Stakeholder Engagement Report - London Councils

and ad hoc. There is no consensus on the effectiveness of mass HIV prevention media
campaigns. The reach of campaigns is generally limited by size of budget. There are
high levels of social media use amongst both gay men and African communities although
patterns of usage were different.
It is acknowledged that people like to access information about health and available
services in an anonymous and confidential manner and that new technology can facilitate
this. However, without some form of co-ordination the potential for duplication is a
waste of time and resources. Any London wide HIV programme need to compliment
HIV Prevention England activity would see all boroughs agreeing on the key messages to
deliver at the same time; however, the methodology for delivering the messages could be
targeted to local needs.
It is recognised that interpersonal (face to face) interventions help people make healthier
life choices, including reducing risk taking behaviours. Interpersonal interventions
acknowledge the complexities of individual lives which clinical/medical models and
population based approaches do not; however, they are time consuming and expensive.
The push to increase HIV testing as a prevention tool was seen as potentially undermining
the individual ‘one to one’ interventions. ‘Warm referrals’ offer a solution to the lost
follow-up; stipulating this and joint working arrangements in Service Level Agreements
(SLAs) between clinical and third sector organisations can facilitate better patient pathways.
The availability of condoms and the promotion of their use was seen as an essential HIV
prevention intervention. There were a significant number of stakeholders who felt that
messages about promoting condom use had faded and that there needed to be more
high profile promotion of their use.
Better value for money could be achieved by using one centralised purchasing system
for condoms, increasing Council purchasing power. At present there are a plethora of
local free condom distribution schemes targeting different populations: gay men, African
people and young people as well as the Pan-London freedoms scheme (which distributes
condoms to gay venues) and C-Card schemes for young people.
Businesses where sex on premises is known to occur need to make a bigger contribution,
with the provision of free condoms being made a requirement of their licence agreements.
Almost all stakeholders cited the lack of consistent PHSE in schools as a gap. Young
people in London are learning about sex from the Internet and therefore there is no way
to ensure that they are getting factual information. The need to educate young gay men
about safer sex was a particular concern considering the HIV prevalence rates in London.
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How to deliver HIV prevention for London
Most stakeholders were concerned as to how to better align clinical service provision
with the HIV prevention agenda, with the role of GUM and community clinics in HIV
prevention increasing. Given that London councils are now responsible for commissioning
GUM services, there are major opportunities to improve the role of GUM in HIV and STI
prevention and to identify additional and alternative settings to increase uptake of HIV/
STI testing.
There was overwhelming consensus from stakeholders that there needs to be a lead
commissioning HIV and Sexual Health coordinator for London with the formal delegated
responsibility to support all 33 London councils. They would work closely with public
health leads, policy organisations, third sector organisations, the London local area teams
at NHS England and service users, in order to develop a robust, strategic, evidence based
commissioning plan for London.