Lynn Hearton, of the sexual health charity FPA (Family Planning Association), talks about bringing sexual and reproductive health under the same umbrella, and gives us an insight into the best practice for arming people with the contraceptive know-how to avoid STIs and unplanned pregnancies...

What's the contraception situation?

Contraception is an important part of sexual and reproductive health. In addition to preventing unintended pregnancy, methods such as condoms can also help protect against STIs.

In sexual health campaigns, people must be able to identify themselves as the one taking risks, otherwise they are not going to recognise the need to change their sexual behaviour.

Contraception has been around a long time - the pill has been used for more than 50 years yet unplanned pregnancies are still happening. Despite huge availability of condoms and awareness of the safer sex message, STIs are on the increase too. As sexual health campaigners, we cannot be there to stop unplanned pregnancies and STIs occurring but we can ensure that people know what to do to protect themselves and where to seek advice.

Uniting sexual and reproductive health

It seems obvious that reproductive health and sexual health are linked but people and health services have a tendency to isolate the two. If you have poor sexual health and you are catching STIs then your reproductive health is likely to be affected.

If a person does not want to get pregnant they know they can use contraception, but STIs are more complicated. People understand that contraception can help prevent pregnancy but many are shocked to find out that STIs can be transmitted by non-penetrative means, such as oral sex and skin-to-skin contact.

Barrier methods, such as condoms, offer effective protection against both unplanned pregnancy and STIs, but if unprotected sex happens people should be told where they can go and what they need to do in order to resolve the situation and prevent it from happening again. People need to be armed in advance with the information they need in order to protect themselves.

Bridging the age gap

Quite rightly, most sexual health campaigns have been focussed on young people with information and clinics tailored specifically for them. However, greater numbers of older people forming new sexual relationships are being diagnosed with STIs.

Older people are perceived to be less at risk - because they have been in long-term monogamous relationships, believe they are infertile and are often made to feel like they should know better. If they have recently ended a long term relationship, they may never have used a condom and may not be equipped with the language or confidence to discuss contraception and sexual health with a healthcare professional.

Both the young and older people have very similar worries about whether their sexual behaviour or lifestyle is going to be judged if they seek help and advice. They also have concerns about the confidentiality of any information that is shared with health care professionals.

Older people have more contact with health services so we need to take the opportunity to help them to identify themselves in sexual health campaigns. Including routine sexual health questions in consultations and advising older people about clinics and preventative methods would be a huge step forward.

Best practice for healthcare professionals

The complexity of a person's circumstances is difficult to weave into contraceptive decisions and sexual health campaigns. Not understanding the risks underpins many of the situations people find themselves in: improving knowledge is a fundamental place to start. People of all ages need to realise that STIs and unplanned pregnancies could happen to them, must be fully aware of the risks and be informed about where they can go for advice, testing and treatment.

Healthcare professionals need to be proactive about raising sexual health issues and become more opportunistic when giving advice; particularly with older people. Sexual health services need to be more individual-centred so that they can offer advice that encompasses all facets of sexual and reproductive health.

We must begin to recognise that STIs and pregnancy are not two separate issues: they come under the same sexual health umbrella. Ultimately, we need to consider a more holistic approach to providing sexual health services with a focus that is not just on young people.

About the author:

Lynn Hearton is the Helpline & Information Services Manager of the sexual health charity FPA (Family Planning Association). As part of the FPA, Lynn works to provide straightforward information, advice and support to all people across the UK on all aspects of sexual health, sex and relationships.

Article release date: 5th May 2011