Sexual Health Week 2020

Get your RSE in gear, Sexual Health Week 2020

The theme of this year’s Sexual Health Week is ‘Get your RSE in gear’, focusing on the introduction by the Department of Education of compulsory Relationships Education for primary pupils and Relationships and Sex Education (RSE) for secondary pupils this month in England.

Despite the impact the school curriculum has faced since March 2020 due to COVID-19, schools are being encouraged to begin teaching RSE. The subject is now compulsory, with schools who are facing challenging circumstances being advised to begin lessons by at least the start of the summer term 2021.

The implementation of compulsory RSE provides an opportunity to provide young people with the tools and skills they need to have good sexual health, and enable them to make informed decisions which impact their wellbeing. It will also provide young people with the education they need to learn about HIV and sexually transmitted infections (STIs).

What support do teachers need?

– Dave Grimmett, Head of PHSEE, Highgate Wood School

‘RSE is an important part of every student’s education which should not be underestimated. RSE empowers students to make informed life choices in situations which may affect their mental or physical health, RSE also holds the power to reduce the negative consequences of these decisions in the future.

‘RSE is often thought of as being focussed on romantic and/or sexual relationships. However, it also empowers students to become better citizens by encouraging them to value or at least appreciate the differences of others’ states of being, experiences, choices and beliefs. Whether this relates to gender, sexuality, culture or religious custom it inspires students to reflect on their own actions and how this may positively or negatively impact on someone else. In other words we are teaching students to be kind in their adult relationships, a trait which we try to instil at a young age in friendships but don’t always discuss as they become older.

‘My school highly welcomed RSE becoming compulsory as it has provided us with a greater understanding of what education young people need rather than what areas we think we should cover. It was validating as I felt our school had already delivered key areas of RSE, but it was obvious there were subjects we still needed to tackle.

‘As we create and update our curriculum, it is the perfect time to be innovative in what is taught and the way it is taught. This can be daunting for schools and colleagues who are new to teaching the content or have limited experience of teaching RSE. It may also be difficult for some schools to know how to adapt to the change, and to create enough time and space for RSE to be taught effectively, although this is important.’

Teachers can be supported with practical information from experienced health professionals and Voluntary, Community and Social Enterprise (VCSE) partners including:

  • The shared experiences of how to approach sensitive issues in group settings.
  • Examples of group activities that deliver health promotion work effectively that teachers could adapt to deliver RSE.
  • Resources such as videos or stories that communicate with young people clearly and could be used as a platform for further discussion and learning.
  • Key contacts in your organisations who can liaise with RSE leads in local schools and pass on relevant information and messages across local authorities.
  • Willing colleagues visiting schools or engaging via video conferencing to speak with RSE teachers and other key groups such as students school councils to answer questions they may have or to provide advice.
  • As the experts in sexual health, provide particular messages or local campaigns you want teachers to share with young people in your area.

While teachers and educational professionals are updating their curriculums and ensuring the professional development of RSE leads and their peers includes training on RSE, now is the best time to embed good practice and creatively share ideas and experiences.

Sexual health and HIV prevention ambitions

The Government has made clear commitments to establishing a national sexual health strategy to tackle increasing rates of STIs, and to reducing new HIV transmissions to zero by 2030.

The introduction of compulsory RSE adds vital support to these initiatives achieving their targets. Not only does RSE educate current and future generations of young people, but it also increases the volume of professionals working within the systems that can nurture good sexual health.

Health professionals working in sexual health and HIV, including those from VCSE organisations, commissioners and public health experts, clinicians and researchers, must support teachers as they navigate the new curriculum.

Educational professionals can provide vital expertise and pathways to reaching young people, who are some of the most disproportionately affected populations by high rates of STIs.

Get your RSE in gear’ is a perfect call to action to encourage experts in sexual health and HIV to think about how they evaluate the support they provide to educational professionals, and to motivate teachers to deliver good quality and engaging RSE in their classrooms.

Sexually transmitted infections in 2019

Public Health England (PHE) has released the latest sexually transmitted infection (STI) surveillance data for 2019. Following the upward trend since 2015, STIs diagnoses have risen again and 468,342 diagnoses were made in England in 2019, a 5% increase from 2018.

Total number of STI diagnoses, England 2010 to 2019
Key findings

Diagnoses

  • 468,342 diagnoses of STIs in England in 2019.
    • 249,690 recorded gender ‘male’.
    • 216,058 recorded gender ‘female’.
  • 26% increase in gonorrhoea since 2018, the highest since records began in 1918.
  • 10% increase in syphilis since 2018. In women the increase is 36%, but 81% of infections were recorded in men who have sex with men (MSM), of which almost a third (31%) were MSM living with diagnosed HIV.
  • 7% increase in number of consultations at sexual health services.
    • This is largely driven by a 84% increase in consultations reported by internet services (from 260,708 to 480,112).
  • 11% decrease in genital warts.

Testing and screening

  • The National Chlamydia Screening Programme (NCSP) conducted 2% more tests in 2019 compared to 2018; however, there has been a 13% decline since 2015 (from 1,546,180 in 2015 to 1,339,913 in 2019).
  • 181 sexual health services reported testing for Mycoplasma genitalium (M.Gen) in 2019, compared to 107 in 2018.
    • This increase in testing capabilities has largely influenced the 196% increase in M.Gen diagnoses in 2019, up to 5,311.

Disproportionately impacted populations

Young heterosexuals 15 to 24 years; black ethnic minorities; and gay, bisexual and other MSM continue to report the highest rates of STIs in England.

Young heterosexuals

The majority of chlamydia diagnoses (62%) and gonorrhoea diagnoses (54%) in sexual health services were made in young heterosexuals. This group was also attributed to 41% of genital herpes diagnoses and 40% of genital warts.

MSM

Bacterial STIs are more likely to be diagnosed in MSM than other men. 81% of syphilis diagnoses were in MSM as well as 66% of gonorrhoea. The most common STIs have seen substantial increases in this population, with gonorrhoea diagnoses increasing by 26% and chlamydia diagnoses by 21%.

Of all MSM diagnosed with an STI in sexual health services in 2019, 18% were living with diagnosed HIV. A breakdown of STIs diagnosed in MSM by HIV status is provided in the graph below.

STI diagnoses among MSM by HIV status, 2010-2019

Black minority ethnic and other impacted populations

Black minority ethnic (BME) populations continue to be disproportionately impacted by STIs. In particular, the rate of gonorrhoea in BME people is 3.5x that of the general population and the rate of trichomoniasis is 9x that of the general population.
The largest proportional increase in all new STI diagnoses was in people of Asian ethnicity (16%; from 15,168 to 17,522), this was largely due to large increases in new gonorrhoea (36%) and chlamydia (27%) diagnoses.
The disparities between different ethnic groups are best seen in these images below, looking at rates of STIs for both men and women.

Rates of STI diagnoses by ethnic group among males, England 2019

Rates of STI diagnoses by ethnic group among females, England 2019

PHE has provided data based on World regions of birth, these have shown high overall increases of STI diagnoses in England with:

  • 9% of people born in the EU,
  • 11% of people born in North America,
  • 12% of people born in South Asia,
  • 16% of people born in South America,
  • 21% of people born in Central America.

Impact of COVID-19

The latest data release does not cover the period since the COVID-19 pandemic began. However, PHE has advised that they are already analysing the surveillance data and how the impact of the COVID-19 response in England has affected HIV and STI service provision and epidemiology. Provisional findings are due in the coming months.

The latest report outlines how the national programme with PHE, Terrence Higgins Trust and 56 Dean Street delivered 10,000 free self-sampling HIV (and opt-in syphilis test) kits as part of the summer ‘Break the chain’ campaign.

PHE has also published a new national framework for e-sexual and reproductive healthcare. This provides information on how e-sexual and reproductive services can complement specialist, clinic-based facilities in local areas, providing other methods of accessing healthcare.

Resources from PHE

Sexually transmitted infections and chlamydia screening in England: 2019 [PDF].

Latest STI data tables, infographics and supplemental information.

National framework for e-sexual and reproductive healthcare: User guide [PDF]

Community HIV testing and COVID-19

Community HIV testing and COVID-19

HIV Prevention England and NAT (National AIDS Trust) invite you to join us for this online event exploring how to deliver safe and effective community HIV testing in the current context of COVID-19, and launching NAT’s two new toolkits, created to support the effective design and evaluation of community HIV testing.

Community-based HIV testing is a valuable contributor to the effort to end HIV transmissions in England. By drawing on the best practice of current community testing providers, these toolkits explore the key questions to consider when designing and delivering community testing interventions in England. They also support stronger evaluation of interventions to ensure that lessons are learned and national understanding of community testing is improved.

This event is intended for:

  • Providers and commissioners of community testing.
  • Community organisations interested in setting up testing interventions.
  • Wider colleagues in sexual and public health.

NAT’s community testing project was funded through the Public Health England Innovation Fund and some of the content of the toolkits is specific to England. However, the toolkits and discussion will still be likely to have relevance in other parts of the UK.

HIV Prevention England and a wider Advisory Group have supported NAT throughout the project.

When: 3.30-5pm, Wednesday 26 August 2020

Register for this event