SEXUAL HEALTH NEEDS ASSESSMENT FOR TAMESIDE June 2015 Ruth du Plessis [email protected] Contents 1. Executive Summary ....................................................................................................... 4 Prevention ......................................................................................................................... 5 Demography ...................................................................................................................... 6 Service Provision ............................................................................................................... 6 Spend ................................................................................................................................ 7 Sexually Transmitted Infections ......................................................................................... 7 Contraception .................................................................................................................... 7 Sexual Violence ................................................................................................................. 8 Young people .................................................................................................................... 8 Commissioning across Greater Manchester ...................................................................... 8 Gaps in knowledge and services ....................................................................................... 8 2. Introduction .................................................................................................................... 9 2.1 A public health priority ................................................................................................. 9 2.2 Purpose ..................................................................................................................... 10 2.3 Scope ........................................................................................................................ 10 2.4Background ................................................................................................................ 11 2.4.1 National Trends ................................................................................................... 11 2.4.2 Impact ................................................................................................................. 12 2.4.3 Risky behaviours/high risk groups (see NICE) .................................................... 12 2.5 National Policy Context .............................................................................................. 13 2.6 Roles and responsibilities .......................................................................................... 14 2.7 Public Health Outcome Framework Indicators ........................................................... 16 3. Cost effectiveness ........................................................................................................ 16 4. Methodology ................................................................................................................ 18 5. Demographics .............................................................................................................. 18 5.1 Population density ..................................................................................................... 18 5.2 Age and gender ......................................................................................................... 19 5.3 Deprivation ................................................................................................................ 22 5.3.1 Tameside Deprivation by ward, 2010 .................................................................. 23 5.4 Ethnicity ..................................................................................................................... 23 6. Strategic Structures ..................................................................................................... 24 6.1 CASH/GUM Service .................................................................................................. 26 6.2 General Practice ........................................................................................................ 28 6.3 Pharmacy .................................................................................................................. 28 6.4 Specialist services ..................................................................................................... 29 1 7. Sexually Transmitted Infections (STI) ........................................................................... 29 7.1 Reinfection ................................................................................................................ 30 7.2 Condom provision ...................................................................................................... 30 7.3 Partner notification ..................................................................................................... 31 7.4 Chlamydia ................................................................................................................. 31 7.5 Warts ......................................................................................................................... 36 7.6 Herpes ....................................................................................................................... 38 7.7 Gonorrhoea ............................................................................................................... 40 7.8 Syphilis ...................................................................................................................... 42 7.9 HPV ........................................................................................................................... 44 7.10 HIV .......................................................................................................................... 45 7.10.1 Incidence of HIV ................................................................................................ 45 7.10.2 Offer and uptake at GUM clinics ........................................................................ 46 7.10.3 HIV late diagnosis ............................................................................................. 46 7.10.4 HIV Testing ....................................................................................................... 47 7.10.5 People living with HIV........................................................................................ 47 7.10.6 Services for HIV ................................................................................................ 47 7.11 Hepatitis .................................................................................................................. 48 8. Contraception .............................................................................................................. 48 8.1 Emergency Hormonal Contraception (EHC) .............................................................. 49 8.1.1 EHC access in Tameside .................................................................................... 50 8.2 Long Acting Reversible Contraception ....................................................................... 51 9. Abortion ....................................................................................................................... 54 9.1 Repeat abortions ....................................................................................................... 56 9.2 Abortion Services ...................................................................................................... 56 10. Teenage Pregnancy ................................................................................................. 57 11. Sexual violence ........................................................................................................ 58 12. Sexual Health across the life course ......................................................................... 59 12.1 Under 16s ................................................................................................................ 59 12.1.1 Sex and relationship Education (SRE) .............................................................. 59 12.1.2 Under age sex and child exploitation ................................................................. 59 12.2 Age 16 to 24 ............................................................................................................ 60 12.2.1 Service provision ............................................................................................... 61 12. 2.2 School Nursing Service .................................................................................... 62 12.3 Age 25 to 49 ............................................................................................................ 63 12.4 Age 50 plus ............................................................................................................. 63 2 13. Sexual Health of Specific Groups ............................................................................. 63 13.1 Deprivation .............................................................................................................. 63 13.2 BME groups ............................................................................................................. 64 13. 2.1 HIV ..................................................................................................................