The strategy hoped to reach its aims (see Box Two) by delivering evidence-based effective local HIV/STI programmes so that people could make informed decisions about preventing STIs, including HIV, and by setting a target to reduce the number of newly acquired HIV infections. It also hoped to increase the offer and uptake of HIV testing to reduce the number of undi-agnosed people with HIV in the UK, as well as increasing the offer and uptake of hepatitis B vaccine, both of which policies came with specific targets.
It highlights collaborative working between providers so that they deliver a more comprehensive sexual health service to patients and sees a broader role for those working in primary-care settings. The strategy also sets out a new way of working in which there will be three levels of service provision (see Table 1). The strategy acknowledges that for good practice level one service should be universally provided in General Practice, but that level two will also be provided by some general practitioners that have a 'special interest' in sexual health as well as in family planning clinics. Departments of sexual and reproductive health and HIV will provide the specialist level three services.
This comes at a time when GPs are over-stretched, and with practice nurses and primary-care nurse practitioners already providing contraceptive care (LSC, 2002) it is natural to assume that their roles will be expanded to incorporate these recommendations. It has been suggested that nurses working in primary care already provide advice and health promotion around sexual health issues (LSC, 2002). Alternatively, GP practices may employ sexual health nurse practitioners to undertake clinical sessions for them.
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