The sexual health of young people presents many challenges. While much has been done to address screening and treatment, there is also a need to address cultural diversity if we are to make sexual health accessible to black and ethnic minorities. Vanessa McFarlane, Health Promotion Specialist in Black and Minority Ethnic Sexual Health, and project leader of 'awaredressers Nottingham' now explains.

Sexual health remains a concern for everybody, but I have always been anxious about how inequality based on ethnicity could affect the way condoms are accessed and distributed amongst black and minority ethnic groups. Young people who belong to these groups can feel awkward approaching sexual health services and this could encourage them to take risks with their sexual health.

Nottingham is home to a diverse black and ethnic minority community and I was keen to find a practical way to engage with young people in the area to help improve access to condoms and make a positive difference to the rising rates of teenage pregnancy and STIs.

It was clear that we would need an innovative way to reach young people. Finding a place where young black and ethnic minority men feel they can talk openly about sex and not feel self-conscious seemed to be a good place to make condoms available. If we could make accessing condoms as easy as going for a haircut... we would probably find a solution.

It was this idea that helped us to develop the awaredressers Nottingham in 2002. We started the scheme with one simple premise: young people attend the barber's shop regularly; it is not somewhere they feel apprehensive about going so why not make condoms available there?

Barber shops can be fun, lively places where men talk and banter with each other. Inevitably, this can lead to talking about sex. This seemed like a logical place to have free condoms on display. We hoped this would encourage young men to carry protection without having to have what they perceive to be an embarrassing conversation with a health professional.

Protecting everybody...

To make the scheme work, we had to recruit barbers who were happy to take on the role of being a volunteer condom distribution worker. Initially, it was important for us to show that giving out condoms would not interfere with their normal business. After all, as a barber, they really just want to cut hair!

Given the fact that there is no monetary gain for them, we were pleased when five barbers agreed to join the scheme. They display the condoms in their shop and encourage young men aged 18 and above to help themselves.

We gave the legality of the scheme careful consideration and it is important to recognise that these barbers are not pretending to be health professionals; they simply provide access to condoms. We do not put pressure or responsibility on them to talk to the young people about STIs but we do offer them training on how to refer someone on to health services if they are asked, or feel it is appropriate

We keep track of condom distribution by asking people to fill out a simple form anonymously with basic details such as their age, ethnicity and gender and we can therefore pinpoint where there is a demand for condoms.

A cut above the rest

The scheme has been running nearly 8 years now and we are very pleased with the positive feedback we receive from both the scheme users and the barbers. We are even more pleased with the fact that the scheme has not only encouraged young people to take condoms, but has also made them think about their sexual health and the risks of chancing it.

One barber has received such a positive response that he now accommodates a visiting nurse from the Sexual Health Outreach Team (SHOT) twice a month to offer support within the studio. This has opened another avenue of support to help young people access services. Keeping the scheme 'user-friendly' has helped the awaredressers to grow in size and popularity. We now operate in fifteen outlets including barber shops, hair dressers and studios and believe we have the capacity to expand to twenty outlets across the area.

Community spirit

The enthusiasm, support and altruism of our volunteers has certainly helped us make the awaredressers Nottingham scheme a success. We also know that a key factor in making the scheme work has been by distributing high quality condoms that the young people prefer to use. Thankfully this does not mean high cost; condom manufacturers like Durex have been very supportive of the scheme and we have found that their discounted clinic packs have enabled us to make the most of our budget.

Since the scheme started, we have shown how we have made funding from charitable contributions go a long way and have since generated financial support within NHS Nottingham city. They have agreed to back us until 2012 so that we can help them meet their sexual health targets.

Making the difference

Within the NHS Nottingham City, sexual health services are under pressure to reach screening targets for chlamydia and ongoing prevention is also a priority. We know that young people who use awaredressers Nottingham are using the condoms because we find that the barbers report that a particular condom type has been very popular and we are then asked to get more in. If a particular condom is in demand, the young men must be talking amongst themselves and encouraging others to try the condoms.

If they are using the condoms, they are protecting their sexual health and that of others. We are therefore confident that we are making a valid contribution in preventing disease and teenage pregnancy within the Nottingham area.

For us, the biggest success of awaredressers has been successfully bringing sexual health to the community. The scheme continues to break down barriers and eliminate access issues whilst making it acceptable for young people to talk about condoms, knowing that they are in easy reach. We would like to see similar schemes start all over the country and would encourage anyone with confidence and passion to take up this cause. The ever increasing of diversity of the nation means that schemes such as awaredressers will always be in demand.

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About the author:

Vanessa McFarlane has been a Health Promotion Specialist for the past 14 years and moved into BME Sexual health 9 years ago. She is particularly passionate about raising awareness and reducing the stigma around HIV and sees 'awaredressers Nottingham' as an excellent outreach opportunity to do this.

Article release date: 22nd February 2010