Advice on... Sexual health
Thursday, March 6, 2008
There has been a surge in the number of young people contracting sexually transmitted infections in recent years. But advising teenagers about sexual health matters poses ethical dilemmas for youth workers. Advisory service Brook offers some answers.
Q: How many teenagers are contracting sexually transmitted infections (STIs)?
A: Since 1995 there has been a dramatic rise in the diagnosis of acute STIs such as genital chlamydia, gonorrhoea, syphilis and genital warts. Chlamydia cases increased by more than 200 per cent between 1995 and 2004, gonorrhoea cases by more than 100 per cent and syphilis, which only affects a small number of people, rocketed by 1,497 per cent. In particular, there has been a large increase in sexually transmitted infections among teenage women and men who have sex with men.
In 2004, 76 per cent of diagnoses of chlamydia infections in women occurred in the under-25 age group and 36 per cent of diagnoses were in 16- to 19-year-old young women. It is estimated that as many as one in 10 sexually active young women may be carrying the infection. A chlamydia screening programme, launched in 1999, will provide a clearer picture.
Q: Why are STIs so common among teenagers?
A: There is evidence that young people's awareness of STIs is increasing but that they do not perceive themselves as at risk. A survey in 2004 found that 92 per cent of women and 87 per cent of men aged 16 to 24 were aware of chlamydia but only 58 per cent of women and 64 per cent of men in the same age group said they always used condoms.
Q: Why do STIs require treatment?
A: STIs can have serious longer-term consequences. They can cause fertility problems or ectopic pregnancy and can lead to other serious infections such as pelvic inflammatory disease. They are usually caught from having vaginal or anal sex without a condom, or sometimes through oral sex.
They can also be passed by skin- to-skin genital contact with someone who has an STI. Some of the most common STIs have no symptoms so it is important young people are screened if they have put themselves at risk of infection.
Q: What can be done?
A: Brook believes young people need to be well informed about the risks of STIs and teenage pregnancy so that when they choose to become sexually active they are able to protect their sexual health.
Sexual health information, education and services also need to be relevant to young people's experience of sex and relationships. Messages need to link unwanted pregnancy, STIs and HIV together and put them in the context of young people's lives.
Making sex and relationships education a statutory part of the national curriculum and providing services that are accessible, confidential and well publicised are crucial to improving young people's sexual health.
It is important to encourage the use of condoms, either alone or in addition to the usual method of contraception, to protect against STIs.
Q: What should I do if I suspect a young person is having unprotected or risky sex?
A: The revised version of Working Together to Safeguard Children from Harm provides guidance on working with sexually active young people. But different organisations will have different protocols and guidelines. Clearly, decisions depend on the age and circumstances of the young person.
Youth workers can give young people, including those under 16, information about contraception and sexual health and details of local services. There is also no law that prevents appropriately trained youth workers from giving condoms to young people.
It is good practice for youth workers to follow the Fraser Guidelines. This states that when making decisions about whether to share information about a young person the child's best interests must be the overriding consideration. Professionals have discretion to make decisions on a case-by-case basis.
The guidance states that cases involving under-13s should always be discussed with a nominated child protection lead officer in the practitioner's organisation. However, professionals have the discretion not to refer a young person to other agencies where this would not be in their best interest.
For more guidance on young people and confidentiality, see www.brook.org.uk/content/M1_sexandthelaw.asp
This article has been complied by Brook's Ask Brook advisers
MORE INFO
Brook has experience of clinical, education and outreach work with young people. You can find out where your nearest Brook is by visiting www.brook.org.uk
Other useful websites include:
- www.fpa.org.uk
- www.playingsafely.co.uk
- www.ruthinking.co.uk
- www.thesite.org.uk
- www.tht.org.uk
