Abstract:The sexual health needs of teenagers differ from those of adults.
Young sexually active teenagers are at high risk of Chlamydia trachomatis genital infection and its complications.
Teenage pregnancy continues to be a problem in Australia.
Current preventive strategies and clinical services in this domain of adolescent health in Australia are deficient.
Australia can learn from the innovative and effective strategies developed in various countries for preventing high‐risk sexual behaviours in teenagers.
“…Indigenous teenagers, like other teenagers, are experimenting with sex, but not practising safe sex reliably. They need access to comprehensive information about sex, relationships, contraception and infections in a safe, shame‐free environment 11 , 15 …”
Section: Discussionmentioning
confidence: 99%
“…The high teenage fertility rate among Indigenous women of 69 per 1000 is more than four times the rate among all Australian teenage women; 8 20.2% of pregnant women seen at the Mums and Babies section of Townsville Aboriginal and Islander Health Services are teenagers 9 . Indigenous young people are considered a priority group for sexually transmitted infection (STI) strategies 10 and teenage pregnancy programs, 11 and have lower rates of contraceptive use than non‐Indigenous young people 12 . Indigenous adolescents deal with youth transitions and sexual maturation in a society that is often hostile, 13 facing socioeconomic and educational disadvantage while working through tasks integral to forming their Indigenous cultural identity 14 .…”
Objective: To gain some understanding of the attitudes and behaviours of Indigenous young people in Townsville concerning relationships, contraception and safe sex.
Design: Cross‐sectional study using a computer‐assisted self‐administered survey and single‐sex focus group discussions designed by a Young Mums’ Group operating on participatory action principles and acting as peer interviewers.
Participants and setting: 171 Indigenous students in Years 9–11 at three high schools and 15 residents of a homeless youth shelter in Townsville, Queensland, 27 April – 8 December 2004.
Main outcome measures: Self‐reported attitudes and behaviour about relationships, sexual intercourse and contraception.
Results: 84/183 participants (45.9%) reported past sexual intercourse, with 56.1% commencing intercourse at age 13–14 years. The likelihood of having had sex increased with being male (P = 0.001), increasing age, increased perceived sexual activity of peer group (both P = 0.000), and drinking alcohol at least weekly (P = 0.015). Young women were more likely to report unwanted sexual touching (P = 0.031), and less likely to report enjoying sexual intercourse (P = 0.001). The main qualitative themes concerned females’ reputations, coercion, and denial of female desire. Only 49/80 participants (61.3%) reported always using condoms. The main reasons for not using contraception were “just not thinking about it”, shame, and problems with access. Despite having reasonable knowledge about contraception, most lacked the confidence and negotiation skills to communicate with partners about condom use.
Conclusions: Like teenagers elsewhere, Indigenous teenagers in Townsville are becoming sexually active at a young age, and not practising safe sex reliably. The need to protect their reputations puts young women at risk by not being prepared for safe sex by carrying condoms.
“…Indigenous teenagers, like other teenagers, are experimenting with sex, but not practising safe sex reliably. They need access to comprehensive information about sex, relationships, contraception and infections in a safe, shame‐free environment 11 , 15 …”
Section: Discussionmentioning
confidence: 99%
“…The high teenage fertility rate among Indigenous women of 69 per 1000 is more than four times the rate among all Australian teenage women; 8 20.2% of pregnant women seen at the Mums and Babies section of Townsville Aboriginal and Islander Health Services are teenagers 9 . Indigenous young people are considered a priority group for sexually transmitted infection (STI) strategies 10 and teenage pregnancy programs, 11 and have lower rates of contraceptive use than non‐Indigenous young people 12 . Indigenous adolescents deal with youth transitions and sexual maturation in a society that is often hostile, 13 facing socioeconomic and educational disadvantage while working through tasks integral to forming their Indigenous cultural identity 14 .…”
Objective: To gain some understanding of the attitudes and behaviours of Indigenous young people in Townsville concerning relationships, contraception and safe sex.
Design: Cross‐sectional study using a computer‐assisted self‐administered survey and single‐sex focus group discussions designed by a Young Mums’ Group operating on participatory action principles and acting as peer interviewers.
Participants and setting: 171 Indigenous students in Years 9–11 at three high schools and 15 residents of a homeless youth shelter in Townsville, Queensland, 27 April – 8 December 2004.
Main outcome measures: Self‐reported attitudes and behaviour about relationships, sexual intercourse and contraception.
Results: 84/183 participants (45.9%) reported past sexual intercourse, with 56.1% commencing intercourse at age 13–14 years. The likelihood of having had sex increased with being male (P = 0.001), increasing age, increased perceived sexual activity of peer group (both P = 0.000), and drinking alcohol at least weekly (P = 0.015). Young women were more likely to report unwanted sexual touching (P = 0.031), and less likely to report enjoying sexual intercourse (P = 0.001). The main qualitative themes concerned females’ reputations, coercion, and denial of female desire. Only 49/80 participants (61.3%) reported always using condoms. The main reasons for not using contraception were “just not thinking about it”, shame, and problems with access. Despite having reasonable knowledge about contraception, most lacked the confidence and negotiation skills to communicate with partners about condom use.
Conclusions: Like teenagers elsewhere, Indigenous teenagers in Townsville are becoming sexually active at a young age, and not practising safe sex reliably. The need to protect their reputations puts young women at risk by not being prepared for safe sex by carrying condoms.
“…(, p. 174) argue that ‘health promotion has largely failed Indigenous communities by focusing on narrowly defined behaviour change with little attention to upstream factors’. While there is a need to understand and address the precursors of both sexual and non‐sexual risk behaviours in all adolescents (Skinner & Hickey ), this is particularly relevant for Indigenous adolescents among whom sexual health is acutely influenced by social determinants of health (Marmot ). In discussing sexual health through the remainder of this article, we use the World Health Organization definition of:…a state of physical, emotional, mental and social well‐being in relation to sexuality; it is not merely the absence of disease, dysfunction or infirmity.…”
While research indicates that Aboriginal and Torres Strait Islander adolescents may be at increased risk of some sexually transmitted infections, there is limited information about factors that may place these young people at more risk of adverse sexual health than their non‐Indigenous counterparts. Current research has tended to focus on surveillance‐type data, but there is an increasing need to understand social determinants of sexual health risk. This systematic review assessed the evidence of social determinants impacting on Aboriginal and Torres Strait Islander adolescents’ sexual health in Australia. Published, English‐language literature was searched across key databases from 2003 to 2015. Fourteen studies were included in the qualitative synthesis. Findings suggest that social determinants such as access to healthcare, poverty, substance use, educational disadvantage, sociocultural context, gender inequalities, status and identity, and social disadvantage impacted on Indigenous adolescents’ sexual behaviours and sexual health risk. Evidence from the literature included in the review suggests that peer education may be an acceptable and appropriate approach for addressing such issues. There remains a need for programmes and services to be community‐developed and community‐led, thus ensuring cultural appropriateness and relevance. However, there is also a significant need for such programmes to be effectively and rigorously evaluated with data that goes beyond surveillance, and seeks to unpack how sexual norms are experienced by Indigenous adolescents, particularly outside of remote Australia – and how these experiences act as either risk or protective factors to good sexual health and positive social and emotional well‐being.
“…First, despite the prevalence of sexually transmissible infections [56-59], the delivery of sexual healthcare is limited, particularly within primary care [60-63]. This can have serious implications as some STIs remain asymptomatic and have long-term effects if left untreated [64,65]. Second, the Australian primary care sector is experiencing significant reform, the aim of which is to ‘shift the centre of gravity of the health system from hospitals to primary health care’ [66], p. 1.…”
BackgroundThe primary care sector represents the linchpin of many health systems. However, the translation of evidence-based practices into patient care can be difficult, particularly during healthcare reform. This can have significant implications for patients, their communities, and the public purse. This is aptly demonstrated in the area of sexual health. The aim of this paper is to determine what works to facilitate evidence-based sexual healthcare within the primary care sector.Methods431 clinicians (214 general practitioners and 217 practice nurses) in New South Wales, Australia, were surveyed about their awareness, their use, the perceived impact, and the factors that hindered the use of six resources to promote sexual healthcare. Descriptive statistics were calculated from the responses to the closed survey items, while responses to open-ended item were thematically analyzed.ResultsAll six resources were reported to improve the delivery of evidence-based sexual healthcare. Two resources – both double-sided A4-placards – had the greatest reach and use. Barriers that hindered resource-use included limited time, limited perceived need, and limited access to, or familiarity with the resources. Furthermore, the reorganization of the primary care sector and the removal of particular medical benefits scheme items may have hampered clinician capacity to translate evidence-based practices into patient care.ConclusionsFindings reveal: (1) the translation of evidence-based practices into patient care is viable despite reform; (2) the potential value of a multi-modal approach; (3) the dissemination of relatively inexpensive resources might influence clinical practices; and (4) reforms to governance and/or funding arrangements may widen the void between evidence-based practices and patient care.
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