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IReSH calls for an intersectional and wholistic approach to revising the Healthcare Improvement Standards for Sexual Health

A working group comprised of members of the IReSH network operations group developed a response to the consultation on the Healthcare Improvement Scotland Standards for Sexual Health in July 2021.

Given the cross-sector and interdisciplinary nature of IRESH, our aim was to avoid duplicating responses from clinical services and third sector organisations that have specific expertise relevant to individual Standards. We sought to complement this by sharing overarching comments on the draft Standards as a whole. Our main comments on the Standards highlight the need to centre an intersectional approach to sexual health and justice, and to be explicit in naming and responding to the structural inequalities that currently affect sexual health, wellbeing, and justice in Scotland.

We suggest that there is a need to explicitly acknowledge the increasingly hostile environment (exacerbated by the COVID-19 pandemic) in relation to sexual and gender rights, racism, immigration, ableism and increased socio-economic inequalities. These factors directly impact the availability of, and access to, sexual and reproductive health services. This is important because it affects the sexual health and wellbeing of individuals and communities across Scotland, and beyond.

We commend the importance of championing human rights and taking a rights-based approach in the Standards. However, we suggest that this should be expanded beyond the current focus only on young people and emphasised across all the Standards with concrete acknowledgement of, and suggested responses to, the structural barriers to sexual and reproductive justice in other areas of service provision.

We recognise the limits of the Standards in tackling structural social inequalities. However, we suggest that they do not go far enough; neither naming such issues, nor in providing further guidance on addressing inequalities and ongoing discrimination. In our response, we draw attention to examples of where there is an absence of this approach, and where this has potential material consequences for the sexual and reproductive health and wellbeing of communities

In line with participatory engagement principles, we strongly support the need for involvement of key stakeholders (community, third sector, research, clinical) in determining the implementation and monitoring of Standards at a local level. Given the strong emphasis on ‘engagement’, and recognising the diverse ways in which this term is used and applied, we suggest that more explicit reference is made to using local data to inform meaningful engagement work (and links to guidance on community engagement), so that such work does not inadvertently replicate the inequalities that boards seek to address.

We recognise the challenges associated with drafting the updated Sexual Health Standards at a time when there are rapid and ongoing changes in local and national policy and current clinical best practice in the context of COVID-19. We suggest that it may be worth revisiting the current structure of the Standards, which represents a mix of broad areas for improvement (leadership and governance, sexual wellbeing, access etc.), service delivery (STI prevention, detection and management, abortion care etc.) and key populations (young people, GBMSM). In particular, we note that this ‘siloed’ approach, with explicit sections focused on the needs of some key populations (young people and GBMSM), but not others (communities of colour, disabled people, including people with learning difficulties, LGBTQ+ people etc.) could inadvertently lead to further exacerbating inequalities. As such, we suggest that there may be benefits to reframing using an intersectional approach that acknowledges overlapping identities, and intersectional issues that shape availability, access, and experiences of sexual and reproductive healthcare.

As an interdisciplinary network of researchers, health practitioners, third sector organisations and community stakeholders, we welcome the chance to respond to sexual health Standards, and encourage further discussion on how sexual health provision can be central to acknowledging and addressing entrenched structural inequalities that affect us all.

Click here to download the full IReSH response

IReSH and COVID-19

The arrival of COVID-19 and the dramatic public health measures in Scotland that have been taken – and will need to continue for the foreseeable future – has meant that as a network, we have had to make some tough decisions. In light of the ongoing public health emergency, we announced a few weeks ago that we would postpone our national Conference Sex, Drugs & Scotland’s Health, which was originally scheduled to be held in June in Dundee. We’ve pushed the conference to 2 – 4 June 2021 and will provide more details later in the year. We were very disappointed to not move forward with a great programme of events and are planning to provide elements of the conference through some digital presentations and/or events and blogs – watch this space for more details!

We are also focusing on increasing our digital presence through our recently revamped website, which will feature a space for blogs and videos to share research, reflections and information. We’ve got some new blogs coming up in the next little while, so keep a look-out for those. Also, feel free to get in touch with us if you have ideas for materials you would like to share.

Finally, as many of us re-orient – or indeed heighten – our efforts to care for ourselves and others and to continue to support the sexual and reproductive health and wellbeing – and rights – of our communities, we have pulled together some fantastic resources that our partners and friends have put together in the immediate response to COVID-19 and its implications for sexual and reproductive health. We hope you find these resources useful and that you can continue to care for yourself – and others – in these uncertain times.

• PrEPster hosted a Facebook Live event on Covid-19, HIV and LGBT health: what do we need to know? in mid-march, which is still able to be seen here: https://www.facebook.com/prepster.info/videos/246665113035089/

• PrEPster have also created a very useful page that is regularly being updated with information about COVID-19 & all things sexual health and HIV here: https://prepster.info/covid/

• HIV Scotland have offered information and support for people living with HIV and PrEP users here: https://www.hiv.scot/coronavirus

• Waverley Care have provided information about COVID-19 & sexual health here: https://www.waverleycare.org/news/coronavirus-covid-19-information-and-advice

• FSRH and coalition partners have put together a special COVID-19 issue of their Sexual Health, Reproductive Health & HIV Policy eBulletin here https://mailchi.mp/fsrh/sexual-health-reproductive-health-hiv-policy-ebulletin-coronavirus-special-issue?e=45b6f30b2d

• Umbrella Lane have provided information and guidance on COVID-19 for people who sell sex – https://www.umbrellalane.org/#/covid19/

• Scottish Drugs Forum have published guidance on COVID-19 to support people who inject drugs here: http://www.sdf.org.uk/covid-19-guidance/

• Scottish Trans Alliance have provided some information on ongoing support for people accessing trans health care services here: https://www.scottishtrans.org/important-information-about-continuing-your-hormones-during-the-coronavirus-outbreak/

• Sexual and Reproductive Health and Rights Matter hosted a webinar on the implications of COVID-19 for SRHR and can be watched here: http://www.srhm.org/news/covid-19-what-implications-for-sexual-and-reproductive-health-and-rights/

Welcome to the new IReSH website!

IReSH is a network that that brings researchers, health practitioners and community stakeholders together to collaborate on research in sexual health and blood borne viruses in Scotland. The network includes researchers, NHS clinicians and health promotion practitioners, policymakers, third sector organisations and community groups. Through our events and online presence, we aim to share our research and practice in order to identify and respond to existing sexual health and BBV inequalities and challenges and to promote wellbeing in Scotland.

Continue reading “Welcome to the new IReSH website!”

Sex, Drugs and Scotland’s Health: Call for Submissions

IReSH and HIV Scotland are proud to announce that Sex, Drugs and Scotland’s Health – a national conference on Scotland’s Sexual Health and Wellbeing – will take place in Dundee on 3-5 June 2020.

Where do we go next for sexual health in Scotland? Organised by a cross-sector partnership, this conference will be used to highlight new and emerging research, support workforce development and connect communities and those working within the SHBBV field in Scotland, the UK and internationally. At its heart will be discussion and debate around sexual health and blood-borne viruses in Scotland.

The conference will bring together researchers, third sector organisations, and healthcare professionals who are committed to improving and supporting inclusive sexual health and wellbeing in Scotland.

Abstract Submission for the conference is now open! Please follow this link to the page to find out more and to submit your abstract. The Submission Guidelines are linked here.

Please use this form to submit your proposals for talks, panel discussions, creative and performance contributions. Abstracts should be submitted by 31 January. We will aim to contact you with the outcome of your proposal(s) by the middle of February 2020.

If you have any questions at this point, please contact conf@hiv.scot

Interested in the conference, and want to keep up to date with news? Register your interest here for all conference updates.