Sexual health-Module 145
With 6,000 pharmacies offering chlamydia screening, counter staff have an essential role in raising awareness of the issues surrounding sexual health
• Learn strategies for getting people to talk about sexual health
• Find out about how to promote safe sex in your community
• Discover why pharmacy should be at the forefront of reducing STIs.
Download a pdf version of this module here
Download the Test Your Knowledge questions here
There has never been a more important time to help people feel confident in talking about sexual health. Cases of sexually transmitted infections (STIs) have been on the rise for years. Yet in 2010, for the first time in more than a decade, there was a slight drop in numbers. This is in no small part thanks to the National Chlamydia Screening Programme, which last year saw a 10 per cent increase in chlamydia tests done in the community but, for the first time, no increase in new diagnoses.
The Health Protection Agency called the figures a "milestone" and hopes it is the start of a downward trend. But there is no room for complacency and pharmacy has a key role to play in improving sexual health and being proactive in getting people to talk about safe sex.
Take every opportunity
The most obvious circumstance to start a conversation about sexual health is when someone comes in for emergency hormonal contraception.
But while this can be a helpful time to bring up chlamydia screening and condom use, pharmacy staff need to also make sure they are being proactive in talking about and promoting sexual health in general.
According to the National Pharmacy Association (NPA), 6,000 pharmacies across the UK now offer screening for chlamydia, yet in a recent survey half of those asked did not know that pharmacy did any testing for STIs. The NPA says pharmacies need to take the opportunity to raise awareness of the services that are available, which will in turn increase their own sales.
For chlamydia screening, it is important that those eligible for free testing (see Counterculture on p10) are made aware of their options. This can be done through posters advertising the service, or cards handed out with prescriptions for contraception or to young people buying condoms. Some pharmacies have had great success by handing out information on testing to everyone within the 16-24 age range.
Putting people at ease
Whether it is a nervous, shy,16-year-old or a middle-aged romantic embarking on a new relationship for the first time in years, it can be very embarrassing for patients to ask pharmacy staff about contraception or sexual health. Every conversation needs to be approached with tact and understanding, and every effort should be made to make the customer as comfortable as possible.
Be aware if someone is feeling very uncomfortable talking to you and ensure customers are aware of the private consultation area, where they can speak without people overhearing them. Remember that for many people the pharmacy, with its long opening hours and no need for an appointment, may be the only place they are able to access sexual health advice from a health professional.
To help people to feel comfortable, it is important to listen fully to what they are saying without making any assumptions or judgment. It can also help to pay attention to their body language and mirror them – for example if they are speaking very quietly, do the same and slowly bring your voice up to help them feel more at ease. If you are confident, then the patient will feel far more relaxed.
Promotion and publicity
Starting a conversation on sexual health can be much easier if you have promotional materials to hand. Giving out a leaflet on chlamydia screening or STIs can be a good way to start a discussion about safe sex, and may lead to further questions from the patient.
Posters advertising sexual health services are also vital. Some pharmacies advertise chlamydia testing near the condom display to raise awareness of the services available. It also means you can ask people if they have seen the posters and would like any more information.
It may also be useful to leave leaflets out on the counter and use them as
a way to initiate a discussion, especially if you see someone looking at them or showing an interest. It is important not to be overzealous and push people into a conversation they do not want to have, but providing them with information they can take away and mull over may help them feel more confident the next time they visit the pharmacy.
Think about how to involve sexual health in other campaigns; for example, the start of summer would be a good time to run an information campaign on preparing for holiday, including safe sex information among tips on safe tanning and getting travel vaccinations.
Don't wait for them to come to you
One way to reach people you might not normally see in the pharmacy is to get out into the community and raise awareness, for example a stall at a local supermarket or a fete. Make it fun, hand out promotional material and get people talking. As well as potentially getting new customers, it helps to boost the pharmacy's profile as being at the heart of the community.
It is also a good chance to practice talking about these sometimes very sensitive issues. And you might just find that people are more willing to talk and ask questions in a more informal setting.
Try not to have preconceptions about who might need or want sexual health advice. Chlamydia screening is aimed at young people, and the under 25s are most at risk from STIs.
But advice about condoms, the risks of STIs and the importance
of being safe should also be made available across the board. Parents may also want information to help them educate their teenage children.
Be prepared
It is important you have the information at your fingertips; if someone has built up the courage to ask you for help, it is important not to just fob them off. Having information leaflets available in the store can be really important. Make sure you are up to date on sexual health information and understand how best to advise on safe sex.
If you cannot answer their question or they would like more information than you have available, then you need to be able to advise them on where they can go for additional help (see box, below left, for a list of useful resources).
Role playing exercises can also help you feel more confident when talking to members of the public about sexual health. Colleagues can give supportive feedback about how best to broach the topic or how to deal with a nervous, reluctant customer.
Top 5 STIs diagnosed in England*
Chlamydia 189,612
Genital warts 75,615
Genital herpes 29,703
Gonorrhoea 16,531
Syphilis 2,624
*Health Protection Agency figures for 2010, not including HIV
Case study: A Healthy Living Pharmacy approach
A good way to stop people feeling embarrassed about sexual health is to mention it while giving general advice, says Pam MacPherson, pharmacy manager at Rowlands Pharmacy's Kingston Crescent branch in Portsmouth. As a Healthy Living Pharmacy, her team are very proactive about going out into the community and raising awareness of the importance of good sexual health; staff have even been known to don a pair of huge pants with safe sex messages over their uniforms to grab attention.
But the strategy they have found to be most effective is to bring it up in private consultations offering a general health check, Ms MacPherson says.
"We did an under 25s health check where we went out to waiting people and offered them a general health check and brought them into the consultation area," she explains.
"We did BMI and blood pressure tests, and then incorporated sexual health as part of it, offering them a chlamydia test. We found it was much easier this way and the patient was more relaxed."
Key points
• In 2010, new diagnoses of STIs dropped slightly for the first time in a decade, suggesting that chlamydia screening and other campaigns may be starting to have an impact but there is no room for complacency
• It is vital that pharmacy is proactive in promoting good sexual health in young and old, and free chlamydia testing for the under 25s
• By making clever use of promotional materials and targeting campaigns where appropriate, pharmacy staff can direct people to good information, help them get tested for STIs and encourage them to be safe.
Evaluation
• Do you feel confident in starting a conversation about sexual health?
• Are you aware of the services the pharmacy offers, for example chlamydia testing, and why you should encourage people to sign up?
• Can you improve how the pharmacy promotes safe sex?
• Do your customers have easy access to good information on sexual health, for example information leaflets on the counter?
Information
Health Protection Agency www.hpa.org.uk
The Family Planning Association www.fpa.org.uk
Marie Stopes www.mariestopes.org.uk
Brook – advice for under 25s www.brook.org.uk
Lesbian and Gay Switchboard www.llgs.org.uk
