Birmingham’s sexual health service works in partnership with the city’s leading LGBT charity to provide tailored support to the gay, lesbian, bisexual and trans community. There has been a dedicated sexual health clinic in place since 2015 and more recently the service has partnered with the substance misuse team to launch a Chemsex support service.
A bespoke service for LGBT community
Birmingham and Solihull councils jointly commission sexual and reproductive health services from Umbrella, which is a partnership of organisations led by University Hospitals Birmingham NHS Foundation Trust.
It runs a network of dedicated clinics to provide access to testing and treatment and also partners with nearly 300 GPs and pharmacies to provide access to support. At home testing can also be ordered and there is a Chat Health messaging service too.
One of its key partners is Birmingham LGBT, the city’s leading charity for lesbian, gay, bisexual and trans people. Together they run a bespoke clinic for the LGBT community from the charity’s headquarters in the city centre.
It includes a six-day-a-week drop-in service and on-site nurse and consultant-led appointments on two days. There is even a weekly clinic for trans people. The LGBT community can access everything from STI and HIV testing to general support and advice as well as contraception.
There are also dedicated sexual health workers for black and Asian and Middle Eastern LGBT communities as well as peer support sessions as these groups having particularly low levels of engagement with sexual health services because of the stigma that exists.
The partnership work with Birmingham LGBT has proved incredibly effective. Over the past year nearly 1,000 appointments for treatment and testing have been held at Birmingham LGBT clinic, but many more have been given advice and support.
Public Health Service Lead for Adults Juliet Grainger said: “There is a huge benefit working with community organisations like this – they are trusted by the community and that in turn helps improve engagement.”
Tackling the Chemsex risks
At the start of this year the support in place at Birmingham LGBT was extended to include a specialist Chemsex support service. Chemfidential was launched in partnership with Change Grow Live (CGL), the city’s adult substance misuse provider.
CGL provide the equivalent of 1.5 full-time staff to work alongside the sexual health team to work with people who are engaging in Chemsex, the practice of taking part in sexual activity under the influence of drugs.
Chemsex can have a negative impact on physical health, including your heart and brain as well as contributing to anxiety and depression. There is also an increased risk of infections and blood borne viruses like HIV and hepatitis C and hepatitis B, while also sometimes leading to unsafe sex and rougher sex than usual, which can cause bleeding and other injuries.
The support service aims to counter these risks by encouraging people make healthier choices by either doing things more safely, cutting down or stopping altogether.
To help, they can arrange access to substance misuse support as well as sexual health treatment such as PrEP. People can also get free condoms, lubes and gloves. Those receiving support are also advised about “Chemsex first aid”, including what to do in situations where things have gone wrong, such as if a person is too high, unconscious or has cuts and bleeds.
Commissioning Manager for Adult Public Health Services Karl Beese said: “The focus is on prevention and safer practices. Chemsex is something that is often hidden and services are unaware of who is practising it. It only seems to come to light when people come forward for treatment.
“This service has only just started recently, but we hope it will help keep people safer by creating a closer integration between sexual health and substance misuse services and allow us to engage people in conversations at an earlier stage.”
To aid that CGL and Umbrella have signed a community partner agreement, which allows them to share knowledge and resources, such as STI kits and condoms. Umbrella are also helping train CGL staff as part of the deal with CGL being able to offer their knowledge of substance misuse to Umbrella and its delivery partners. “It is a reciprocal arrangement. We think it will be of real benefit. It reflects the fact there is a real synergy between the two services,” added Mr Beese.
Tackling stigma ‘a key challenge’
The work with the LGBT community is just one part of Birmingham’s approach to sexual health and its wider goal of becoming stopping all new HIV infections by 2030 under the Fast Track City initiative led by UNAIDS.
The aim is for 95 per cent to be diagnosed, 95 per cent of those diagnosed to be on treatment and 95 per cent on treatment to have suppressed viral loads.
Birmingham has also added viral hepatitis and Tuberculosis to the initiative because these conditions can be co-targeted with HIV.
The council has recently carried out an improvement exercise with the Umbrella team to review progress with increasing uptake of PrEP identified as one of its key short-term goals.
Cabinet Member for Health and Social Councillor Mariam Khan said one of the key challenges the city faces is tackling the stigma that is attached to HIV and some of the other infections in certain communities. “We need to be vocal and ensure people out there get the support they need. That is our aim – to develop new ways of working that reach out to people.”