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Preventing sexually transmitted infections and under-18 conceptions
Short Text
Introduction
This pathway covers recommendations on how to prevent sexually transmitted infections among the whole population and how to prevent under-18 conceptions. It focuses on the provision of one-to-one interventions as part of the routine care provided by primary care, sexual health and contraceptive services. The recommendations are aimed at the NHS, local authorities and the wider public, voluntary, community and private sectors.
Source guidance
The NICE guidance that was used to create the pathway.
Prevention of sexually transmitted infections and under 18 conceptions. NICE public health guidance 3 (2007)
Quality standards
Quality statements
Effective interventions library
Successful effective interventions library details
Implementation
Audit support
Audit support provides ready-to-use criteria, including exceptions, definitions, suggested data sources and a data collection tool.
Costing support
Costing support includes national cost impact reports that summarise the national costs and savings and discuss the assumptions used; costing templates to assess the impact on local budgets; and costing statements when the impact is not significant or impossible to quantify at a national level.
Education tools
NICE has developed online learning modules, in collaboration with a range of providers, including BMJ Learning, to update knowledge on evidence and NICE guidance.
Service planning
Providing implementation advice, these tools help people to plan or deliver services. They can include an overview of the key steps and decision points in the care pathway and suggestions for putting the guidance into practice locally.
Slide sets
Slide sets provide a framework for discussion and assist in local dissemination of the guidance. The slides contain the key messages from NICE guidance and can be tailored for local presentations.
Pathway information
25 October 2011 minor maintenance updates
Supporting information
Glossary
People who are at risk of getting a sexually transmitted infection (STI) include:
- men who have sex with men
- people who have come from or who have visited areas of high HIV prevalence.
Behaviours that increase the risk of STIs include:
- misuse of alcohol and/or substances
- early onset of sexual activity
- unprotected sex and frequent change of and/or multiple sexual partners.
Primary care is healthcare delivered outside hospitals. It includes a range of services provided by GPs, nurses, health visitors, midwives and other healthcare professionals and allied health professionals such as dentists, pharmacists and opticians. It includes community clinics, health centres and walk-in centres.
Preventing STIs and under-18 conceptions
Preventing STIs and under-18 conceptions
Type of recommendation
What type of recommendation are you interested in?
Commissioning and coordinating sexual health services
Commissioning and coordinating sexual health services
Commissioning and coordinating sexual health services
Ensure that sexual health services, including contraceptive and abortion services, are in place to meet local needs. All services should include arrangements for the notification, testing, treatment and follow-up of partners of people who have a sexually transmitted infection (STI) (partner notification).
Define the role and responsibility of each service in relation to partner notification (including referral pathways).
Ensure staff are trained.
Ensure there is an audit and monitoring framework in place.
Implementation tools
Failed to load fragment (default behaviour with no loader supplied): staticcontentfragments/implementation-node-multipleSource guidance
Failed to load fragment (default behaviour with no loader supplied): staticcontentfragments/source-guidance-nodeProviders of sexual health advice
GPs, nurses and other clinicians providing sexual health advice in healthcare settings, school clinics, outreach centres, voluntary, community and other non-healthcare settings
People at risk of STIs
Identifying people at risk of sexually transmitted infections and providing advice
Identifying people at risk of sexually transmitted infections and providing advice
Who should take action?
Health professionals working in: general practice, genitourinary medicine, community health services (including community contraceptive services), voluntary and community organisations and school clinics.
Identifying those who need one-to-one help
Identify individuals at high risk of sexually transmitted infections (STIs) using their sexual history. Opportunities for risk assessment may arise during consultations on contraception, pregnancy or abortion, and when carrying out a cervical smear test, offering an STI test or providing travel immunisation. Risk assessment could also be carried out during routine care or when a new patient registers.
One-to-one discussions
If trained in sexual health, have one-to-one structured discussions with individuals at high risk of STIs. If not, arrange for these discussions to take place with a trained practitioner. The discussions should be structured on the basis of behaviour change theories. They should address factors that can help reduce risk-taking and improve self-efficacy and motivation. Ideally, each session should last at least 15-20 minutes. The number of sessions will depend on individual need.
For details of a range of behaviour change theories see Conner and NormanConner M, Norman P, editors (2005) Predicting health behaviour. Maidenhead: Open University..
Source guidance
Failed to load fragment (default behaviour with no loader supplied): staticcontentfragments/source-guidance-nodeVulnerable young people under 18
Giving sexual health advice to vulnerable young people aged under 18
Giving sexual health advice to vulnerable young people aged under 18
One-to-one sexual health advice
Who should take action?
GPs, nurses and other clinicians working in healthcare settings such as primary care, community contraceptive services, antenatal and postnatal care, abortion and GUM services, drug/alcohol misuse and youth clinics, and pharmacies.
GPs, nurses and other clinicians working in non-healthcare settings such as schools and other education and outreach centres.
What action should be taken?
Where appropriate, provide vulnerable young people with one-to-one sexual health advice on:
- how to prevent and/or get tested for sexually transmitted infections (STIs) and how to prevent unwanted pregnancies
- all methods of reversible contraception, including long-acting reversible contraception (LARC) in line with NICE clinical guideline 30
- how to get and use emergency contraception
- other reproductive issues and concerns.
Provide supporting information on the above in an appropriate format.
Young women who are pregnant or have children
Who should take action?
Midwives and health visitors who provide antenatal, postnatal and child development services.
What action should be taken?
Regularly visit vulnerable women aged under 18 who are pregnant or who are already mothers.
Discuss with them and their partner (where appropriate) how to prevent or get tested for STIs and how to prevent unwanted pregnancies. The discussion should cover:
- all methods of reversible contraception, including LARC in line with NICE clinical guideline 30, and how to get and use emergency contraception
- health promotion advice, in line with NICE guidance on postnatal care
- opportunities for returning to education, training and employment in the future.
Provide supporting information in an appropriate format.
Where appropriate, refer the young woman to the relevant agencies, including services concerned with reintegration into education and work.
Source guidance
Failed to load fragment (default behaviour with no loader supplied): staticcontentfragments/source-guidance-nodePeople with an STI
Helping people with a sexually transmitted infection to get their partners tested
Helping people with a sexually transmitted infection to get their partners tested
Who should take action?
Health professionals, including those with a responsibility for helping to contact, test and treat partners of patients with a sexually transmitted infection (STI) and including those working in school clinics.
What action should be taken?
Help patients with an STI to get their partners tested and treated (partner notification), when necessary. This support should be tailored to meet the patient's individual needs.
If necessary, refer patients to a specialist with responsibility for partner notification. (Partner notification may be undertaken by the health professional or by the patient.)
Provide the patient and their partners with infection-specific information, including advice about possible re-infection. For chlamydia infection, also consider providing a home sampling kit.
Source guidance
Failed to load fragment (default behaviour with no loader supplied): staticcontentfragments/source-guidance-nodeHIV prevention
View the 'HIV testing and prevention overview' pathPaths in this pathway
Pathway created: August 2011 Last updated: October 2011
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