In 2020 the south London boroughs of Lambeth, Southwark and Lewisham sought to tackle the inequalities faced by black, Asian and Latin American people by commissioning a sexual health promotion service to work with these communities.
The south London boroughs of Lambeth, Southwark and Lewisham have commissioned a sexual health promotion partnership to engage with people from black, Asian and multi-ethnic communities. The partnership works alongside community groups to train staff from a range of organisations and backgrounds and runs awareness-raising events and campaigns for local residents.
Working with trusted community partners
Lambeth, Southwark and Lewisham face some of the greatest sexual health challenges in the country. Together, they have the highest rate of diagnosed HIV in England with just over 8,000 residents living with the condition.
The boroughs are also among the most ethnically diverse – with around half the local population from black, Asian and multi-ethnic communities. Significant inequalities exist in terms of sexual and reproductive health with people from black Asian and Multi-Ethnic communities being at higher risk of some sexually transmitted infections and of late diagnosis of HIV.
Lambeth Public Health Consultant Rachel Scantlebury said: “It is clear too many black, Asian and Latin American people in our community have subpar experiences when it comes to their sexual and reproductive health so what we have done is try to find ways to work with the community to improve access to services.”
In 2020 the councils sought to further tackle these inequalities by commissioning a sexual health promotion service to work with these communities. Love Sex Life (LSL) is a partnership led by sexual health charity Brook, working in partnership with Shape History and other community organisations.
It has three main objectives:
- Creating safer spaces where people from black, Asian and multi-ethnic communities feel more comfortable accessing sexual health advice and support.
- Tackling stigma around HIV and other sexually transmitted infections.
- Developing greater understanding of sexual and reproductive health needs and how people from these communities would like to have their needs met.
In working towards these objectives, LSL’s activities complement the jointly commissioned sexual and reproductive health services, which are delivered by the three main hospital NHS trusts in the boroughs – King’s College Hospital NHS Foundation Trust, Guy’s and St Thomas’ NHS Foundation Trust and Lewisham and Greenwich NHS Trust.
From training to awareness raising
LSL’s work has included regular training for local GPs and a wide range of other health and non-health professionals. This on-going training has been delivered in a variety of ways both in-person and remotely and involves a series of themed workshops on topics such as consent, contraception, healthy relationships, sex and pleasure and HIV stigma.
Attendees have been taught about these issues, including a focus on how those from black Asian and multi-ethnic communities might experience them and given advice on how to support residents from these groups to meet their sexual health needs.
An additional project run last year on improving access to HIV therapy PrEP, which LSL was involved with along with local organisations Aymara and the Africa Advocacy Foundation. The work saw community champions talk to residents about HIV and PrEP. In some cases this included accompanying residents to visit sexual and reproductive health clinics to access the treatment.
Events and digital awareness campaigns have also been run, reaching many hundreds of people. These have included setting up stalls at many festivals and fairs. Last summer one was held at the Lambeth Country Show.
LSL outreach worker Chad Morgan, who ran the stall at the fair, said such events are a great way of engaging people with around 40 people a day taking time to ask questions and find out about services during the event.
A common response I get when doing outreach is that I’m married and don’t need to be tested.
However black women represent around two thirds of all women receiving HIV care in the three boroughs and so it is important that women from these groups come forward for HIV testing.”
‘We’ve got better understanding of barriers to access’
The work is well on the way to having an impact. To date, over 700 professionals have attended training, and PrEP uptake has increased as a result of the awareness project.
Ms Scantlebury said: “By working with community groups it gives the service legitimacy across different groups in our boroughs. They are trusted by the local population and that helps us engage them in a way we could not if we just relied on the traditional sexual health service approach.
“They understand the barriers different communities face – whether it is to do with a lack of awareness, language, stigma or other challenges. We can be really targeted with the work – working with groups to access communities that are hidden from our services.”
LSL and other community providers have also worked alongside services such as immigration and finance and welfare advice support and run sexual health awareness at their events.
Ms Scantlebury said: “We try to be really opportunistic by piggy-backing on other events where we know people are going to be. At these events the partnership provides advice and signposts people to services. We also have a range of open-access clinics across the boroughs alongside an online testing service.”
The boroughs also seek to address inequalities in access in other ways too. For example, King’s College Hospital has a dedicated clinic for transgender, trans and non-binary people called CliniQ. It is run on Tuesdays and provides access to HIV testing, PrEP, HIV care and support, cervical smears, hormone injections and hormone blood tests.
Meanwhile, Brook runs a condom distribution scheme for young people called Come Correct, providing free access to condoms and help and advice on how to access services.
“Everything we do we do it through the lens of reducing inequalities whether STI, HIV or access to contraception. We try to understand which groups are most at risk and design approaches that work for them,” added Ms Scantlebury.