Surveillance decision

Surveillance decision

We will update the guideline on sexually transmitted infections and under-18 conceptions: prevention.

Reasons for the decision

Changing context

The guideline was published in 2007 and has not been updated subsequently. However, the policy and commissioning landscape has changed considerably since the guideline was published. Topic experts' feedback from surveillance reviews in 2014 and 2018 highlighted substantial changes in the commissioning and delivery of sexual health services since the guidance was originally published, which potentially make implementation of the recommendations as they are written problematic.

Expert comments also noted the changed context for young people and adults in terms of the impact of new behaviours (such as making contacts through social media), practices (such as chemsex – the consumption of drugs to facilitate sexual activity) and environmental factors (such as child sex exploitation).

Current approaches for reducing sexually transmitted infections (STIs)

Experts also identified that the recommendations are out of date. In particular, they noted that the guideline doesn't reflect current practice, such as approaches for reducing STIs by improving awareness and the uptake of prevention strategies and testing (see intelligence gathered during surveillance for further details).

The current recommendations only fulfil a small part of the referral from the Department of Health from 2005, because the guideline covers one-to-one interventions to prevent STIs and under‑18 conceptions. An updated guideline could provide greater focus and detail of effective interventions for STI prevention, and clarify which interventions work in which settings and for which populations. It could also provide a focus on population groups that are disproportionately burdened with STIs: black and minority ethnic groups, men who have sex with men, and heterosexual young people up to 25.

A new referral was issued by the Department of Health and Social Care in February 2018, to produce NICE guidance on 'reducing STIs'. This new referral duplicates part of the existing referral for NICE guideline PH3. The update will therefore fulfil requirements of the new referral.

NICE guidance in this area

As part of the current surveillance review, we compared the guideline recommendations with existing NICE guidelines in the area. There are some points of overlap with NICE guidelines that published after 2007. These overlaps can be managed through the planned NICE guideline PH3 update with a modified scope. It is anticipated that the focus on under‑18 conceptions would be removed, because that topic is covered by the more recent NICE guideline on contraceptive services for under 25s.

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