UK national guideline on safer sex advice

Abstract

Summary: This guideline provides evidence-based guidance on the content of safer sex advice and the provision of brief behaviour change interventions deliverable in genitourinary (GU) medicine clinics. Much of the advice is applicable to other healthcare settings including general practice and clinics providing HIV care. Advice on condom use and effectiveness, oral sex and other sexual practices, testing for sexually transmitted infections (STI) and partner reduction is provided. Advice specific to the transmission of HIV infection including seroadaptive behaviours and negotiated safety is also included. An accompanying review of the evidence supporting the guideline with a complete reference list is available online. A patient information leaflet based on the advice statements developed is also available through the BASHH website.Keywords: sexually transmitted diseases, safe sex, risk reduction behaviour, condoms, HIV infections SCOPE AND PURPOSEThe objective of this document is to provide guidance for practitioners in Level 3 genitourinary (GU) medicine services (Tier 5 in Scotland) on safer sex advice provided in sexually transmitted infection (STI) and HIV management consultations. The guideline consists of: † Recommendations on the format and delivery of brief behaviour change interventions deliverable in GU medicine clinics; † Recommendations on the content of safer sex advice given to individuals at continued risk of STI; † Additional advice to be provided for those living with HIV, or from groups with higher rates of HIV incidence.Much of the guidance is applicable in other sexual health and general practice settings, including HIV care services. The evidence base for the recommendations is summarized in an accompanying online document. Issues relating to implementation of behaviour change interventions in clinics, such as designing service structures and care pathways or the competencies required in different multidisciplinary staff groups, will be addressed in British Psychological Society (BPS) Good Practice Guidelines.1 Safer sex advice and individual behaviour change interventions provided within clinics are elements of a combination prevention approach to STIs and HIV 2,3 that may also include group and community-based behavioural interventions, structural and social changes and for HIV, biomedical interventions including postexposure prophylaxis for HIV following sexual exposure (PEPSE), pre-exposure prophylaxis (PrEP) 4 and the early initiation of antiretroviral therapy (ART). IDENTIFYING CANDIDATES FOR SAFER SEX ADVICE AND OTHER PREVENTION INTERVENTIONSNo systematic reviews, meta-analyses or original studies describing methods to systematically target potential candidates for interventions were found. The selection of patients for advice and behavioural interventions should be based on demographic group and individual history taking to identify recognised risk factors. 5,6 Guidance on eliciting risk factors is detailed in the BPS guidelines.1 Those at increased risk may include: † Adolescents...

2016 United Kingdom national guideline on the sexual health care of men who have sex with men

“…(410) and longitudinal studies support the contention that the risk is significantly lower than that for vaginal or anal sex and may be zero in some untreated individuals (45). There is no published estimate for an upper confidence limit for transmission risk through oral sex with undetectable HIV viral load but given that sexual behaviours in both HPTN 052 and the PARTNER study would include oral sex in both heterosexual and MSM couples, it seems that a best estimate of transmission risk for oral sex with undetectable viral load is zero.…”

Sexual health promotion for young people delivered via digital media: a scoping review

“…The UK Guidelines on Safer Sex Advice recommend evidence-based behaviour-change interventions for those at higher risk of STIs (including young people), focusing on enhancing communication skills and increasing motivation to adopt safer sexual behaviours. 36 Techniques such as motivational interviewing are recommended to increase motivation to adopt safer sexual behaviours, and the guideline recommends that detailed and tailored information on safer sex should form part of all sexual health consultations (in settings such as general practice as well as sexual health clinics). The NICE guidance on one-to-one interventions to reduce STIs and under-18 conceptions recommends that clinicians assess STI risk when the opportunity arises, for example when someone attends for contraception or registers as a new patient.…”

The clinical effectiveness of individual behaviour change interventions to reduce risky sexual behaviour after a negative human immunodeficiency virus test in men who have sex with men: systematic and realist reviews and intervention development

“…Of particular note are NHS Healthcare Improvement Scotland's Standards for Human Immunodeficiency Virus (HIV) Services 38 and the UK National Guideline on Safer Sex Advice. 39 Of note, the latter, while providing evidence-based recommendations, has a remit that covers a range of STIs (i.e. it is not solely concerned with HIV infection prevention).…”

“…39 The authors reported that, in an assessment of 24 sentinel GUM clinics, there was a low level of offer and uptake of behaviour change interventions to higher-risk MSM. They note that reasons for this poor compliance may relate to patient factors (e.g.…”

“…in the UK) 39 and by the US Centers for Disease Control and Prevention (CDC). It is defined as 'directive, client-centred BACKGROUND AND RATIONALE NIHR Journals Library www.journalslibrary.nihr.ac.uk counselling .…”