P 55

Ymchwiliad i’r Adolygiad Blaenoriaethau ar gyfer y Pwyllgor Iechyd, Gofal Cymdeithasol a Chwaraeon

Inquiry into the Priorities for the Health, Social Care and Sport Committee

Ymateb gan: Ymddiriedolaeth Terrence Higgins

Response from: Terrence Higgins Trust

Submission to Health, Social Care and Sport Committee

Priorities for the coming year

Terrence Higgins Trust is the UK’s largest HIV and sexual health charity, with over 30 service centres across England, Scotland and Wales. We are a campaigning organisation which advocates on behalf of people living with or affected by HIV or poor sexual health.

We have set out below the areas that we believe the Committee should take up as a matter of urgency.

Access to sexual health services

We would like the Committee to undertake an inquiry looking at the current level of access to sexual health services.

Access to sexual health services across Wales continues to deteriorate. There is currently no statutory sexual health service provision of any kind in Powys. Sexual health prevention and health promotion services have been decommissioned in three Local Health Board’s (Betsi, Cwm Taf, Hywel dda) despite these areas being the most deprived.  Cwm Taf has the highest rate of teenage pregnancy in Wales and Hywel dda is a rural area with the closest sexual health clinic located 60 miles away in Swansea.

Yet rates of HIV and sexually transmitted infections continue to rise across the country. Over the last two years there has been an increase in reports of new diagnoses of herpes, gonorrhoea, chlamydia and hepatitis B as well as an outbreak of syphilis which is continuing to affect some areas of Wales. 2014 saw the highest ever number of new HIV diagnoses in Wales, affecting both men who have sex with men and heterosexuals. The number of new HIV diagnoses in people aged over 45 continues to rise.

There is a lack of national and local leadership and prioritisation of HIV and sexual health. From 2010 – 2015 the Welsh Government worked towards implementing a National Action Plan on Sexual Health and Wellbeing. This action plan has now come to an end with no new strategy is in place. Action is needed to ensure that a new action plan is drafted as a matter of urgency, that it is written in partnership with communities affected by HIV and sexual health, and that a new action plan addresses the current and emerging issues around HIV and sexual health including access to services, availability of PrEP, and sexualised drug use.

There needs to be clear mechanisms to hold to account those organisations and individuals who are responsible for meeting the sexual health needs of the people of Wales.  There are no national indicators holding local health boards to account on the degree to which they meet local HIV and sexual health needs. Within the national Public Health Outcomes Framework (PHOF) there are no indicators for sexually transmitted infections or HIV. This is in contrast to the PHOF in England that includes indicators on chlamydia detection rates and HIV late diagnosis ensuring transparency on where areas of the country are falling behind in their actions around sexual health.

Policy around HIV should be evidence based. Yet a lack of investment and prioritisation has resulted in poor quality HIV and sexual health surveillance data in Wales - lagging far behind the comprehensive data collected and made publically available in England and Scotland.

HIV and poor sexual health disproportionately affect the most marginalised in our society and directly reflect the inequalities that they face. Sexual health has fallen off the national and local agenda across the country and the inexcusable lack of access to services must be addressed.

Sex and Relationships Education

Our recent report “Shh no talking” included the SRE experiences of over 900 young people, 11% of whom lived in Wales. The report found there was extreme variations in access to, and quality of SRE. However it was clear that young people want SRE – LGBT-inclusive SRE - that answers the many questions they have around sex and relationships. 

The report found:

· 1 in 7 young people did not receive any SRE at school at all

· 99% of young people thought age appropriate SRE should be taught in all schools

· Half of young people rated the SRE they received as poor or terrible and only 2% rated it as excellent.

· Only 5% of young people were taught about LGBT sex and relationships yet 97% thought that all SRE should be LGBT-inclusive

· 75% of young people have not learnt about consent.

Evidence has shown pupils with good SRE demonstrate sophisticated personal and social skills, and can confidently and maturely discuss the issues raised in lessons.

SRE can give children and young people the skills and knowledge to:

· Better manage their sexual health

· Be more informed about teenage pregnancy and contraception

· Be informed and supported if they are LGBT, and to challenge and report homophobic bullying

· Be more aware of the unrealistic portrayal of sex in pornography and be safer on the internet

· Identify airbrushing in the media and recognise unrealistic portrayals of the human body

· Be aware of abuse and be empowered to report it if they suffer abuse

Young people need an impartial education on how to address matters such as contraception, STIs, HIV and teenage pregnancy in an age appropriate manner. When young people are equipped with the knowledge they need to make informed decisions, they are more confident in having the relationships they want. International evidence from UNESCO research shows that when taught properly, SRE can delay sexual activity. 

Young people across Wales are not getting the SRE they want and need. This needs to urgently change.