Appendix B: gaps in the evidence

Appendix B: gaps in the evidence

PHIAC identified a number of gaps in the evidence relating to the one to one interventions under examination, in particular, from the UK, based on an assessment of the evidence, stakeholder comments and fieldwork. These are set out below.

  1. More rigorous evaluation of the effectiveness and cost effectiveness of one to one interventions to prevent STIs (including HIV) and under 18 conceptions in the UK. Studies should be sufficiently powered to detect a reduction in STI infections and conceptions. They should include the following:

    • interventions by different health professionals in different settings (for example, in schools, youth and outreach settings)

    • peer led interventions

    • interventions aimed at vulnerable groups.

  2. A comparison of the relative effectiveness and cost effectivness of one to one and group interventions aimed at reducing STIs and unintended teenage pregnancies.

  3. An evaluation of the most effective and cost effective ways of communicating sexual health information to young people and the wider public. In particular, an assessment of effective and cost effective ways of addressing the stigma and discrimination surrounding sexual health issues.

  4. An evaluation of the relative effectiveness and cost effectiveness of proactive and opportunistic screening to detect, prevent and reduce chlamydia.

  5. An evaluation of the relative effectiveness and cost effectiveness of different methods of partner notification.

  6. Generation of QALYs for use in cost-effectiveness analysis by deriving utility scores for individuals with STIs and for underage conception. Utility scores need to be quantified for the UK population as a whole and among high risk groups (for example, for re-infection and multiple infection rates and the incidence of other health complications).

  7. Studies to reflect the effects of onward transmission of STIs, using dynamic (rather than static) modelling to capture re-infection rates and further health consequences.

PHIAC made 5 recommendations for research. These are listed in section 5.