Chapter 2: The Outcomes
In line with the Scottish Government's Quality Strategy, this Framework is focussed on outcomes rather than inputs or processes. This approach will ensure that all partners, nationally and locally, are working to the same shared agenda while having the freedom to take different approaches in the way things are done. We want to foster innovation and imaginative solutions to delivery, while retaining a focus on what we ultimately want to achieve.
The Framework Outcomes are:
Outcome 1: Fewer newly acquired blood borne virus and sexually transmitted infections; fewer unintended pregnancies.
The Framework intends to improve public health through reducing the harm that can be caused through preventable infections and poor sexual and reproductive health. This will be achieved through strong health improvement prevention and education initiatives amongst professionals and the public (especially those at risk).
Outcome 2: A reduction in the health inequalities gap in sexual health and blood borne viruses.
Health inequalities remain a significant challenge in Scotland. This is clearly illustrated across sexual health and blood borne viruses, where the greatest impact is on those most vulnerable in society, from socio-economic inequality to the impact of sexual orientation, gender and race.
This outcome will support focussed improvement and targeted intervention locally and nationally in order to ensure that nobody is inappropriately disadvantaged in prevention, treatment and care.
Outcome 3: People affected by blood borne viruses lead longer, healthier lives.
More and better targeted testing, early diagnosis and effective treatment and care of blood borne virus infections underpinned by high quality personal and social support are essential in ensuring long-term health. Effective treatment, and curing of infections where this is possible, will help reduce onwards transmission. The Framework will seek to improve practice in these areas. Better partnership working, including closer links with sexual health and drug and alcohol misuse partners, will support people living with blood borne viruses.
Outcome 4. Sexual relationships are free from coercion and harm.
Holistic approaches to sexual wellbeing are central, not only to tackling sexual ill-health but to ensuring a positive approach to sex and sexual relationships for people of all ages. This includes tackling issues around gender-based violence, homophobia and racism.
This will be achieved through improvements in knowledge and awareness; promotion of positive sexual health and through targeted education, awareness raising and social marketing amongst the public and professionals.
Outcome 5: A society where the attitudes of individuals, the public, professionals and the media in Scotland towards sexual health and blood borne viruses are positive, non-stigmatising and supportive.
Changing the culture in Scotland around sex, sexual relationships, sexual health and blood borne viruses is challenging, but vitally important.
We must support people living in Scotland to improve their health and wellbeing by encouraging communication and positive attitudes to sex, sexual health and blood borne viruses.
Changing the culture is also essential if we are to reduce onward transmission of infection and ensure that those people living with, and affected by, blood borne viruses are able to feel they are equal and valued members of our society. Many people living in Scotland have outdated knowledge about blood borne viruses, the way in which they are transmitted, life expectancy, quality of life for someone living with a blood borne virus and the realities of living on treatment for a lifetime.
Linking with these ambitions, there is a need to normalise attitudes towards the provision of HIV, viral hepatitis and sexual healthcare in Scotland, moving away from an exceptional approach and towards a more transparent and mainstream one.
The indicators which will measure progress against these outcomes are set out in more detail in Appendix 1.