{"id":2280,"date":"2020-05-18T05:12:39","date_gmt":"2020-05-18T05:12:39","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmjsrh\/?p=2280"},"modified":"2020-05-19T11:40:41","modified_gmt":"2020-05-19T11:40:41","slug":"signposting-online","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmjsrh\/2020\/05\/18\/signposting-online\/","title":{"rendered":"Signposting patients to sexual health online\u00a0&#8211; don\u2019t forget the health (or the sex)"},"content":{"rendered":"<p style=\"text-align: right\"><em>Dr Julia Bailey, University College London eHealth Unit<\/em><\/p>\n<p style=\"text-align: right\"><a href=\"https:\/\/twitter.com\/juliavbailey?lang=en\">@juliavbailey<\/a><\/p>\n<p>The Covid-19 pandemic has prompted an unprecedented shift to remote health services as a response to social distancing for patient and practitioner safety. Sexual health clinic capacity has been cut as staff have been deployed to other parts of the health service, and patients are now asked to contact health services by phone or video-link, with clinic visits reserved for a small proportion of people who need to be seen (<a href=\"https:\/\/www.fsrh.org\/fsrh-and-covid-19-resources-and-information-for-srh\/\">FSRH guidance<\/a>). People can also access online sexual health services for STI testing (+\/- contraception), in areas where this service is provided.<\/p>\n<p>The shift to remote consultations is likely to make it more difficult to offer holistic healthcare and health promotion. For example, patients welcome opportunities to discuss sexual wellbeing beyond physical health (e.g. sexuality, sexual difficulties, sexual pleasure), but picking up on this will be more challenging with less opportunity to notice non-verbal cues and to establish trust (e.g. whilst examining).<\/p>\n<p>Resources via the Internet and mobile phone can offer private, convenient access to information, which may be particularly welcome for topics which can be difficult to discuss (e.g. sex, sexuality, sexual difficulties). Online sexual health services can offer efficient STI testing and treatment, but do not usually offer evidence-based sexual health promotion. Interactive (i.e. tailored) digital interventions are effective for <a href=\"http:\/\/dx.doi.org\/10.1258\/ijsa.2011.011221\">learning<\/a> and <a href=\"https:\/\/journals.lww.com\/aidsonline\/Fulltext\/2009\/01020\/Efficacy_of_computer_technology_based_HIV.15.aspx\">sexual behaviour change<\/a>, and could be incorporated into online sexual health pathways.<\/p>\n<p>There is no nationally commissioned digital sexual health programme, and digital innovation varies widely across the UK. There are thousands of health apps and websites, but only a tiny minority have been rigorously evaluated and it is difficult to know which to recommend \u2013 the <a href=\"https:\/\/www.nhs.uk\/apps-library\/\">NHS apps library<\/a> curates trustworthy resources.<\/p>\n<p><strong><em>Digital sexual health resources for patients \u2013 some suggestions:<\/em><\/strong><\/p>\n<p><em>Before (or instead of) appointments:<\/em><\/p>\n<ul>\n<li><strong>Covid-19: <\/strong><a href=\"https:\/\/www.contraceptionchoices.org\/coronavirus-and-sexual-health-services\">Accessing sexual health services<\/a><\/li>\n<li><strong>Websites for young people<\/strong>: e.g. <a href=\"https:\/\/www.brook.org.uk\/help-advice\/\">Brook<\/a>, <a href=\"https:\/\/www.bishuk.com\/\">BISH<\/a>, <a href=\"https:\/\/sexetc.org\/\">SexEtc<\/a><\/li>\n<li><strong>Online information and advice: <\/strong><a href=\"https:\/\/www.sexandu.ca\/\">Sex and sexuality<\/a>; <a href=\"https:\/\/www.relate.org.uk\/relationship-help\">Relationships<\/a>; <a href=\"http:\/\/www.contraceptionchoices.org\">Contraception<\/a>; <a href=\"https:\/\/www.tht.org.uk\/hiv-and-sexual-health\/sexual-health\/stis\">STIs and HIV<\/a>; <a href=\"https:\/\/www.nhs.uk\/live-well\/sexual-health\/\">NHS sexual health information<\/a><\/li>\n<li><strong>Symptom checker<\/strong>: <a href=\"https:\/\/111.nhs.uk\/\">NHS 111 Online<\/a>; <a href=\"https:\/\/patient.info\/symptom-checker\">Patient Info<\/a><\/li>\n<li><strong>Decision aids<\/strong> (e.g. <a href=\"https:\/\/www.contraceptionchoices.org\/whats-right-for-me\">Contraception choices<\/a>; <a href=\"http:\/\/pennineyoungpractitionersgroup.weebly.com\/uploads\/1\/9\/8\/5\/19850715\/gpst_combined_hrt_pda.pdf\">Hormone replacement therapy<\/a>)<\/li>\n<li><strong>Videos<\/strong> prior to appointments (e.g. <a href=\"https:\/\/youtu.be\/opnXt3m2Nno\">Implant insertion and removal<\/a>; <a href=\"https:\/\/youtu.be\/XHRYE2FsXmc\">IUD\/IUS insertion<\/a>; <a href=\"https:\/\/www.youtube.com\/watch?v=Afdmh8E5K6M\">Cervical smear procedures<\/a>)<\/li>\n<li><strong>Mobile phone apps <\/strong>e.g. for <a href=\"https:\/\/weareferly.com\/\">sex and pleasure<\/a>, <a href=\"https:\/\/www.downyourdrink.org.uk\/\">alcohol harm reduction<\/a>, <a href=\"http:\/\/www.sf28.co.uk\/\">smoking cessation<\/a>.<\/li>\n<li><strong>Interactive digital interventions <\/strong>e.g. for <a href=\"https:\/\/dx.doi.org\/10.2196%2F11242\">condom use<\/a>; <a href=\"https:\/\/www.cochranelibrary.com\/cdsr\/doi\/10.1002\/14651858.CD006483.pub2\/full\">STI\/HIV prevention<\/a>; <a href=\"https:\/\/havelockonlineworkshops.teachable.com\">sexual difficulties<\/a><\/li>\n<\/ul>\n<p><em>After a diagnosis\/ongoing support:<\/em><\/p>\n<ul>\n<li><strong>Trustworthy patient information<\/strong> (e.g. <a href=\"https:\/\/herpes.org.uk\/\">herpes<\/a>; <a href=\"https:\/\/patient.info\/sexual-health\/sexually-transmitted-infections-leaflet\/anogenital-warts\">genital warts<\/a>; <a href=\"https:\/\/patient.info\/digestive-health\/hepatitis\/hepatitis-b\">Hepatitis B<\/a>, <a href=\"https:\/\/patient.info\/digestive-health\/hepatitis\/hepatitis-c\">Hepatitis C<\/a>; <a href=\"\/\/www.tht.org.uk\/\">HIV<\/a>)<\/li>\n<li><strong>Electronic <\/strong><a href=\"https:\/\/www.gmfa.org.uk\/notifying-my-partners\"><strong>partner notification<\/strong><\/a><\/li>\n<li><strong>Text message interventions: <\/strong>g. for <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC4982424\/\">safer sex, STI testing<\/a>; <a href=\"https:\/\/bmjopen.bmj.com\/content\/bmjopen\/6\/12\/e013045.full.pdf\">support after acute STI diagnosis<\/a><\/li>\n<li><strong>Online support groups<\/strong> (e.g. <a href=\"https:\/\/www.tht.org.uk\/our-services\/services-your-area\/support-people-living-hiv\">HIV<\/a> support; <a href=\"https:\/\/www.supportgroups.com\/\">+ Support Groups<\/a>; <a href=\"https:\/\/healthunlocked.com\/#bashh\">Health Unlocked forum<\/a>)<\/li>\n<li><strong>Email or text reminders<\/strong> (e.g. for <a href=\"https:\/\/www.cochranelibrary.com\/cdsr\/doi\/10.1002\/14651858.CD011159.pub2\/full\">contraception<\/a> or <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/29101138\">HIV medication including PrEP<\/a>)<\/li>\n<\/ul>\n<p><strong><em>Tips for writing patient materials<\/em><\/strong><\/p>\n<ul>\n<li><strong>Don\u2019t reinvent the wheel!<\/strong> Check what\u2019s already available<\/li>\n<li><strong>Involve target users<\/strong> to make sure material meet their needs, priorities and preferences<\/li>\n<li><strong>Draw on principles of <\/strong><a href=\"http:\/\/www.journalslibrary.nihr.ac.uk\/phr\/volume-3\/issue-13\"><strong>evidence-based sexual health promotion<\/strong><\/a><\/li>\n<li><strong>Address barriers to access<\/strong>, e.g. audio and video formats; material in first languages<\/li>\n<li><strong>Address groups whose needs are often overlooked<\/strong> (e.g. women who have sex with women, trans, non-binary, intersex, and disabled people).<\/li>\n<\/ul>\n<p><strong><em>Summary<\/em><\/strong><\/p>\n<p>The post-pandemic \u2018new normal\u2019 will include digital health. There are some excellent online sexual health information resources available, and there is currently an unprecedented opportunity to offer <a href=\"https:\/\/www.bmj.com\/content\/350\/bmj.h1099\">evidence-based, tailored sexual health promotion<\/a> to complement online and clinician-delivered sexual health services.<\/p>\n<p style=\"text-align: left\"><a href=\"https:\/\/blogs.bmj.com\/bmjsrh\/files\/2020\/05\/ehealth_logo.png\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-thumbnail wp-image-2281\" src=\"https:\/\/blogs.bmj.com\/bmjsrh\/files\/2020\/05\/ehealth_logo-150x150.png\" alt=\"\" width=\"150\" height=\"150\" \/><\/a><\/p>\n<p><a href=\"https:\/\/www.ucl.ac.uk\/epidemiology-health-care\/research\/pcph\/research\/e-health-unit\/people\/julia-bailey\">Dr Julia Bailey<\/a> is a senior researcher at the <a href=\"https:\/\/www.ucl.ac.uk\/epidemiology-health-care\/research\/primary-care-and-population-health\/research\/ehealth\">UCL eHealth Unit,<\/a> and a specialty doctor in community sexual health. Her research focuses on sexual health promotion via the Internet and mobile phones.<\/p>\n<h6>This post is part of a series on sexual health during the Covid-19 crisis. See also:<\/h6>\n<ul>\n<li>\n<h6><a href=\"https:\/\/blogs.bmj.com\/bmjsrh\/2020\/05\/08\/covid-remote-health\/\" rel=\"bookmark\">The COVID-19 lockdown is accelerating the shift toward online and remote health to meet women\u2019s reproductive health needs<\/a><\/h6>\n<\/li>\n<li class=\"entry-title\">\n<h6><a href=\"https:\/\/blogs.bmj.com\/bmjsrh\/2020\/04\/08\/protecting-women-covid\/\" rel=\"bookmark\">Ensuring personalised care for pregnant women during COVID-19<\/a><\/h6>\n<\/li>\n<li class=\"entry-title\">\n<h6><a href=\"https:\/\/blogs.bmj.com\/bmjsrh\/2020\/04\/02\/home-birth-covid-19\/\" rel=\"bookmark\">Home-Birthing and Free-Birthing in the era of COVID-19<\/a><\/h6>\n<\/li>\n<\/ul>\n<p><!--TrendMD v2.4.8--><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Dr Julia Bailey, University College London eHealth Unit @juliavbailey The Covid-19 pandemic has prompted an unprecedented shift to remote health services as a response to social distancing for patient and practitioner safety. Sexual health clinic capacity has been cut as staff have been deployed to other parts of the health service, and patients are now [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bmjsrh\/2020\/05\/18\/signposting-online\/\">Read More&#8230;<\/a><\/p>\n","protected":false},"author":364,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[7420,2599,2583,1141,304],"tags":[],"class_list":["post-2280","post","type-post","status-publish","format-standard","hentry","category-clinical-practice","category-contraceptive-methods","category-international","category-news","category-public-health"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Signposting patients to sexual health online\u00a0- don\u2019t forget the health (or the sex) - BMJ Sexual &amp; Reproductive Health blog<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/bmjsrh\/2020\/05\/18\/signposting-online\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Signposting patients to sexual health online\u00a0- don\u2019t forget the health (or the sex) - BMJ Sexual &amp; Reproductive Health blog\" \/>\n<meta property=\"og:description\" content=\"Dr Julia Bailey, University College London eHealth Unit @juliavbailey The Covid-19 pandemic has prompted an unprecedented shift to remote health services as a response to social distancing for patient and practitioner safety. 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