Inequalities, political and economic contexts all have an effect on a population’s sexual health.
The Coronavirus pandemic has been proclaimed to be a ‘watershed moment’ for health inequalities, with structural disadvantage and discrimination clearly demonstrated to be determinants of people’s health in recent weeks.
Inequalities, political and economic contexts all have an effect on a population’s sexual health. When we are able to comprehensively review this period, we will likely see that the restricted access to sexual health services will undoubtedly have a disproportionate impact on communities that are vulnerable, isolated, living in poverty and / or are already more likely to experience poor sexual health as a direct result of discrimination and stigma.
Lockdown can only exacerbate these inequalities by building upon existing barriers and creating additional ones
A broad range of communities are instead loosely categorised under acronyms that allow important details to be missed and prevent effective intersectional analysis from being undertaken. This hinders a more accurate picture of the nation’s sexual health, and allows health disparities to increase and continue.
Lockdown can only exacerbate these inequalities by building upon existing barriers and creating additional ones, amplifying the inequitable access to sexual health services that a number of communities experience.
Viccie Hamlet, Education and Well-being Coordinator at national sexual health charity Brook described to me, over email, the work that their education service team undertakes in Merseyside: working to engage with young people, developing a rapport and increasing confidence and self esteem in order for them to feel comfortable to attend clinical services. Now that staff are unable to deliver their regular activities, young people are without the engagement that Brook professionals offer to support their initial visit.
“Those young people who already access clinical and education services, do so not only for sexual health support but for emotional health and well-being reasons which can include matters around safeguarding, sexuality and gender and relationships. From the perspective of the education team, those service users most vulnerable now will be those struggling with mental health, those in unhealthy relationships, those hiding their sexuality and gender from families.”
“People not able to work from home, people who have to go to work to support their families so don’t have time or ability to access even the most restricted of sexual health services right now. Those demographics are going to suﬀer the hardest when we close services, because of not knowing where to go, and possibly struggling to access online services because of not having that facility or the time.”
I asked, as the country slowly returns to a more familiar routine of socialising, what issues do sexual health professionals anticipate as clinics resume their regular service?
“In terms of STI’s it’s hard to know which way that may go. On one hand people are social isolating so people may be
having less sex, in which case – less transmission. However people who have pre-existing STI’s, where the infection may be left untreated for a longer period of time, or people who don’t want to leave the house or go to hospital, we may see more complications from STIs being untreated such as Pelvic Inflammatory Disease. People could potentially be transmitting STI’s to those within, or indeed, outside of the household because of not getting treatment early.”
Dr. Sowemimo also raised that sexual health professionals have expressed expectations of increased sexual activity after a long period of isolation for many, and with it a greater renewed need for their services. However, will they be able to cope with a surge in demand?
Public health funding was cut by £700 million between 2014-2020, resulting in sexual health budgets being reduced by a quarter
The necessity of well-funded and fully supported sexual health services has been ignored and undermined for too long. In the coming months and years, it will be more important than ever that these services are financed sustainably in order to secure their outreach and ensure accessibility to those that need it most.
The feature image shows a doctor’s waiting room. In the centre of the room there is a green leaf plant, with two chairs and a table set out either side of it. Photograph by Vanessa, used under the Creative Commons License
The first image shows a brick wall with a blue heart painted on it. Within the heart, in white lettering, it reads ‘NHS’. Photograph by Gordon Joly, used under the Creative Commons License