Local authorities and HIV prevention
“The drug and alcohol, homeless and carers team have all been trained to offer blood spot testing and carry these to offer to individuals in any locality area”
“[Name of service] provides information on needle exchange… and is due to provide testing and other advice on addictions.”
- Local Authority Social Worker
Local authorities contribute in particular to two key HIV prevention areas - testing and education.
Research for the HIV Scotland report 'Making the Vision a Reality' (January 2015) showed that a number of local authorities either directly provide testing services, or fund testing initiatives which are run by third sector organisations.
Where local authorities provide testing services directly, these are often linked to drug, alcohol and addictions services. In some areas local authority staff have been specifically trained to provide blood spot testing, and carried test kits with them to offer testing when carrying out their duties. During the research, local authorities also identified their contribution to harm reduction strategies - such as supporting needle exchange programmes - as being a key component of HIV prevention work.
The way in which testing is provided varies across local authorities. For example, one local authority social work team supporting people living with and at risk of HIV and viral hepatitis - as part of a drug and alcohol service - has taken the decision not to offer testing. This was because the service operates a policy of not conducting tests to determine whether clients with drug addictions had relapsed, in order to build a relationship of trust between clients and social workers. As testing someone for a blood borne virus might be viewed by some clients as inadvertently testing for continued drug use, there was concern that this might undermine confidence in the service.
In addition to testing, local authorities also play a key role in education and health promotion. Local authorities are responsible for ensuring that Relationships, Sexual Health and Parenthood Education (RSHP) is delivered to all young people. Whilst guidance on the provision of RSHP exists for local authorities, it is still up to local authorities and head teachers to decide what is provided in their schools and what training is provided to support their staff.
One local authority described having a specific sexual health team which takes a pro-active role in relation to education and health promotion. This team directly provides seminars for young people within schools about sexual health and risk taking behaviour. A section of each four hour seminar is specifically dedicated to considerations of HIV and includes a panel discussion with people living with HIV.
Because of their work with local communities, councils are also well placed to act as a partner to NHS colleagues in health promotion and education about sexual health outside of formal education settings. Interviews carried out with local authority staff showed that joint education and health promotion activities - including developing staff training for groups such as teachers and social workers - are primarily organised through formalised structures such as the local MCN and community health partnerships.