Memorandum by the Royal College of Physicians
of Edinburgh (HA 6)
The Royal College of Physicians of Edinburgh
welcomes the opportunity to offer evidence to the Health Committee
on its "Inquiry into new developments in HIV/AIDS and Sexual
Health Policy" and offers the following brief comments to
inform their discussions:
1. The campaign by the Terence Higgins Trust
and the All Parliament Group on AIDS to exempt all sexually transmitted
infections (STIs) from overseas patient charges should be supported.
There are strong public health, economic and humanitarian reasons
for this including the reduction of HIV infections and associated
conditions and the containment of costs by avoiding emergency
inpatient care and expensive antiretroviral drug treatments.
2. There is a need for a national strategy
to promote initiatives designed to reduce the onward transmission
rates for HIV and STIs. Such initiatives should include compulsory
education in schools, targeted public health campaigns, UK wide
chlamydia screening and improved access to diagnostic testing
in the community.
3. A recent article in the International
Journal of STD and AIDS, reporting a study by Kinghorn, suggests
that previously targeted funds for GUM services in England may
not be getting through to front line teams. The infrastructure
and staffing levels in GUM are not improving despite previous
reports of a crisis in the service. This must be investigated.
4. Although the Health Committee is primarily
concerned with England, there is no finalised Sexual Health Strategy
in Scotland or Northern Ireland and efforts through clinical and
political networks to address this would be welcome and mutually
5. The trend indicators for sexual health
continue to show rising infection rates, increasing pregnancy
and reduction in the age of coitarche. This is a public health
crisis that results in significant spending across the health
services in infertility, cervical neoplasia, and infectious obstetric/paediatric
complications and antiretroviral therapy. An integrated approach
to improving accessible diagnostic services, prevention measures,
treatment and contact tracing are essential if these trends are
to be reversed.