CURRENT PROJECTS

Nudge Associates work with You

Nudge Associates is working on several skills development opportunities, alongside currently providing support and advice services to the following clients:

• Royal Borough of Kingston (All-age Learning Difficulties Collaborative Transformation)
• The Martin Fisher Foundation ('Towards Zero HIV' Strategy Development)
• HIVsport (Marketing / Fundraising Strategy Development)

Nudge Associates are a team of independent consultants that have come together to provide bespoke support, advice and skills development services for the health, wellbeing and development sectors.

HIVsport Marketing and Fundraising Strategy

Public health needs of LGBT communities

The Lesbian, Gay, Bisexual and Trans Public Health Outcomes Framework Companion Document makes the following universal recommendations (published by Public Health England):

Ÿ1. Health and Wellbeing Boards and Directors of Public Health should ensure that the Joint Strategic Needs Assessment explicitly considers the needs of the local LGB&T community.

2. Health and Wellbeing Board Chairs must ensure that Health and Wellbeing Strategy implementation plans and supporting strategies explicitly consider the actions to reduce inequalities affecting LGB&T communities..

3. All health and social care commissioners should ensure that they are paying due regard to the needs of LGB&T people, as required under Section 149 of the Equality Act 2010, the Public Sector Equality Duty. The use of equality impact assessment frameworks for population strategy documents and action plans can help to meet this requirement.

4. All health and social care providers should implement the published guidance, as referenced in the supporting Resources document, on becoming LGB&T-friendly providers. 

Chemsex: exploring sex and drugs among gay men in south London

This study by Sigma Research, explored drug use in sexual contexts among gay men and bisexual men men who lived in south London. It concentrated on men who had used any of the three main chemsex drugs - crystal methamphetamine, GHB/GBL, and mephedrone either immediately before, or during sex with other men. It explored perceived norms about drug use in the gay scene; mens’ experiences of using drugs during sex (both good and bad); if or how they think about HIV or STIs when they are having sex on drugs; and whether they have ever sought help to manage their drug use or sexual behaviour.

Study took place between August 2013 to March 2014.

Sexual Health Services Review 2016

The aim of this review is to establish wether the:

- Locally commissioned sexual and reproductive health services are delivering an effective offer for local residents;

 - Future commissioning model stands to be effective;

- Council can be assured that the commissioning of the service in 2014 was carried out appropriately.

The case for Sexual Health, Reproductive Health and HIV Services

Investment in sexual health and reproductive health services can deliver healthcare savings through preventing unplanned pregnancies and reducing the transmission of Sexually Transmitted Infections (STIs). The direct costs of treating STIs cost the health service in England for example, approximately £165 million a year. 

Provision of contraception is an important healthcare service, which contributes to better maternal and child health. Contraception services probably save the NHS over £2.5 billion a year and the cost benefit of contraceptives is well established and has been estimated at £11 for every £1 spent.

HIV imposes a significant burden on health care resources at around £580 million a year. As well as high costs of treatment and care, HIV is associated with serious morbidity, significant mortality and a high number of potential years of life lost. Preventing the onward infection of one case of HIV could save around £0.5 million in health care costs and individual health gains.

Women who have sex with women (WSW)

The term WSW is used in relation to the views of, and about, any woman that has self-defined as lesbian, bisexual or unsure / still deciding, and any woman that has had sex with another woman that may be considering having sex with another woman.

Young WSW in particular may not be able to make informed choices. There may be assumptions from health and social care providers that WSW are not at risk of Sexually Transmitted Infections (STIs). The National Survey of Sexual Attitudes and Lifestyles 2013 however, shows more women are having relationships with women. Some WSW may have male partners as well as female partners.

The gaps in relation to sexual health of WSW could be partly addressed by providing health professionals with training on WSW relationships:

When women access services from GPs, consultants and other health professionals, it is assumed that they are in relationships with men. Questions and plans for medical investigations begin with this starting point. A small change in the way questions are phrased would make a big difference. This could be ongoing and during medical training (pre-employment).

In general, language used in relation to women and sexual health is focused around preventing pregnancy and not sexual health and behaviour.

Working towards zero new HIV infections in Brighton & Hove

The Martin Fisher Foundation vision is to accelerate TOWARDS ZERO HIV stigma, ZERO new HIV infections and ZERO deaths from HIV in Brighton & Hove, and it is currently working with stakeholders to develop a 'Towards Zero HIV' strategy and implementation plan that will set out ways in which everyone can contribute to this important aspirational goal.

Genitourinary Medicine Clinic Activity Dataset (GUMCAD) categories doesn’t count WSW as WSW if they also have sex with men.

Improving this could provide more information about the sexual health of WSW.

WSW are not necessarily encouraged to attend sexual health services, even if they have multiple sexual partners and may only attend when they have symptoms of an STI.