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Boost access to free condoms to cut STIs, says NICE

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Sexual health services and others should hand out more free condoms to people most at risk of contracting sexually transmitted infections (STIs), according to new public health guidance.

The guidelines, issued by the National Institute for Health and Care Excellence, recommend that healthcare commissioners, including councils, set up condom distribution schemes to reach different groups, including young people.

“Condoms are the best way to prevent most infections being passed on through sex”

Christine Carson

At a time when public health budgets are under pressure, the strategy is a cheap and effective way of helping prevent STIs, said the experts behind the NICE recommendations.

The guidance said free condoms could be distributed through pharmacies, sexual health charities and universities.

However, it said such schemes should also teach young people aged between 16 and 18 how to use condoms effectively and safely, and what to do and where to go if a condom fails.

This should include information about emergency contraception and post-exposure prophylaxis.

NICE said making condoms more widely available could help “significantly reduce” STIs, with more than 435,000 diagnosed in England in 2015, costing the NHS millions of pounds.

While there has been an overall decrease in the total number of STIs, data from Public Health England shows there have been large increases in STIs among specific groups such as young people aged 16 to 24 and gay men.

Rates of syphilis increased by 76% between 2012 and 2015, while cases of gonorrhoea went up by 53% in that time.

“These guidelines provide evidence and guidance for local authorities”

Anthony Nardone

Most diagnoses of chlamydia and genital warts were found among young people aged 15 to 24, while most diagnoses of gonorrhoea and syphilis were found in men who have sex with men.

“Condoms are the best way to prevent most infections being passed on through sex,” said Christine Carson, programme director of the NICE centre for guidelines.

“If local authorities and other commissioners can work together to improve condom availability and use among people at high-risk we could significantly reduce the rates of STIs,” she said.

Dr Anthony Nardone, sexual health promotion lead at Public Health England, said distribution schemes that promoted the use of condoms and safer sexual behaviour could help reduce STIs including HIV.

“These guidelines provide evidence and guidance for local authorities, in collaboration with other organisations, to consider how best to establish these schemes to meet the needs of their local populations,” he said.

However, according to a major new study of services across the UK, prompt access to sexual health clinics, especially for those with urgent symptoms, has got worse in recent years.

The study, published earlier this week, found many genitourinary medicine (GUM) clinics were failing to meet national standards that recommend pretty much all patients should be offered an appointment within 48 hours.

Meanwhile, a separate UK study has indicated that men find self-testing acceptable to screen for sexually transmitted infections.

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