sex, alcohol and racism

I have just come back from a joint meeting between the APPG on sexual health and the APPG on alcohol misuse. A specialist liver doctor explained how 20% of people have dangerous or hazardous drinking habits drink 80% of all alcohol. He also talked about research in their local area done in partnership with the sexual health service which showed that about 35% of people attending a GUM clinic to be tested for a sexually transmitted infection thought that alcohol was either definitely or possibly a cause for them taking risks with their sexual health.

Two people from Brook in Birmingham presented on their work with young people and professionals on the links between sex and alcohol. They reminded us that young people are learning about alcohol use and misuse from the adults around them; that we must be mindful that most young people do not have a serious problem with alcohol; that clinical consultations must focus on building a relationship of trust, and that this relationship of trust can only be built if we spend enough time with each individual - we cannot rush people through on a conveyer belt approach. And of course finding enough time is often one of the biggest challenges we can face as professionals.

In an engaging presentation they created a series of spoof newspaper headlines challenging some of the myths about the sexual behaviours and attitudes of both younger and older people. These combined with information about the training course for professionals, 'sex, alcohol and rubber ducks', the offer of a demonstration of beer goggles, picking up pennies, and the display of condoms and condom demonstrators gave the meeting attendees a practical experience of the creative approach Brook takes to educating young people about the links between alcohol and sexual health.

I am just watching last weeks Panorama programme on racism in a housing estate near Bristol. It is really disturbing watching and is making me feel desperately sad. This programme is an urgent reminder to anyone who believes that racism is a thing of the past, and a reminder that we must not stop for one minute in challenging racism in all its forms and promoting positive relations and community cohesion from the earliest opportunity in our schools and communities.

Helping turn the tide on STI rise amongst young people

Today the Health Protection Agency confirmed again that rates of sexually transmitted infection are still rising amongst young people. In all my conversations today i have reminded people that if we encourage more people to test, we will find out about more infections that were previously undiagnosed. Doubtless for a small minority this will be confirmation of the sexual immorality amongst the young. I do not agree - I think it is confirmation that we are not doing enough to support young people to make good decisions and choices that enable them to protect their physical and emotional health. As a country we have a collective responsibility to;

Work to change our unhelpful culture where sex is viewed negatively and sexually active young people are seen as out of control. We need to help young people feel confident about relationships and sex, and equip them with the skills to make good decisions so they can enjoy and take responsibility for their sexual health

Ensure sexual health services do not see continued disinvestment in ongoing efforts to balance the books. If this continues, we will see the consequences in increased teenage pregnancy and STI rates in a very short time

Commit to make Personal, Social and Health Education statutory in schools so every child learns about sex, relationships and sexuality wherever they live.
Currently too many receive little if any good sex education.

Invest in innovative community outreach programmes that reach out to the most vulnerable, building bridges between them and services and helping them take control of their sexual lives.

Talking SHARP

Brook is currently funded by the Camelot Foundation (www.camelotfoundation.org.uk)to run a project called SHARP (sexual health advocacy and research project). The project aims to train and support young people to be researchers and advocated on sexual health issues that matter to them. After a residential event a group of young people have begun exploring issues with their peers. Their first piece of research focuses on sexual health services. Yet again their findings confirm that they want any services to be close enough to get to, open when they want them to be, and friendly towards young people. These don't seem like big asks, however if young people still feel it necessary to tell us this is what they want, then clearly we haven't got there yet.

So let us imagine as sexual health service providers we get this universal access right. Young people know where we are, trust us to be nice to them and can get to us easily. As we work to get this bit right, we also need to find creative ways of motivating young people to think about contraception before they have sex. Last week one young man involved inour work told us that it was the chance to get tested for STIs and free condoms that motivating him and it struck me we often focus on finding out about those who don't access services and that we need to invest a bit more resource in finding out more about the stories of those young people who do access services and do use contraception successfully, so we can learn about the motivators and barriers, and develop our strategies and approaches accordingly.

Emergency contraception in schools - setting the record straight

Yet again there is a misleading story in the press about school based sexual health services this week. According to the story there are hundreds of eleven year olds having sex and being encouraged to do so by the provision of emergency contraception in schools.

Most young people under the age of 16 do not have sex. At 11 the numbers of children who have consensual sex, that is not abusive are tiny. Any professional told by an 11 year old they are having sex is always extremely concerned. In almost all cases it will be viewed as a child protection issue, and sensitive work with the child so they can identify what help is needed and the best way to get help will take place. Telling the parent may not always be the answer, if there is abuse or violence in the family for example.

This is true whether the health service provision is located in the community or provided on school premises. Across the country schools decide to establish health services on school grounds because young people and professionals tell them they are needed. Not just for sex advice but so young people can get help on a whole range of issues from stress, pressure and emotional well being, sorting out spots and smelly feet, getting contraception and emergency contraception, issues with family and friends etc. Providing these services is the right and moral thing for schools to do, particularly where young people cannot get to any others, for example those who live in rural areas and are bussed many miles to school each day.

And schools develop these services with the support of the absolute vast majority of parents and the community - yet we never hear their voices because of the deafening cry from the tiny numbers of parents who do not support them. We get many calls at Brook from parents who find themselves upset when they find their daughter is on the pill, or has found themselves pregnant. Typically the story takes a similar path - i wish she wasn't having sex, and if she is i wish she had been able to talk to me, and as the conversation develops parents say if felt she couldn't talk to me I am so pleased there was somewhere she could go to get help to stay safe.

That somewhere may be Brook, it may be a school based service, or it may be the local GP. The important thing is not where it is, but that it is provided by trained staff who are committed to young people's safety, who will help them think about the rights and choices they have, including the right not to have sex, and will also encourage them to talk to an adult they trust.

Up and down the country professionals are working hard to work in partnership with parents and to support young people to make real choices about relationships so they can enjoy and take responsibility for the sex they have, when they do decide to have it.

Six things i have said a lot recently and need others to say them to.

I have found myself saying the following things a lot to young people we work with, journalists, friends, my partner, family, parents, carers and professional colleagues over the last month or so - please pass them on to others by making people aware of this blog or email me and I can send them to you.

1. Most young people under the age of 16 do not have sex and if we forget this we contribute to young people's belief that everyone else is doing it
2. Teenage pregnancy rates in the UK are the lowest they have been for over twenty years and nationally the rates are continuing to go down
3. Sexually transmitted infection rates are increasing at least in part because we are encouraging more young people to get tested - eight years or so ago when we were developing the national sexual health strategy for England we did predict rates would go up before we expected to see them coming down
4. Celebrity culture is only one aspect of our culture around sex, sexuality and relationships - we must not get overly distracted by this and our challenge is to keep our eye on the big picture to promote a culture that values young people's developing sense of identity and sexuality and respects their rights
5. There is no scientific evidence to support reducing the time limit for abortion and we must maintain the upper limit at 24 weeks
6. Not all young people receive good quality Personal, Social and Health Education in schools (this is the subject in which teaching about sex and relationships takes place).

First class service all round

I was recently in Manchester for a Black Health Agency Board meeting. I took the opportunity to visit our services in Manchester. The speed of Virgin trains leaves me feeling decidedly sick for the first half an hour after arriving so to right myself, I walked in the rain to the Centre which is 15 minutes from the station. When I arrived, I couldn’t help but wonder if this is what Chief Executives are supposed to look like. Vanity fears aside, I met some staff who I have not met before, and others who I recognise, but still struggle desperately to remember the names of. Their determination to make the centre a welcoming and comfortable place for young people and to keep on getting better and better at what they do is simply remarkable. (And the new building is lovely too!)

I also visited Stockton to meet some of the team who have just established our new services there. They are already starting to fly – they are getting out and about in the schools and youth settings as part of their outreach. 17 young people attended one of the clinic sessions in the last couple of weeks, and whilst some of the other sessions are slower to start, I am sure it won’t take long before those who are visiting the service tell others, who tell others, who…

Then when I got on the train and looked at my seat reservation, I realised I was in first class – two single tickets, including one first class ticket had been cheaper than a return… Probably a very good job I won’t be getting used to it - the size of the seats make it harder to use a laptop comfortably anyway.