ID: 943

Type of submission: Oral

Conference track: Practice

Topics: Harm Reduction Services and Service Provision; Human Rights and Harm Reduction

Presenting author: Elana Covshoff

Presenting author biography:

Elana Covshoff, the SHRINE Programme Manager, has 10 years experience managing a variety of community based sexual and reproductive health programmes in London, United Kingdom. She also has a MA in Human Rights Law from the School of Oriental and African Studies, University of London.

Sexual and Reproductive Health Rights, Inclusion and Empowerment (SHRINE): Developing a human rights based approach to frontline sexual and reproductive health service (SRH) for targeted groups in London, England1

Elana Covshoff, Lucy Wilson, Julie Hannah, Rudiger Pittrof

Issue:
Persons with substance dependency have a higher incidence of STIs, HIV, sexual abuse and unplanned pregnancies. Pregnancies are frequently medically complicated and socially traumatic if children are taken into care. However, this population does not use mainstream SRH services. SHRINE aims to improve the availability, acceptability, accessibility and quality of SRH services for historically highly stigmatised target groups.1

Setting:
London boroughs of Lambeth and Southwark2

Project:
Guys and St Thomas’ Charity have funded SHRINE to:
1. Establish a human rights driven SRH service for highly stigmatised target groups
2. Develop a dedicated appointment clinic to enable better access to mainstream SRH services
3. Maintain the pre-SHRINE SRH clinics in addiction services and develop further services embedded within psychiatric and learning disability services, with additional outreach like home visits

Outcomes:
An analysis of the first 2 years of service provision in specialist addiction services found that using the most conservative assumptions the provision of 133 years of long acting reversible contraception alone resulted in net savings for the NHS and social care of £118, 564. This is over 4.5 times the investment for the service during the same time and disregards any SRH benefits provided to men accessing the same service.3

1 Target groups include: persons experiencing drug dependence, people experiencing serious mental illness (bi-polar or schizophrenia), and persons with learning disabilities.
In line with General Comment 14 on the right to health
2 Approximately 10,000 people are reported to suffer from drug dependency, serious mental illness and learning disabilities, Lambeth, Southwark and Lewisham Sexual Health Strategy for 2014-17
3 Wilson, Lucy. (September 2015). An Economic Analysis of a Specialist Sexual Health Service within A Substance Abuse Treatment and Rehabilitation Centre in Southwark. Master of Public Health. King’s College London.