1. Condom provision
for young people

2. …we need an open and honest sexual and reproductive health culture, in which condom use is simply the norm – the way of all of us, regardless of age, sexuality practice safer sex…
…England ranks poorly on condom use among sexually active young people compared to the rest of Europe and North America, and young people have higher rates of both sexually transmitted infections (STIs) and abortion compared with older adults
Professor Kevin Fenton, Public Health England
C-Card condom distribution schemes
Why, what and how

3. Tri-borough: sexually transmitted infections
An estimated 15,500 cases a year are diagnosed by local GUM clinics. Data for 2014/15 showed 8779 new cases.
Many STIs are asymptomatic, facilitating the spread of infection;
Amongst men, the most common STIs diagnosed include chlamydia, anogenital warts and gonorrhea, whilst in women the most common STIs diagnosed are chlamydia, anogenital warts and herpes simplex;
Locally, STI infections are predominantly concentrated in men and young people, with the age profile of men affected slightly older than that of women;
Men who have sex with men and Black African and Black Caribbean ethnic groups are also disproportionately affected by STIs, particularly gonorrhea and syphilis.

4. …young people are more likely to use condoms if they are engaged in discussion as well as shown how to use them, they are more likely to use a service that is convenient and where they feel welcome, and they are more likely to ask for advice on sex and relationships if they don’t feel stigmatised for doing so.
Professor Kevin Fenton, Public Health England
C-Card condom distribution schemes
Why, what and how

5. Change in approach by commissioning team
Some Providers were getting condoms via two routes (duplication) - Some providers were already paid as part of their core contract for some form of condom distribution. 
What was found once looking at the data more extensively is that these providers were also registered for the condom scheme and ordering condoms through this route as well. 
In 2015 there were severe cuts to the condom budgets.
The rationale for cuts in condoms budgets was to ensure of an overall cost savings across the three borough across all commissioning.
Some providers were ordering from 3 separate accounts
Some providers were ordering large volumes and we could not justify who or where these condoms were being distributed to and we have no evidential data regarding the positive impact this was resulting in.
The scheme was refreshed in 2013 and despite attempts to garner this data, it was not shared. 
This made it very difficult to argue with senior managers to continue funding at its peak rate when the returns are so low.  5

6. As an interim measure it was agreed that rather than cut the whole service it will be reduced until a more robust reporting mechanism could be sustained and evidenced. 
Also as the sexual health procurement is well underway it may form part of the new service as an additional service the provider manages but this has not been confirmed or agreed yet and may/may not be a viable option. 

7. Current provision Condom Distribution Training
Tri-borough training programme
Freedoms service
Account set up via a request through the commissioning team
Annual budget
Currently a variety of services across the three boroughs distributing condoms

8. Current provision – Condom Distribution Training
 To equip staff working with young people, with the skills needed to:
- Discuss sexual health with young people
- Distribute condoms, and lube using a consistent approach
- Provide sexual health information, advice and signposting to services

9. Current provision – Condom Distribution Training
How to discuss sexual health issues with young people to include contraception, sexually transmitted infections and HIV.
Be able to demonstrate the correct way to demonstrate Condom Teach
Understand Sex and the Law
Identifying risky sexual behaviour in young people
How to effectively signpost young people to the appropriate services
How to monitor the distribution of condoms for commissioning purposes
By the end of the training participants will have gained knowledge and understanding of:

10. What do you currently do in your service?
What has had an impact on
your condom provision? 10

11. What challenges may we face when engaging
with young people about condom use?

12. What do we need to have in place to strengthen the current model?

13. Condom Excuses Condoms cut off my circulation. They spoil the mood...
I don’t have any infections!
Sex doesn’t feel as good…
I can’t find one that fits!
Ask participants to discuss with the person next to them a response to one of the excuses.
I have superb control!
If you love me, you wouldn’t ask me to wear one.
I’ve already been tested and treated, I can’t catch it again.

14. Ordering
Each organisation that has completed the Condom Distribution Tri-borough training can register to distribute condoms
Organisations can register by contacting the Public Health commissioner Theresa McShane:
Each organisation will have an annual budget to spend on condoms

15. Any questions