Young people’s use and views of a school-based sexual health drop-in service in areas of high deprivation

Abstract

Objective: To describe patterns and reasons of attendance and young people’s views of the drop-in service. Design: Analysis of a prospective database, questionnaire survey and qualitative interviews and discussions. Setting: Sexual health drop-in clinics in 16 secondary schools (including three pupil-referral units) in deprived areas of a city in South West England Methods: Nurse-completed consultations with young people; self-report questionnaires distributed by youth workers at the clinics; and interviews with young people in personal, social and health education (PSHE) lessons and at lunchtimes. Results: 515 young people made 1,303 visits over 15 months for nurse consultations (mean age 14.7 years). The mean age of first sex was 13.8 years (range 10 to 16 years). The service attracted ‘hard-to-reach’ young people, including boys, those less academically able, and those engaging in sexual intercourse at younger ages. A wide range of services were taken up including contraception, emergency contraception, sexually transmitted infections (STIs) testing and treatment, pregnancy tests, and referral to other services. Young people reported high levels of satisfaction with staff attitudes and clinic environment. Youth workers saw a younger age group than nurses, giving advice prior to sexual activity, about relationships, ‘safer sex’ and delaying sex. Barriers to use included: worries about embarrassment, cultural issues, and confidentiality. Conclusions: Locating sexual health drop-in clinics in schools within deprived communities makes them accessible to many vulnerable young people. Those having sex early attended, often before they had sex, and a large number of boys came for advice and condoms.