Sexual And Reproductive Health Of Young People

Pregnancy, child birth and sexually transmitted infections are major health concerns for young people. In Australia, pregnancy termination (abortion) is the second most common hospital procedure for girls and young women aged 12 to 24 years. Contraception and sexual health problems are the most common issues for which young women see their family doctors. Young men seek help less frequently, but they also have concerns about sexual health, contraception and sexually transmitted infections.

Sexual behaviour of teenagers

• Teenagers tend to take risks because of their stage of development. Some take many more risks than others, but all may take risks with their health.

• Teenagers often take risks because they believe that they will not be harmed – they tend to think of themselves as immortal or invincible. They also like experimenting and want the approval of their friends.

• Teenagers generally do not understand how easy it is to become pregnant or to catch a sexually transmitted infection.

• Teenagers often have short-term relationships – if they are sexually active, the risk of problems arising is greater with a greater number of sexual contacts.

• They often do not follow safer sex guidelines, even when they know what to do, and why.

Contraception

• On average, teenagers do not seek information from a doctor about contraception until at least 12 months after they have started sexual activities.

• About 45% of sexually active teenagers in Australia do not use condoms most of the time (condoms can prevent the spread of many sexually transmitted infections, as well as prevent pregnancy).

• About 30% use only condoms, which are less effective than some other forms of contraception.

• Half of adolescent pregnancies happen in the first six months of sexual activity.

• Teenagers are the most frequent users of emergency contraception.

Sexually transmitted infections

• Chlamydia infections are common in young people, and seem to be increasingly common.

• Most infections with chlamydia do not cause symptoms, but the infection can cause pelvic inflammatory disease in women (PID), and go on to cause infertility (inability to have babies), chronic pelvic pain and ectopic pregnancy (where the baby develops outside of the uterus - a potentially life-threatening situation for the mother).

• Chlamydia infections in males often do not cause any symptoms, and can be passed on to women without the male knowing it.

• Gonorrhea is another sexually transmitted infection that is occurring more often

Teenage pregnancy

• In South Australia in 2005, 923 teenage women gave birth and 887 teenage women had terminations of pregnancy (abortions). The teenage pregnancy rate of 36.1 per 1000 women in 2005 was the lowest rate recorded since 1970 which is when statistics began to be available.

• Young women who become pregnant in their teenage years are more likely to be single, smokers, to be living in areas that are socially disadvantaged, and to be using illicit drugs or alcohol – however, many pregnant young women do not fit this ‘stereotype’. Young aboriginal women are also more likely to get pregnant during their teenage years.

• Babies who are born to teenage mothers are more likely to be born early, have a low birth weight and have major health problems at birth.

Prevention of high-risk sexual behaviour

• Countries that have in-depth sexual health education programs (such as the Netherlands and some other European countries) have a lower rate of teenage pregnancy, terminations and sexually transmitted infections.

• Countries such as Australia, USA and Britain, where there is less comprehensive education about sexual health, have significantly higher rates of teenage sexually transmitted infections, teenage pregnancies and terminations.

• Many people strongly believe that teaching young people about contraception and safe sex promotes earlier sexual activity, but research evidence does not support this belief.

• Programs that also look at other risk behaviours, and that help young people to make safe choices and resist social pressures, seem most effective.

• Having easy access to contraceptive products is also seen as important.

Going to a doctor or health clinic

• Many young people find it difficult to talk about their sexual health needs, especially if they are not sure that the doctor will keep the visit confidential.

• There are youth health services in many areas, and sexual health is a very frequent reason for visits. At these clinics, confidentiality is very important.

• There are also clinics that specialise in sexually transmitted infections. They provide expertise and a very confidential service.

• In some regions (eg. in South Australia), parental consent is needed for treatment of young people under 16 years of age.