Sexual Health and Reproductive Services

The purpose and reasons for the modification are detailed below: Expanding HIV Pre-exposure prophylaxis (PrEP) - HIV PrEP is a vital tool for preventing HIV transmission. The contract currently delivers HIV PrEP but the Council intends to expand access to this to populations currently not accessing the service, including black and minority ethnic groups and women, with new injectable techniques likely to be more acceptable and accessible to these groups Doxycycline post-exposure prophylaxis (Doxy-PEP) - The UK has released its first national clinical guidelines for doxycycline post-exposure prophylaxis (Doxy-PEP) to prevent syphilis and chlamydia.

New Doxy-PEP drug interventions are available and the Council is seeking to implement this guidance using new interventions. Integration of Tuberculosis (TB) testing - The Council is seeking to integrate testing of viral Hepatitis B and C and Tuberculosis (TB) into the service because these conditions can be effectively co-targeted with significant overlap with respect to specific cohorts at high risk.

There is a high co-infection rate for TB and HIV. Testing at the same time allows for faster diagnosis, better treatment planning and helps prevent serious illness and spread.

Whilst there is an existing TB prevention and control service which is delivered by the same provider (LUHFT) it is not commissioned by LCC and it does not offer latent TB screening. Adding TB testing to the existing contract will enable more effective and efficient targeting of population groups at increased risk of TB. The contracted provider is already targeting these at risk groups for STI and BBV screening.