Give young people and gay men free condoms to reduce STIs, watchdog says

Local authorities should run schemes to supply young people with free condoms and sex advice in an attempt to curtail the number of sexually transmitted infections, a health watchdog body has said.

They should also consider giving free condoms to gay men, among whom the increase in infections such as HIV and gonorrhoea is of serious concern.

The draft guidance from Nice, the National Institute for Health and Care Excellence, has opened for consultation two days after NHS England lost a high court battle brought by Aids campaigners who want it to pay for drugs to prevent gay men who do not use condoms becoming infected with HIV.

NHS England has said it will appeal, but if it loses it will weigh up the value of the drug, Truvada, which costs about £5,000 a year per person, against treatments needed for other groups, including children with cystic fibrosis.

Related: NHS England reconsiders decision over HIV PrEP drug

Nice says condoms need to be more widely accessible to prevent sexually transmitted infections, including HIV, particularly by the 16-24 age group and men who have sex with men. They should be free for those most at risk.

It comes amid concern that the use of condoms is primarily motivated by birth control, rather than their ability to prevent the spread of infections, and are therefore substituted with other forms of stopping pregnancy that do not offer the same protection against STIs.

Approximately 435,000 STIs were diagnosed in England in 2015, including 200,000 cases of chlamydia, says Nice. Syphilis and gonorrhoea rates have risen by 76% and 53% respectively between 2012 and 2015. The Family Planning Association (FPA) has estimated that the cost to the NHS of treating STIs was £620m in 2014. Nearly 4,000 people are infected with HIV in England every year. The lifelong treatment they require costs an average of £380,000.

“We know condoms can protect against many sexually transmitted infections including chlamydia, gonorrhoea and syphilis,” said Christine Carson, programme director of the centre for guidelines at Nice. “The recent increase in rates of gonorrhoea and syphilis among men who have sex with men has been attributed to high levels of sex without using a condom.

“If local authorities and other commissioners can work together to increase condom availability and use among high-risk groups we could significantly reduce the rates of STIs.”

Nice recommends more condom schemes should be set up by local authorities targeted at young people, based on existing models that offer a free supply but tied to sexual advice and counselling. The most common such scheme is the C-card, the most successful of which allows young people to obtain free condoms once they have been through an information and advice session with a trained counsellor.

The FPA said getting condoms to young people was key to tackling STIs. “However, as well as making condoms more easily and widely available, it’s also really important to back that up with education and support and to think about what barriers may exist to people actually choosing to use them,” said chief executive Natika H Halil.

“This should start with statutory sex and relationships education in schools so young people are equipped with the skills and confidence they need to have those important conversations about safer sex with partners.”

Halil added: “Condoms are already available for free in some places but there are always opportunities to reach more people, including in non-traditional health settings.

“It’s also important to reiterate the fact that condoms protect against both unplanned pregnancy and STIs, so even if you are using another method of contraception and don’t think about using condoms, you may be at risk of infection.”

Give young people and gay men free condoms to reduce STIs, watchdog says

Politicians who make porn stars wear condoms disregard the real HIV fight | Nichi Hodgson

If porn performers had a wellness and safety mantra, “your wellness is your wealth” would most likely be it. Which is why it truly is well worth taking seriously the many “porn stars” who oppose a California bill allegedly designed to better safeguard their health and security by mandating condom use and the reporting of sexually-transmitted infections tests in the porn market.

The legislation – which the state assembly passed in May possibly and cleared one particular of two needed state Senate committees right here on Wednesday – needs that performers use condoms in the course of filmed anal and/or vaginal sex scenes that employers shell out for HIV testing and that workers report their check benefits to the state’s occupational security board. The stated objective of the bill is to lessen the transmission of sexually transmitted infections and HIV because, its authors claim, “the sector has by no means supplied a single affordable suggestion to universally shield its employees and now opposes the quite STD testing protocol that they developed and inconsistently use”.

Aside from the civil liberties issues raised by reporting highly inflammatory individual wellness details to a government company, there are two key questions raised by the legislation. The initial is whether the private porn market genuinely wants to comply with a new law due to the fact legislators want to “shield” them, given the low rate of business HIV infection in contrast to the population at massive. The 2nd is why the California State Senate is so concerned about porn business prices of HIV infection when, as porn performer Jiz Lee testified on Wednesday, “this work isn’t helping communities who are actually at chance”.

Really merely, the porn-condom mandate is a red herring in the real battle towards HIV/Aids. And on pride weekend in San Francisco, you may even contact it a sham.

In accordance to the San Francisco Aids Basis, one.7m Americans have been infected with HIV given that 1981, and California ranks 2nd only to New York in the sheer cumulative number of instances. Approximately seven,000 Californians will turn out to be infected with HIV this year, the vast majority of whom won’t work in the grownup industry. Even Senator Holly Mitchell, who voted for the bill in committee on Wednesday, did so only following producing the stage that the legislation does not seem to be to address “the demographic in fact at risk” for HIV transmission – African-Americans, and African-American ladies in certain. (Notably, Aids Lifecycle reviews that survival prices soon after HIV diagnosis is is lowest amongst African-Americans.)

The tabloids love to titillate with tales of an infection-riddled Pornland, but the handful of HIV circumstances that have prompted filming moratoriums in the previous decade have been just that – a handful. Any infection that influences performers, regardless of whether it originates off-set or on, has to be taken seriously. But to place the market danger into point of view, as of 2010, there had been 57 documented transmissions and 143 achievable transmissions of HIV amongst healthcare workers in the prior 3 decades, a count described by the Centers for Condition Control and Prevention as “extremely uncommon”. The porn sector, meanwhile, has not had a confirmed situation of on-set herteosexual transmission since 2004 and LA County confirmed a total of 22 performers who had been confirmed good in between 2004 and 2009.

Supporters of California’s condom bill frequently argue that requiring condoms in porn is akin to requiring challenging hats be worn by development staff. But, as Lorelei Lee put it on Wednesday, “hard hats never harm their wearers”, but condoms do: they can lead to “floor burn up” (or excessive irritation of performers’ mucus membranes), and therefore enhance the risk of any STI transmission between performers. Beyond which, condoms (even when undamaged and utilized effectively) never offer absolute protection against a assortment of STIs, including herpes, syphillis, genital warts and pubic lice.

But even if all the arguments in favor of the bill had been demonstrably correct, all the money and other resources invested to argue for and pass this legislation – let alone defend any resulting law in court – would nearly undoubtedly be far better invested providing added HIV education and testing (like addiction care), on a lot more analysis for a vaccine and/or a cure, for therapy programs for individuals contaminated, and on palliative care for those with Aids.

Get, for instance, the district of Assemblyman Isadore Hall, the bill’s sponsor: he represents Compton, a Southern Californian district with an alarmingly substantial fee of HIV infection – where the Aids Healthcare Foundation, which supports Hall’s legislation, does not even have a clinic. (The foundation itself prioritizes funding for treatment method more than any remedy-centered investigation, and its chief, Michael Weinstein, personally denounced the pre-exposure prophylactic drug Trovadour as a “celebration drug”.) Hall’s personal constituents are far more very likely to advantage from funds spent on other, verified techniques of stopping HIV transmission and caring for people who contracted the virus than they ever will be from forcing California-based porn performers to wear condoms on set.

Registered nurse and veteran porn performer Nina Hartley informed the state assembly in April that the bill is “a remedy in search of a problem”. It truly is a headline-producing distraction from and a pat solution to a actual crisis – ongoing HIV and other STI transmission – that many Californians encounter, (a crisis that only Senator Mark Leno recognized as a compelling cause for opposing the bill). It is also has the possible to actually enhance the prevalence of STIs amid the population it purports to aid, in addition to decreasing their privacy and inflating the stigmatization they already grapple with on a daily basis. But, provided the existing hostility of many in government to these in the porn market, charging ahead with a moral crusade is apparently preferable to listening to performers give proof about their personal jobs.

Politicians who make porn stars wear condoms disregard the real HIV fight | Nichi Hodgson

Colleges Ought to Be Handing Out Condoms

There is nothing at all like intercourse to get people all sizzling and bothered, and when you add colleges into the mix the palpitations are off the chart. So it is no shock that calls for contraception to be accessible in school have created something of a frenzy.

But opponents disregard the reality that younger people have sex, and if we are to minimize the variety of undesired pregnancies then colleges must be handing out condoms.

The latest furore has been prompted by the Nationwide Institute for Wellness and Clinical Excellence (Nice), the U.K.’s advisory body on health and social care. Wonderful issued advice this week urging colleges to offer free contraception, like the morning-after pill and condoms, to college students, even when they are underage (sixteen in the U.K.).

In accordance to Professor Mike Kelly, director of the Centre for Public Well being, schools are a essential supply of advice on sexual well being for youthful people. “Evidence plainly exhibits that the availability of contraception decreases the rate of undesirable pregnancies,” he adds.

This echoes advice issued in the U.S. final autumn by the American Academy of Pediatrics that condoms must be available in schools and other community venues.

Even though the conception rate amid beneath-18s is falling in England and Wales, at 27.9 per one,000 15-17-yr-previous girls it is nevertheless one of the highest in Europe. Amid under-16s, six out of 10 pregnancies consequence in abortion.

Regardless of this, there are those who argue that offering out contraception is condoning underage intercourse, even encouraging men and women to break the law that sex training must be the preserve of mothers and fathers and that schools ought to promote abstinence. Amongst these uneasy with the advice is Health Secretary Jeremy Hunt, who is reported to think it will encourage the spread of sexually transmitted ailments.

But the actuality is that youthful people will have sex whether or not contraception is accessible or not. What contraception does is cease those experiences resulting in pregnancy. Condoms also defend youthful individuals against HIV and other sexually transmitted conditions. Condoms do not encourage individuals to have sex, but they do motivate them to behave responsibly and not consider hazards.

Condoms really don’t inspire youthful men and women to have intercourse, but they do inspire them to behave responsibly

It is not as if youthful people are unaware of sex until they are shown how to place a condom on a banana. The ubiquity of pornography on the web signifies that this generation has been much more exposed to intercourse than any other in background. One recent research reported that six% of beneath-16s had viewed hardcore pornography more than a 1-month time period, which if anything seems like an underestimate.

Handing out contraception is not enough on its very own. It need to be accompanied by high-top quality intercourse schooling of the sort that is sadly typically lacking in schools. According to one particular survey earlier this 12 months, a third of youthful individuals explained they did not understand about consent in intercourse schooling lessons.

The place sex schooling has been properly-imagined out and developed in conjunction with wellness services it has been proven to be successful. In one particular town in east Scotland, beneath-age pregnancies fell by 40% in three many years after a college introduced a comprehensive system of intercourse training, involving peer educators and, yes, school nurses giving out contraception.

Alternatively of expecting younger folks to wait to have intercourse, we ought to accept that some of them will not. We need to encourage them to see sex as organic, and set it in the context of their lives and relationships, to feel not just about obtaining intercourse but about who they are possessing it with and why, and to truly feel comfortable about discussing contraception. And if they need to have a condom or a morning-after pill, they need to have it.

Colleges Ought to Be Handing Out Condoms