Why Sexual Health? 5 th July, 2007 Penny Goold - Consultant GUM, Whittall Street Clinic Sharon Myring - Head of Sexual Health Directorate HOBtPCT

Overview  Sexual health in the UK  Impact of sexual ‘ill-health’  Facts for Birmingham Young People Young People Black & Minority Ethnic Groups Black & Minority Ethnic Groups  A story from the ‘front line’  Local Health Services  The Gaps

Sexual Health in the UK  Fist intercourse is happening at a younger age  Higher rates of life time & multiple partners  Highest rates of under-18 conceptions in Europe  STIs have increased over the last 12 years Chlamydia 300% Chlamydia 300% Gonorrhoea 200% Gonorrhoea 200% HIV 300% HIV 300% Syphilis 2000% Syphilis 2000%  Burden of infection in young people and BME 1. Wellings et al. Lancet 2001;358(9296):

Impact  Common  Health Physical Physical Infertility (Chlamydia & Gonorrhoea)Infertility (Chlamydia & Gonorrhoea) Cancer (Human Papilloma virus)Cancer (Human Papilloma virus) Morbidity & Mortality (Herpes, Syphilis, HIV, teenage pregnancy)Morbidity & Mortality (Herpes, Syphilis, HIV, teenage pregnancy) Psychological Psychological Stigma of infectionStigma of infection Unwanted pregnancyUnwanted pregnancy  Social Teenage pregnancy Teenage pregnancy Less likely to finish education/poverty/single parentLess likely to finish education/poverty/single parent  Financial Fertility treatment Fertility treatment Teenage pregnancy - £63 million per annum & Benefits Teenage pregnancy - £63 million per annum & Benefits Hospital admissions (Syphilis, HIV) Hospital admissions (Syphilis, HIV)

Young People in Birmingham

Under-18 conceptions, 2005 Area Per yrs % Leading to abortion England West Mids Birmingham MCD Coventry MCD Dudley MCD Sandwell MCD Solihull MCD Walsall MCD W’hampton MCD

Burden of STI in young people ♀♂Chlamydia75%57% Gonorrhoea70%39% STIs diagnosed in year olds in UK, 2005 B’ham & Solihull STI data, 2005 West Mids STI Surveillance Project

Chlamydia  Risk Factors Under 25 New partner >1 partner in 1 year ‘the pill’ Abortion

Black & Minority Ethnic Groups in Birmingham

Ethnic inequalities West Midlands STI Surveillance Project

HIV  154 new cases in 2005 (B’ham & Solihull) 47% white / 38% Black African 47% white / 38% Black African 64% heterosexually acquired (26% MSM) 64% heterosexually acquired (26% MSM) 89% acquired abroad89% acquired abroad West Midlands STI Surveillance Project 1/3 of HIV infected individuals living in the UK are undiagnosed

Syphilis

Syphilis 20 fold rise in cases

HoBtPCT sexual health services Genitourinary Medicine (GUM) Reproductive and Sexual Health (contraceptive services, RSH) Sexual Health Promotion Healthy Gay Life Safe Chlamydia Screening Programme HIV Treatment Services (hosted at UHBFT)

Location of services

Issues: Inequity of GUM provision, particularly limited in the south of Birmingham Gap in the numbers of young people accessing contraceptive services Need to increase access to services particularly for young people and BME communities Young people tell us that they want to access services and information close to home and in ‘their’ venues e.g. Youth shops, connexions, schools, colleges Need to promote sexual health and services available in the above locations and places like Broad Street As described in the ‘Teenage Pregnancy Next Steps:’ paper this all requires active engagement of, and partnership working with: Education City council Local authority Local business Social care Youth Support Services