Youth Sexual Health Facts and Figures Dr Lewis Marshall Sexual Health Physician Fremantle Hospital

Who’s doing what? 34% males and 43% females in secondary school have ever had sexual intercourse 1 (36% and 33% in 2002) 30% have had more than 3 partners in past 12 months ( 20% in 2002) 50% always used condoms ( 52% in 2002) 10% most recent sexual encounter was with someone of same gender 38% young women & 19% men reported ever having had unwanted sex 1. 4 th National Survey of Australian Secondary Students, HIV and Sexual Health

What are they getting Chlamydia is the most common notifiable disease in WA Prevalence varies from 3-18% depending on who tested Notifications serious underestimation of disease Most people with infection have no symptoms Teenage pregnancy

Number of chlamydia notifications by sex, WA, 2002 to 2011 Source: Epidemiology and Surveillance Program, Communicable Disease Control Directorate (CDCD)

Number of gonorrhoea notifications by sex, WA, 2002 to 2011 Source: Epidemiology and Surveillance Program, Communicable Disease Control Directorate (CDCD)

Number of chlamydia notifications by age group and sex *, WA, 2011 Source: Epidemiology and Surveillance Program, Communicable Disease Control Directorate (CDCD) * Excludes unknown or indeterminate sex

Number and proportion of chlamydia in year olds, WA, 2002 to 2011 Source: Epidemiology and Surveillance Program, Communicable Disease Control Directorate (CDCD)

Number of gonorrhoea notifications by age group and sex *, WA, 2011 Source: Epidemiology and Surveillance Program, Communicable Disease Control Directorate (CDCD) * Excludes unknown or indeterminate sex

Source: Epidemiology and Surveillance Program, Communicable Disease Control Directorate (CDCD) STI, BBV and HIV Aboriginal: Non- Aboriginal rate ratios 1, WA, 2011

Source: Epidemiology and Surveillance Program, Communicable Disease Control Directorate (CDCD) Chlamydia and gonorrhoea age-standardised notification rates 1 by region, WA, 2011

Teenage Births in WA

Age specific fertility rates (per 1000 per year) for 15 – 19 year old women using data from the Australian Bureau of Statistics. Data from the Australian Bureau of Statistics, Birth Catalogues (1, 5-8). YearNTTASQLDWANSWSAVICACTAUST

Teenage births WA yrs1 14yrs12 15yrs40 16yrs126 17yrs252 18yrs389

Induced abortions in WA Under

What services exist General Practice – Most young people attend a GP at least once a year ( 86% F and 67% M) but most not tested (<10%) State Services NGOs ( essentially Metro only ) – FPWA – Head Space ( Mental Health focus) – WAAC ACCHOS Local Government Corrective Services Very few youth specific services

State services RPH FH KEMH EDs Public Health units –Community health

Gonorrhoea Management site AboriginalNon Aboriginal Public Hospital Community Health 38%4% Sexual Health Family Planning 4%25% AMS42%1% GP9%64% Other7%

Issues Education –Variable commitment Health promotion and prevention –Visibility of the health issue Service provision –Workforce –Testing opportunities –Youth specific services Youth health planning and policy

Workforce Only positions for Sexual health physicians in South Metro Only 3 FTE available –Succession planning difficult Only one designated Nurse practitioner position Community Health staff not available in Metro Advanced Practice Nurse process stalled

What are possible solutions? Better Education – Youth, HCWs and Youth workers Empower young people to ask for testing – Reduce stigma Remove barriers to testing and treatment Provide youth specific services – Affordable, accessible, appropriate Invest in Sexual Health Services Develop and promulgate a Youth Health Policy