Genito-Urinary Medicine (GUM)
The Relationship Between Sexual Health and Climate Change
How Is Climate Change Affecting Genitourinary Health?
Genitourinary medicine encompasses integrated sexual health, contraception and HIV services. It is a specialty often intertwined with health inequalities which climate change is known to exacerbate.
Extreme weather events affect healthcare infrastructure creating barriers to accessing testing, contraception and treatment resulting in significant impacts on health outcomes.
Indirect consequences of climate change such as food insecurity and climate-induced migration have been linked to increase exposure to sexual and gender-based violence and risky sexual behaviours such as transactional sex.
Changes in patterns of vector borne disease and increased prevalence of infectious diseases driven by climate change could also risk health outcomes for people living with HIV.
How is GUM Affecting Climate Change?
Preventative practice, the most powerful principle of sustainable healthcare, is a cornerstone of genitourinary medicine including strategies such as cervical screening, vaccination, contraception and pre-exposure prophylaxis for HIV.
However, every health contact carries environmental impacts. Within outpatient appointments energy usage, travel, medicines and medical equipment carries a carbon footprint.
For people living with HIV there are life-long check-ups and medications to be taken. Ward stays for patients with advanced HIV can be resource intensive with long admissions and numerous complex investigations and treatment plans.
10 Steps for a Greener HIV and Sexual Health Clinic
This toolkit was compiled by the Joint BASHH/BHIVA Sustainable Healthcare Special Interest Group and is co-badged by The Centre for Sustainable Healthcare.
Discussion Ideas with Patients and Colleagues
Patients:
"Would you be happy with a telephone follow up appointment? It could save you money and time and help the environment."
"When extreme weather is predicted, such as heavy rain or particularly hot weather, it is important that you ensure you have supplies of your regular medication, as you may find that flooding or heatwaves make you less able to get to your pharmacy to get the medication."
Colleagues
"How can we reduce the number of blood tests we do on patients?"
"Is there a way of streamlining this patient’s doctor and nurse appointments to reduce repeated travel to clinic?"
Highest Impact Actions for GUM Departments
Embed climate change and healthcare sustainability in all education and governance activities
Review the "10 Steps for a Greener HIV and Sexual Health Clinic" report and work through their recommended actions
Minimise unnecessary travel. Consider virtual clinics, streamlining appointments and facilitating care closer to home for example satellite clinics or home self-testing kits.
Reduction and Re-use of some medical equipment. Examples include re-usable tourniquets, specula or by streamlining useage such as a ‘Gloves Off’ campaign.
For More Information
Check out the British Association for Sexual Health and HIV, British HIV Association and the Centre for Sustainable Healthcare's "10 Steps for a Greener HIV and Sexual Health Clinic" and the Centre for Sustainable Healthcare's GUM network