1. 1

2. To explore the role of the SCPHN in supporting families and individuals in maintaining sexual health. WE WILL:   Consider the more usual  Consider groups, families and individuals with specific needs 2

3.  Raising awareness……  Passing on information….  Making suggestions  Referring on… 3

4.  Being aware of the link between sexual problems and the success of couple relationships  Most couples will experience sexual difficulties at some point in their relationship  Young people seek to be ‘sexually normal’ which might bring extra risks to their health 4

5.  Listening with an open mind, being sensitive - some people may have a relevant sexual history – they may have been sexually abused.  Helping people talk – finding a balance – not seeming to pry but being frank.  Helping people to manage guilt. 5

6. Sexual health is defined by the WHO as Enjoyment of sexual relation without exploitation, oppression or abuse. Safe pregnancy and childbirth, and avoidance of unintended pregnancies. Absence and avoidance of sexually transmitted infections, including HIV 6

7. May be a symptom of relationship problems Or maybe a cause Sexual problems can have physical or psychological causes, sometimes both. Physical reasons include illness, infection or side effects from medications. Psychological causes can be linked to relationship difficulties, uncertainties about sexuality, and previous sexual experiences. Many sexual problems are temporary 7

8.  Contraception  sexually transmitted infections  planning to become pregnant  pregnant and are not sure you want to have a baby  abortion  having problems with sex life  been sexually assaulted. 8

9.  Sexual behaviour  Physical issues – pain  STIs  Fear of pregnancy – contraception  Myths – many simple sexual problems arise from ignorance, anxiety, feeling guilty, or false expectations. 9

10. What is normal Experimenting…. (Use of sexual aids, porn) Mismatch of expectations 10

11.  The average age at first intercourse has fallen from 17 to 16 for both men and women.  Nearly a third (30 per cent) of men and a quarter (26 per cent) of women aged 16–19 first had sexual intercourse before the age of 16.  About 80 per cent of people aged 16–24 said they had used a condom when they first had sex, compared with 40 per cent of those in their early 30s.  Less than one in ten (7.4 per cent men, 9.8 per cent women) had used no contraception at all when they first had sex, compared with about 25 per cent of those in their early 30s. 11

12.  First sex was more likely to be unprotected for the youngest age groups. When first sex occurred at age 13–14, 31 per cent of men and 33.6 per cent of women didn’t use condoms, and 18 per cent of men and 22 per cent of women used no contraception at all.  This is much lower than in the 1990 survey when around 60 per cent of 13–14 year old men and over half of 13–14 year old women used no contraception when they first had sex 12

13. increased numbers of heterosexual partners ever and in the past five years more same sex experiences in the past five years more concurrent partnerships more oral and anal sex in the past year higher incidence of consistent condom use in the past four weeks more men reported paying for sex in the past five years 13

14.  The average frequency of heterosexual intercourse per month was 6.4 for men and 6.5 for women.  2010 – 32% of young women and 26% of young men had never had sex (16 – 24 yrs) 14

15.  Contraception is a personal issue, and finding the right method depends on many factors – including age, medical history, and how many sexual partners you’ve had  http://www.nhs.uk/Livewell/Contracepti on/Pages/Contraception-hub.aspx http://www.nhs.uk/Livewell/Contracepti on/Pages/Contraception-hub.aspx 15

16. Sexual problems Common at times of transition and stress Birth – lack of energy / time / loss of libido / feeling lack of attractiveness / pnd / interest in each other Unemployment Moving house Bereavement 16

17. Tiredness Stitches in the perineum Finding the time when baby's asleep and not likely to wake up for a while Pain or fear of pain Leaking bladder Giving practical advice – pelvic floor exercises. 17

18. Chlamydia Genital herpes Genital warts Gonorrhoea HIV Non specific urethritis Pubic lice and scabies Syphilis Trichomonas vaginalis Thrush and bacterial vaginosis 18

19.  You are not expected to be a sex expert  Consider where you might refer on if a client or young person needs more help.  Some ethnic groups may not be able to discuss these issues with you, consider how you will refer on 19

20.  General practices.  Specialist contraception clinics. Sexual health clinics.  Sexually transmitted infection testing clinics (genitourinary medicine (GUM) clinics).  Pharmacies.  Specialist sexual assault centres 20

21.  Sexual difficulties are experienced by most couples at some time during their relationship  Stigma is an important issue in sexual health.  Help the person normalise their experience.  Encourage to make time and space for the relationship and help them find time for each other  What else do I need to know? 21

22. In 2005, the Department of Health published recommended standards: A programme of sexual health promotion to help reduce the risk of STIs and unwanted pregnancy. Measures to improve detection of sexual health need, including Chlamydia screening. Improving access to, and information on service provision. Speedy detection and management of STIs. Prompt access to contraceptive advice and provision. Services working together to increase choice for their users. 22

23. Find out about contraception, sex and young people, STIs, chlamydia, good sex and talking about sex.  http://www.nhs.uk/Livewell/Se xualhealthtopics/Pages/Sexual- health- hub.aspx?WT.mc_id=110903 http://www.nhs.uk/Livewell/Se xualhealthtopics/Pages/Sexual- health- hub.aspx?WT.mc_id=110903 23