See MHRA press release
See FSRH/RCOG statement

Calls for regulations to allow the continuation of telemedicine for early medical abortion 


A broad coalition of organisations and charities working across sexual and reproductive health have written to government Ministers in England, Wales and Scotland calling for them to make permanent the regulations that allow for telemedical abortion care. At the start of the pandemic, governments in each country granted temporary permission for early medical abortion treatment to be received by post following a telemedical consultation to reduce the transmission of COVID-19. Evidence has shown that the impact of this change has been significant and overwhelmingly positive, with no difference in the safety or efficacy of telemedical care compared to in-clinic care.  Government announcements are expected in the coming weeks, following public consultations on the issue. 
See coalition letter to Minister in England
See coalition letter to Ministers in Wales
See coalition letter to Minister in Scotland

Abortion care services in Northern Ireland 


The Secretary of State Brandon Lewis MP has issued directions to the Northern Ireland Department of Health to commission and make abortion services available in Northern Ireland as soon as possible, by no later than 31 March 2022. He also issued direction to provide immediate support for interim services of early medical abortion. This includes the work of Informing Choices Northern Ireland, who announced in June that they would no longer be able to continue providing the Central Access Point into early medical abortion services after 1st October unless funding is made available.  FSRH and RCOG welcomed the directions but early indications are that First Minister, Paul Givan MLA, is prepared to resist the direction and launch a legal challenge to block the move.
See press release from NI Office
See FSRH & RCOG statement
See press release from ICNI
See news item on Paul Givan response

Changes to the HPV immunisation programme


PHE has informed health professionals who are responsible for commissioning and delivering the human papilloma virus (HPV) immunisation programme that the vaccine supplied for the programme will change from Gardasil® to Gardasil® 9 during the 2021 to 2022 academic year. The change will impact both HPV programmes – for adolescents and for the MSM group up to 45 years of age.
See letter from PHE
Access related professional guidance and patient resources

Changes to National Chlamydia Screening Programme (NCSP)


Following an evidence review and a public consultation, England’s NCSP is changing to focus on reducing reproductive harm of untreated infections in young women. The programme will aim to provide treatment more rapidly and expand testing in community settings for sexually active women aged under 25 years. Until now, the focus has been on increasing chlamydia diagnoses, through asymptomatic screening in young men and women. Some concerns have been raised about the shift in focus to women only and the negative impact of the changes on the health-seeking behaviours of young men, including gay and bisexual men.
See PHE press release
Read about new NCSP programme
See response from FSRH & RCOG
See response from THT

Review of sexual abuse in schools and colleges


Ofsted has released its findings after a rapid review into sexual abuse within educational settings.  The review found that sexual harassment, including online sexual abuse, has become normalised for children and young people and that the school curriculum is not yet adequately supporting them. Ofsted says school and college leaders need to create a culture where sexual harassment and online sexual abuse are not tolerated, and where they identify issues and intervene early to better protect children and young people.
See Ofsted press release
Read full report
See LGA response
See SEF response

Change in NHS Blood Donation rules 


New eligibility rules for blood donation came into force on 14 June 2021.  Individualised risk assessment will replace blanket criteria and mean more people will be able to safely donate blood in the UK, including gay and bisexual men. While HIV charities welcome this change, they have registered some concern about other discriminatory restrictions that have been retained in England such as those around sexual contact with people from countries with higher HIV prevalence, which predominately affect Black communities. THT, National AIDS Trust (NAT) and One Voice Network have written to the Secretary of State for Health and Social Care urging him to rethink this decision.  Governments in Scotland and Wales have already removed this restriction in line with the recommendation by the independent group which was established to review the latest scientific evidence.
Read announcement
See THT news release
See joint letter to Secretary of State for Health and Social Care

If We're Not Counted, We Don't Count!


LGBT Foundation and NHS England have launched a new good practice guide to provide support for services to implement effective sexual orientation and trans status monitoring. The guide contains updated guidance, tips and case studies, and explains how monitoring plays an instrumental role in identifying and addressing inequalities. It also explains how to use the information collected through monitoring to improve services for LGBT people.
Get more information
See guide
Listen to Kings Fund podcast with Dr Michael Brady

Standing with the Trans community 


A coalition of HIV and sexual health charities, including NAT and THT, have come together to issue a joint statement highlighting their commitment to supporting the rights of trans, non-binary, and gender diverse communities.  As well pledging support, the charities say they will stand together with these communities against discrimination and marginalisation and work as allies to meet the challenge of ending HIV by 2030.
See statement

New National HIV Prevention Programme Tender


PHE have now published the tender for the National HIV Prevention Programme 2021-24 via the procurement system Atamis, and with an intended contract start date of Monday 1 November 2021. The current national HIV prevention programme contract ends on 31 July 2021. From Sunday 1 August 2021 the HPE resources portal will be unavailable, and the HPE and It Starts With Me websites and social media channels will remain online but dormant until the new contract is awarded.  
Get more information from the July HPE newsletter

Reproductive Health, Sexual Health and HIV Innovation Fund 2021-22


PHE has opened another round of its Innovation Fund for voluntary sector projects focused on addressing inequalities and poor sexual and/or reproductive health and HIV outcomes. The Fund is open to projects across sexual health, reproductive health and HIV that cost between £30,000 and £60,000.  The deadline for applications is 13 August 2021.
Get more information on application process

Parliament

Health and Care Bill 


The Health and Care Bill was introduced to Parliament on 6 July 2021, setting out how the Government intends to reform the delivery of health services and promote integration between health and care in England. The Bill was debated at second reading on 14 July 2021 and has now been sent to a Public Bill Committee which will scrutinise it and report to the House of Commons by November 2021.This is the first major piece of primary legislation on health and care in England since the Health and Social Care Act 2012. 
See Government press release
See H&C Bill Factsheets
See briefing from Nuffield Trust
See joint statement from LGA, NHS Providers and NHS Confederation

Cross-Party support for buffer zones around abortion clinics 


On 5 July 2021 a cross-party group of MPs supported an amendment to the Police, Crime, Sentencing & Courts Bill tabled by Dr Rupa Huq MP and Sir Bernard Jenkin MP to implement buffer zones around abortion clinics, preventing the harassment of staff and service users. Although Parliament ran out of time to vote on the amendment, it is indicative of the growing support for buffer zones across the political parties. The amendment had the backing of key SRH bodies including RCOG and FSRH.
See amendment (New clause 42)

See RCOG/FSRH statement

APPG SRH meeting on telemedicine and abortion care 


On 19 July 2021 the All-Party Parliamentary Group on Sexual and Reproductive Health (APPG SRH) brought together representatives from across the medical and policy sectors to discuss how telemedicine improves access to abortion care. The APPG SRH has also joined key sector organisations in calling for the continuation of telemedicine for Early Medical Abortion beyond the pandemic.
See press release

Increasing and normalising HIV testing across the UK


The All-Party Parliamentary Group (APPG) on HIV and AIDS has recently published a report recommending that opt-out testing should be adopted across healthcare settings, including when patients register for a GP, present at A&E or when the NHS takes blood samples. The report also recommends that services need to more actively engage under-represented groups in HIV testing. The series of recommendations follows on from the work of the HIV Commission last year and covers 6 key areas, including specific recommendations for the governments in England, Wales, Scotland and Northern Ireland.
See APPG press release
Read full report

Impact of international aids cuts on global HIV and AIDS response 


The All-Party Parliamentary Group on HIV and AIDS, STOPAIDS and Frontline AIDS are now collating written evidence exploring the impact of the international aid cuts made in 2021 on the HIV response and on people living with and affected by HIV. The call for written submissions went out on 2 July with a deadline of 2 August 2021.
Get more information on areas of interest from APPG website

Service standards & guidelines 

The response to COVID-19 is evolving and guidance from key professional organisations may change as new information becomes available.  Below are links to regularly updated COVID-19 guidance and resources. 

FSRH clinical statement on pain associated with IUC insertion 


FSRH has issued a statement on pain associated with intrauterine contraception.  The clinical statement responds to recent media reports of individuals who have experienced discomfort and pain during IUC fitting and considers interventions to manage pain associated with IUC insertion.
Download statement
See follow-up press release

Updated joint framework for restoration of menopause services


The British Menopause Society (BMS), in collaboration with FSRH, RCOG, the Royal College of General Practitioners (RCGP) and the Royal College of Nursing (RCN), has updated its joint framework for the restoration of menopause services in response to COVID-19.
Download updated framework

FSRH updated statement on young people 


FSRH has published an updated position statement on young people. The statement outlines its beliefs and vision for young people's sexual and reproductive healthcare across the UK, including the right young people have to make decisions – informed by their clinicians – about their medical care in line with their evolving maturity. 
Access updated statement

BHIVA guidance for virtual consultations for people with HIV: May 2021


This guidance was released in May in response to the increased proportion of consultations carried out remotely due to COVID-19. The guidance highlights issues important for safe and effective consultation, including awareness of the limitations of remote consultation.
Access guidance

NHIVNA HIV Nursing Modules 


A reminder that the National HIV Nurses Association (NHIVNA) has a series of eight models to support nurses who are working toward Levels 2 and 3 of the National HIV Nursing Competencies, whether working in a hospital or community setting. Participation in the NHIVNA HIV Nursing Modules is free of charge and access is open to all.
Access modules on NHIVNA website

NICE guideline on shared decision making 


The National Institute for Health and Care Excellence (NICE) has recently published a new guideline on shared decision making between service users and healthcare professionals. The new recommendations advise that shared decision making should be part of everyday practice across all healthcare settings. The guideline sets out ways for healthcare professionals to work with people using services to make decisions about their treatment and care, and to ensure this is best practice at an organisational level.
See new guideline (NG 197)

Evidence, data & research 

HIV: Public knowledge and attitudes 


New research published last week (29 July) by National AIDS Trust and Fast-Track Cities London shows how HIV remains a highly stigmatised and often misunderstood health condition. The research surveyed 3,000 people and conducted six focus groups to find out people's knowledge of and attitudes about HIV.  Key findings include patchy knowledge of HIV among the general public, low awareness of key medical advances and effective treatments and stigmatising perceptions of people living with HIV.
See press release
Access full report

National representative data on the health of LGB adults in England 


NHS Digital has published a 'first of its kind' report on the health outcomes and health- related behaviours of lesbian, gay and bisexual (LGB) adults. The data is based on a representative sample of adults aged 16 and over who participated in the Health Survey for England (HSE) between 2011–2018. The report shows that a higher proportion of LGB adults reported ‘bad’ or ‘very bad’ health compared with heterosexual adults and that the prevalence of limiting longstanding illness was higher among LGB adults compared with heterosexual adults.
See NHS Digital news release
Access full report
See infographic summary

Abortion statistics for England and Wales: 2020


DHSC has published the 2020 abortion statistics for England and Wales. The data shows that the introduction of telemedical abortion services has enabled women to undergo abortion at the earliest gestations since records began. It also shows increased rates of abortion among older women, women who are already mothers, and women living in the most deprived areas.
See 2020 data report
See joint statement from RCOG & FSRH

Evaluation of Cervical Screening Saves Lives 2019 campaign 


PHE has published a series of summaries focusing on different evaluation metrics for the first national ‘Cervical Screening Saves Lives’ campaign which ran from 5 March 2019 to 30 April 2019 in England, as part of the wider Be Clear on Cancer initiative.
See relevant documents

YouScreen cervical screening study launched 


YouScreen is a research study that will offer 31,000 women and people with a cervix in north and east London the opportunity to take a self-sample for cervical screening. London has the lowest rate of cervical screening in England and it is hoped that YouScreen self-sampling kits will make cervical screening easier and will encourage more women to be screened.
Find out more about the study

Student relationships, sex and sexual health survey


A report published on 22 July by the Higher Education Policy Institute and Brook provides a rich picture of students’ diverse experiences of relationships, sex and sexual health. Data from the report show that half of sexually active students have never had a test for a sexually transmitted infection (STI) and that only 51% of sexually active students felt safe the first time they had sex at university.
See HEPI press release
Read full report

New HIV centre set up to tackle inequality and improve treatment


A new HIV research centre is being set up by Queen Mary academics to address health inequalities and improve quality of life for everyone affected by HIV. The dedicated centre, based in London, will explore why some groups of people fare much worse than others following an HIV diagnosis. The team of clinicians, scientists, and members of the community will find ways to prevent future HIV infections and trial innovative new treatments.
See news release and get more information

NHIVNA Research Awards


The NHIVNA research and capacity development fellowship awards scheme is open to NHIVNA members. The awards provide funding (£10,000 is available) for research or development projects that will improve the care and management of people with HIV in the UK. The awards are specifically designed to build research capacity by enabling nurses with limited research experience to undertake a project with mentorship and support. The closing date is 31 August 2021.
Get more information about application process

Live surveys on reproductive health, contraception and sexual health services


A number of surveys are currently open to gather views and experiences of reproductive health, contraception and sexual health services.  Click the links below for more information and/or to participate.
PHE/LSHTM Women’s Reproductive Health Experiences Survey
Decolonising Contraception: Black Voices on Contraception Choice
Contraception Choices: Women aged 40-55 experience of using contraception

Reports & other resources

Variation in outcomes in sexual and reproductive health in England


This toolkit from PHE can be used by sexual health commissioners, public health teams and sexual health service providers to explore sexual and reproductive health inequalities at local level. It uses existing data about sexual and reproductive health indicators between and within local authority areas to understand where variation occurs, identify the principal causes and underlying factors and inform ways to target and reduce sexual and reproductive health inequality and improve outcomes.
Access toolkit

Long-acting reversible contraception in the UK

This report published by the British Pregnancy Advisory Service (BPAS), Decolonising Contraception, Shine Aloud and Lancaster University is based on qualitative research into the experiences of LARC users and practitioners. It uses a human rights approach to examine whether some groups are disproportionately targeted for LARC. The authors make some preliminary recommendations and hope the research will expand a conversation on how LARC services can best support the reproductive rights of all women in the UK.

See press release
Read full report
See response from FSRH

Updated FSRH/RCOG abortion care factsheet 


As part of national RSE day FSRH and RCOG launched an updated version of their free Abortion Factsheet resource to support teachers with statutory relationships and sex education (RSE) lessons in secondary schools in the UK. Endorsed by PHE, the Sex Education Forum and PSHE Association, the Factsheet aims to dispel some of the misinformation around this topic and support informed discussions on abortion care in schools.
Download updated factsheet

Abortion Talk 


Abortion Talk is a new charity opening up conversations around abortion by creating spaces for anyone affected by their experience to talk and be heard. It runs a confidential talkline twice weekly and provides workshops for healthcare professionals who work in abortion care.
Find out more about the charity

GMC Guide for LGBT patients 


The General Medical Council (GMC) has published a new guide for lesbian, gay, bisexual and trans (LGBT) patients, setting out what they should expect from their doctor. The GMC guide – its first aimed specifically at LGBT patients – has been produced in conjunction with Stonewall and LGBT doctors’ organisation GLADD.
Read the GMC news release
Access the guide

Sexual Behaviours Traffic Light Tool


This nationally-recognised training resource from Brook has relaunched after undergoing extensive review and redevelopment in 2020. It is now available as a self-directed e-learning course, as well as open-access live training (face-to-face and digital) and bespoke team training. 
Find out more about the tool and training options

Sex work post-COVID


The resource produced by LGBT Foundation and The Men’s Room is designed for sex workers no matter how long they have been working, or where they work, including online, on the street, or at home.
Access resource

HIV and migration 


This new report from NAT sets out the barriers faced by people born abroad living with HIV in the UK.  It finds that many migrants are being left behind in the UK’s response to HIV, despite being disproportionately affected by HIV.  The report offers a series of recommendations for Government departments and national and local bodies to ensure support is in place to improve quality of life for migrants living with HIV, and to end new HIV transmissions.
See NAT press release
Read full report

Types of antiretroviral medications


NAM aidsmap has updated its webpage on the different types of antiretroviral drugs to include information about the first injectable drugs for HIV treatment as well as fostemsavir, a new drug with a novel mode of action. The page covers the most widely used antiretroviral medications in six drug classes.
Access updated webpage

News from IAS 2021  


NAM aidsmap was an official scientific media partner for the 11th International AIDS Society Conference on HIV Science (IAS 2021). NAM aidsmap reported on key research presented at the conference, published news online and sent out five summary bulletins by email in six languages.
Get access to all the conference news

aidsmapCHAT 


NAM aidsmap has finished broadcasting their fourth series of aidsmapCHAT, live discussions on news around the world for people living with HIV. Guests this series have included the Chair of BASHH, Dr John McSorley; consultant physician in sexual health and HIV, Dr Rageshri Dhairyawan; and consultant HIV physician and researcher, Professor Jane Anderson.
Access the fourth series

Campaigns & other news 

Sexual Health Awards 2021


Brook and SH:24’s Sexual Health Awards exist to recognise the people and grassroots initiatives breaking ground in destigmatising sex and sexual health, with a focus on inclusion and diversity.  Nominations for five different categories are open now and winners will be announced during Sexual Health Week in September (see below).
Get more information on how to nominate

Sexual Health Week – 13-19 September 2021


Brook's Sexual Health Week will take place from 13-19 September.  This years theme is Consent: Do You Get It? Brook will be hosting a range of activities over the course of the week to broaden understanding of the topic and empower people to put this into practice in their everyday relationships, both online and offline.
Get more information about plans for the week

The Do It London HIV campaign


A reboot of a local government-backed public health campaign, which highlights the four scientifically proven ways to prevent HIV, was launched on 21 June reminding Londoners to protect their sexual health as social distancing restrictions ease during summer. The campaign is delivered by the London HIV Prevention Programme (LHPP) and supported by London boroughs.
See news release

Life really changed campaign 


THT has launched a new campaign sharing the experiences of people who have overcome challenges of living with HIV to achieve their ambitions. The Life really changed campaign aims to challenge outdated views and educate people on life with HIV today. 
Get more information
See You Tube Channel

RSE Awards - celebrating excellence


Some of the country’s best and most innovative teachers and educators have been celebrated in the national Relationships and Sex Education Awards 2021. Organised by the Sex Education Forum the awards celebrate excellence in teaching RSE in England.
See press release announcing winners

HIV Medicine journal - call for papers


BHIVA is currently inviting paper submissions for a special issue on the topic ‘Women and HIV’, which will be published to coincide with International Women's Day on 8 March 2022. The issue will be guest-edited by Prof Caroline Sabin and Dr Yvonne Gilleece. The deadline is 31 August 2021.
See call for papers

July edition of EUROBulletin


The latest edition of the Sexual Health & HIV Policy EUROBulletin is now available. It includes a round-up of policy news from the region as well as an interview with Dr John Reynolds-Wright of the Medical Research Council Centre for Reproductive Health at the University of Edinburgh on the impact of providing telemedicine services for medical abortion in Scotland in response to COVID-19.
Access July edition
Read eFeature interview with Dr John Reynolds-Wright

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.
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