Brook and PHE launch new C-Card guidance

Today we are launching new Condom Card distribution scheme guidance in partnership with, and funded by, Public Health England, C-card condom distribution schemes. Why, what and how.

In the introduction to the guidance, Prof Kevin Fenton of Public Health England says “we need an open and honest sexual and reproductive health culture, in which condom use is simply the norm”. A C-card scheme is a great way to support young people – they simply have to get hold of a card, have an introductory session on correct condom use and sexual health from a scheme advisor, then afterwards show their card at any participating outlet in order to get a supply of free condoms.

The guidance says, “What many young people want most from a C-card scheme is a trusted adult with whom they can discuss sex and relationships. That’s why practitioners involved in the C-card scheme are skilled at working with young people in a non-judgemental and appropriate manner, and can refer them safely to other more comprehensive or targeted services.”

C-card schemes are a great practical illustration of one of Brook’s core principles – trust young people – as they empower young people to make informed decisions about safer sex. A C-card scheme brings them into contact with networks of people and organisations who can help them with a myriad of issues alongside and including sexual health, through direct support or through signposting to related services.

C-card schemes provide an opportunity to start conversations about sex, relationships, and overall wellbeing with all young people and in particular with young men, who are often less likely than young women to visit health services or to be willing to open up about such issues to a health professional or a youth worker. Youth services which are part of a C-card network may find that their attendance rises, while pharmacies within a C-card scheme also often report a boost in business from young people, who may open up about any other health issues which are playing on their minds when they come in to pick up their free condoms.

From a public health perspective, C-card schemes are vital - we know that in England, condom use among sexually active young people ranks poorly when compared with other European and North American countries, and we must seek to change this. The Department of Health’s 2013 Framework for Sexual Health Improvement in England places a strong emphasis on prevention of sexually transmitted infections and reductions in unplanned pregnancy rates – condom use has a key role to play. The financial investment in a C-card scheme is more than repaid in savings to the public purse, through reduced social costs as well as better sexual health and general wellbeing outcomes among scheme users.

There really is no downside to C-card schemes, and I very much hope that this revised guidance, with its step by step instructions and best practice case studies, will help strengthen the quality and quantity of C-card schemes as part of an integrated package of health services and care for young people.

The guidance can be downloaded from www.brook.org.uk/c-card.

Brook is the UK’s leading young people’s sexual health and wellbeing charity, with services in England, Scotland, Northern Ireland and Jersey. In 2014 we are celebrating 50 years since we opened our doors. We have three key activities: clinical and support services, education and training, campaigning, lobbying and advocacy and last year we helped over 270,000 young people. www.brook.org.uk Twitter: @BrookCharity @BeSexPositive @Simonablake

Condom distribution schemes and boys

Today the Sunday Times reported on new guidance being prepared by Brook that boys as young as 12 will have access to condoms via condom distribution schemes as part of a new strategy across the country.   These condom card schemes have been in operation for over a decade, and as part of a well coordinated package of education, support and services make a vital contribution to helping make sure young people only have sex when they are ready and contributes to a culture which is clear - if you have sex you need to be able to both enjoy and take responsibility for it. 

The Guidance to be published imminently by Brook brings together the learning from existing schemes across the country so others that are thinking about or in the process of setting a scheme up can benefit from the experience of thousands of other people across the country.

As often happens when Brook's work makes the news I get calls from family and friends asking for the real story, sometimes I get taken to task if they believe what they read before clarifying. And often as a result of these conversations I am challenged to think differently or understand an issue from other points of view.  

It was clear today that it is really easy to forget or ignore the significant gender stereotypes and expectations that both boys and girls grow up with in 21st century Britain.  Still, despite some changes, boys  are 'roughed up' from an early age - boys don't cry, be a man, don't be a girl and don't be gay -  and girls taught to play nicely (not like tomboys), to have 'girly ambitions' and not to be angry or outspoken.   

And with these expectations and stereotypes boys learn that they should know everything about sex, want sex all of the time and not need to ask for help.   And so it is a lack of understanding of these unwritten rules that can make sex and relationships education sterile and meaningless for boys (and girls) because it does not pay attention to the strong, pervasive messages about gender in our society.

So when boys of 12, 13 and 14 come to Brook, the absolute majority are not having sex.  Yet often they do want condoms and we want to welcome them.  The world is full of sex and sexual imagery and it is confusing, worrying and frightening if there are not adults able and willing to talk sensibly and help them make sense of these messages.  Boys get less information at home than girls.  The onset of menarche creates a moment for talking about personal issues (although sex and relationships education is not sorted for girls either).  Boys on the other hand have less obvious markers of transition and fathers less confident talking about emotional and sexual issues.

And so it is that boys are hungry for information, hungry to know what sex is, how it happens, why people do it, and a way for them to feel confident to seek that advice is to ask for condoms, to pretend they are having sex.   And giving condoms to younger boys is not, as some argue, a green light for 'any old sex will do'.  At Brook it is a signal that we trust them.  That we value and support them.  That we will help them to understand they must only have sex when they are sure they are ready for it.  That we expect young people to be responsible about sex and that it is sensible for them to know and understand about contraception including what a condom packet is, where the expiry date is, what a condom looks like, feels like etc so when they do choose to have sex they are able to talk about, negotiate and protect themselves.  

Indeed this is what countries with much lower rates of teenage pregnancy do as a matter of course with their young.   Having high expectations for young people's relationships and early sexual experience so they have high expectations of themselves is what marks a responsible society that trusts young people.  Having condom distribution schemes is part of an important package to help develop a positive culture towards young people and sexuality.