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Background
People who are in prison have the same right to healthcare as everyone else. They should be able to access the same quality and range of healthcare as those in the community. Concerns have been expressed that confidentiality is compromised in detention settings; access to HIV-pre-exposure prophylaxis is limited; availability of vaccines is variable; outbreaks of infections are more common and access to sexual healthcare in the UK is sporadic. The Prison Special Interest Group (SIG) was re-established at the beginning of 2020 with the aim to define standards of care for sexual health provision in prisons in the UK and enable standardisation of practice. The SIG also provides peer support to those facilitating sexual health provision in prisons in the UK.
The Prison SIG is open to all professionals involved in the delivery of sexual healthcare in prisons, be that in research, clinical practice or through public health initiatives. We have over 20 members from three of the four nations. Members are from all sections of the multidisciplinary team; including patient representatives, trainee representatives, health advisors, nurses, specialty doctors, consultants, UK Health Security Agency facilitators and Public Health Wales advisers. We have hybrid meetings three times a year.
The work of the Prison SIG
Standards
Members of the SIG in collaboration with the British Association of Sexual Health & HIV (BASHH) Clinical Standards Unit have written The Standards for the Management of Sexual Health in UK Prisons which are due to be published later this year. They have been created to promote and support the equity of sexual healthcare for those in UK prisons. Those in prison should have rapid access to sexual healthcare; appropriate assessment of their sexual health needs with the most appropriate tests and timely results; their confidentiality should be maintained; they should receive good quality services from adequately trained staff; and where needed be referred on to other specialties. To fully understand the barriers faced and the needs of those affected, people in prison need to be included in the development of sexual healthcare services in prisons.
The standards will support commissioners, healthcare providers and those in prison ensure sexual healthcare provision in prison settings mirrors that of the community. Additional measures are outlined in the standards to promote equity of care, such as opt-out screening for bloodborne viruses on arrival and further discussion at 14 days. Screening on arrival at each secure unit will help overcome barriers to screening including the rapid turnover and sometimes frequent movement of those in prison. The standards will enable and promote the very best sexual healthcare within UK prisons to ensure there is limited morbidity, mortality and transmission of sexually transmitted infections in prison settings.
Educational fellowships
Five genitourinary medicine registrars successfully applied for fellowships with the Prison SIG in 2021. Two have been part of the writing group for the standards and two are developing a service ‘map’ of delivery of sexual health and HIV services in prisons across the UK. Another registrar has been looking at and developing surveillance of sexually transmitted infections and HIV in prisons using UK Health Security Agency and Office for Health Improvement and Disparities data sets (The Genitourinary Medicine Clinic Activity Dataset and The HIV and AIDS Reporting System).
Scientific meeting
The Prison SIG were delighted to present at the BASHH Scientific Meeting in October 2022. Educational Fellows gave insights into the data captured so far from the service maps. Our patient representatives gave insightful, frank and moving accounts of sexual healthcare provision in UK prisons. Both the Educational Fellows and the patient representatives highlighted the benefit of the Prison SIGs diverse membership.
The future
The Standards for the Management of Sexual Health in UK Prisons will be published this year. There will be publication of the fellowship work. There will be increasing opportunities to publish research to support the sexual health of people in prison and detention centres. Further educational fellowships will be advertised through BASHH. We hope these opportunities will enhance the standards and guide clinical practice within prisons.
The SIG is always welcoming new members and would be particularly keen to have representation from Northern Ireland.
Ethics statements
Patient consent for publication
Ethics approval
Not applicable.
Footnotes
Handling editor Anna Maria Geretti
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Not commissioned; internally peer reviewed.