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Unmet needs and service gaps

Background papers: Lifestyle and wider determinants :: Sexual health :: Unmet needs and service gaps

HIV testing and diagnosis

Late diagnosis of HIV accounts for 39.5% of all diagnoses (CI 95% 23-63.3) which indicates individuals are not accessing regular testing. Heterosexual contact now accounts for a higher number of infections than among men who have sex with men; therefore the uptake of testing should be promoted and encouraged in all settings.

Chlamydia screening

Increased screening through core services and targeted outreach is required to reach the proposed Public Health Outcome diagnosis range of 2,400 positives per 100,000 15-24 year old population. Medway achieved a detection rate of 1,754/ 100,000 in 2016.

Easy access to STI screening

STI self-sampling kits have been made available through the Integrated Sexual Health Service. These have proved popular with younger adults and demand has outstripped supply, therefore additional resources should be made available to increase the number of tests taken by self-sampling.

Young peoples sexual health services

Accessibility to services for young people has improved, with onsite services available in educational establishments and online self-sampling is popular with adolescents and young adults. Now that the integrated service has begun, young people should be asked for their views on the quality and accessibility of services.

Local termination of pregnancy services:

There has been a fall in women presenting at an early stage of pregnancy; this may have been in part to the disruption to the local Marie Stopes International clinic. A referral pathway has been developed to local SH services but the effectiveness of this pathway needs to be monitored.

Provision of Long Acting Reversible Contraception (LARC)

Promotion and uptake of LARC still require improvement to achieve the South East Average of 54/1000 . Depo and oral contraception (which do not offer the same level of protection as a LARC method) still make up a large proportion of contraception issued through the clinical services.

Sexual Assault Referral Centre (SARC)

Whilst there is a sexual assault referral service located at Beech House, Armstrong Road, Maidstone there remain issues for wrap around services including STI testing and treatment, particularly for pediatric clients.