As we are all aware the UK is facing a major sexual health challenge. Research suggests that sexual health risk-taking behaviour is increasing across the population (DOH summary of intelligence on Sexual Health 2005).
Source HIV & AIDS in the North West of England mid year Report 2008 Centre for Public Health Liverpool John Moores University and Ten years of Monitoring HIV&AIDS in the North West of England July 2007. North West Public Health Observatory Indications of Public Health in the English Regions 6: Sexual Health 2007.
The UK has one of the highest rates of Teenage pregnancy in Western Europe and nearly a quarter of all pregnancies in England and Wales end in abortion. Three in ten of these women have already had one or more previous abortions.
(Source DOH Summary of Intelligence on Sexual Health 2005)
Correct and consistent condom use for all risky sexual acts is an effective barrier to the transmission of STI’s as well as being an accessible form of contraception for either sex.
The national media campaign is targeted at younger men and women to ensure that they understand the real risk of unprotected sex and persuade them of the benefits of using condoms to avoid the risk of STI’s or unplanned pregnancies. www.condomessentialwear.co.uk
The Department of health’s tool kit for Effective Sexual Health Promotion 2003 acknowledges the need to promote sources of free condoms. Identifying that expense is a real issue for many people in choosing whether or not to use condoms. This means that the easier we can make it to access free condoms, the less economic factors will militate against people using them. This is particularly true in terms of younger people.
Condom Distribution schemes are not just about the provision of condoms and lube more importantly they present a point of contact with an individual which enables staff and volunteers to discuss other associated issues.
It is essential that we carry out a review of the current schemes to find out how the condoms are distributed, whether it is by the GP’s or practice nurses, young people’s services or other partner organisations and what is the current target population. There is a need to regularly update the training programmes and administration of the scheme, to better monitor the quality and consistency of the services provided. It is clear that the current schemes and access to them varies widely.
It is anticipated that the provision of condoms and supporting material in a simple, safe and confidential way, will lead to increased awareness about safer sex, unplanned pregnancies, HIV and STI’s.
Young people need a range of access options, for example young people specific services, youth and community venues and or school or community based services. Current developments in the youth and community service, Connexions and social services provide the opportunities needed to distribute condoms on a wider targeted basis. It is essential any proposed development includes these target groups for example young people in care, BME communities, people with disabilities, LGBT groups and substance users.
Many sexually active young people put themselves at risk because they do not use condoms consistently or correctly, according to a study published by Brook, the sexual heath charity for young people.
The study, funded by the Big Lottery Fund and carried out by the Centre for Sexual Health Research at the University of Southampton, found that only around a third of sexually active young people reported using condoms consistently. It also revealed some major gaps in young people's knowledge of sexual health issues. In a survey of more than 1300 young people aged 16-18:
"This report should really focus the minds of everyone who cares about the sexual health of young people today. Condoms are the only way for sexually active young people to protect themselves from sexually transmitted infections (STI's), as well as being an effective form of contraception, as long as they are used properly. Although most young people do now use condoms at least some of the time, the majority are still putting themselves at risk by using them inconsistently and sometimes incorrectly.
"Many also think that STI’s are something that happens to other people - they simply don't believe that the risk applies to them personally. Britain's sexual health crisis won't go away until this problem is tackled head-on in sexual health awareness campaigns and in improved sex and relationships education in schools.
"The findings reveal that school is a key source of information on sexual health - a powerful argument for extending sex and Relationships education and making it a compulsory part of the national curriculum. They also underline the need for sex and relationships education to help young people develop the communication skills and the confidence to discuss this sort of issue. Young people who have discussed and agreed on condom use are more likely to actually use a condom when they do have sex."
52% of young people thought that Chlamydia only affects women
54% did not know that emergency contraception can be taken up to 72 hours after having sex
31% thought that STI’s can be caught from a toilet seat
The majority of young people had used a condom on at least one occasion but only around a third (37% of men and 30% of women) reported using condoms consistently.
Condoms were used primarily for contraceptive purposes rather than STI prevention, and their effectiveness in preventing the transmission of STI’s was sometimes compromised by the inconsistency and poor quality of their use (e.g. the condom was applied too late, or removed too early)
Young people were more likely to use a condom if they had previously discussed and agreed it with their partner; if they had used a condom with their partner before; if sex was very much wanted; and if sexually active friends were thought to use condoms.
Although many young people are worried about STI’s and HIV in general (89% and 83% respectively of those surveyed) much lower proportions consider themselves to be personally at risk of STI’s and HIV (61% and 50% respectively), suggesting that increasing concern or fear over STI’s many not lead to an increase in personal risk perception.
Knowing someone who has been diagnosed with an STI encourages young people to get tested themselves, but does not necessarily motivate them to use condoms to prevent infection in future.