Sexual Health & Family Planning - Essay Example

Sexual Health & Family Planning Name Institution Date Abstract Adolescence is a stage characterized by desire to experiment, influence by peer pressure, relatively short-term relationships, and impractical expectations regarding the likelihood and consequences of contracting STIs and thus adolescences end up engaging in risky sexual behavior which has led to high incidence of STIs among adolescences. Australian adolescents are putting themselves at risk of STI by engaging in risky sexual activities. Sexually Transmitted Infections are among the most common infections among adolescents in Australia. Chlamydia is among the most common notifiable diseases within Australia and studies indicate that Chlamydia infections are very high in young people aged between 15 to 29 years. Sexually transmitted infections are the main causes of female reproductive morbidity where they have been linked to spontaneous abortion, preterm labor, and pelvic inflammatory disease, ectopic pregnancy, chronic pelvic pain, in addition to tubal-factor infertility. Therefore, there is need to have prevention strategies to reduce the rate of STIs among adolescents and eliminate negative consequences of STIs such as inflammatory disease, ectopic pregnancy, tubal-factor infertility and such. Some of the prevention strategies include behavioral approaches that target changing the behavior of adolescents for instance educating adolescents on the importance of practicing safe sex, promoting condom use among adolescents and encouraging them to have sexual partners. Structural approaches have also been found to be effective in reducing STIs and actions such as eliminating barriers that prevent adolescents from maybe practicing safe sex or accessing healthcare facilities may be effective in reducing incidence of STIs among adolescents. Additionally, biomedical approaches such as vaccination, condom use and screening have been shown to be effective in prevention and reducing the rate of STIs infections. Sexually Transmitted Infections in Adolescents in Australia Introduction According to WHO (2010) adolescents are individuals aged between 10 and 19 years and adolescents make up around 20 percent of the world’s population yet the group has been constantly ignored partially because adolescents have been considered as a comparatively healthy age group without heavy burden of diseases. Nonetheless, recently adolescents are being recognized by the policy makers in regard to several health-allied vulnerabilities. The main causes of deaths among adolescents encompass suicide, accidents, drug abuse as well as infections and complications allied to sexual and reproductive health (Allen, 2013). Adolescence is perceived as a determinant of health in later life since behavioral patterns acquired during adolescence last throughout adult life and about 70% of premature deaths among adults result from behaviors that started during adolescence (Allen, 2013). This aim of this paper is to analyse the incidence of STIs among Australian adolescents, their sexual behavior and the preventative measures that can be used in preventing and reducing the incidence of STIs among adolescents. Sexual Behavior and Early Sexual Activity among Adolescents According to Addy (2010), adolescents go through developmental processes that can results to risky sexual behaviors because adolescence stage is normally typified by desire to experiment, being swayed by peer pressure, comparatively short-term relationships, and impractical expectations regarding the probability and consequences of contracting STIs (Addy, 2010). Australian adolescents are putting themselves at risk of STI by engaging in risky sexual activities. For instance, Australian adolescents are the most regular users of emergency contraception at Australian Family Planning clinics and this indicates that adolescents engage in unprotected sexual activities. 45 percent of sexually active high school students in Australia do not always use condoms during sexual activities (Coyle, 2010). In addition, adolescents do not take contraception especially the first one year after starting engaging in sex and thus most of teenage pregnancies take place during the first six months of sexual activity. Due to this and also since younger age is a major risk factor for Chlamydia trachomatis infection, Chlamydia is the most common type of STI among adolescents (Australian Government Department of Health and Ageing, 2010). Engagement of early sexual activity is an alarming issue in adolescent development. Research indicates that adolescents are engaging in sexual activities at earlier ages and generally adolescents aged 15 years and above illustrate a decrease in early sexual activity while younger one aged 13 years and below indicate an increase in sexual activity. Additionally, two-thirds of high students in Australia report engaging in sex prior to high school graduation (Coyle, 2010). Another aspect that influences adolescents to engage in various sexual experimentation activities include peer pressure. Adolescents who experiment in sexual activities are at higher risk of contracting STIs and this also includes HIV/AIDs. Furthermore, risk for early sexual experimentation is allied to additional high-risk behaviors during adolescence such as sexual abuse and drug/alcohol use which are some risk behaviors that contribute to risk sexual behavior among teenagers (Chinsembu, 2009). In regard to teenage, early-maturing teenagers have a higher likelihood of engaging in early sexual experimentation as compared to later-maturing teenagers. The early maturing adolescents confront their upcoming sexuality at younger ages as compared to their peers and have a high likelihood of being pursued by older peers in the society since they are perceived as physically older than their age (Coyle, 2010). Both male and female during the adolescence stage represent a time when they are under so much pressure to engage in sexual activities where adolescence begins earlier in girls than boys where they start growing into womanhood and hence turn into sexualized objects. In the media, images of sexuality can socialize adolescent girls into perceiving themselves as sexual objects. On the other hand, adolescent boys are pressured to demonstrate their manhood by pursuing the girls and these are some of the things that pressurize both young girls and boys to engage in early and risky sexual activities (Etuk, S., 2005). As research indicates, early sexual activities among adolescents do not tackle early patterns of noncoital sexuality. Noncoital sexuality refers to engagement in sexual contact without including exchange of body fluids. Research further indicates that by mid adolescence age, most adolescents have started engaging in sexual experimentation activities, encompassing kissing with about 97% of adolescents having their first kiss by age 15 (Herrling, 2002). Understanding the beginning of noncoital sexuality and aspect that influence its timing is fundamental in delineation of patterns of early sexual activity within adolescents. Even though research indicates that young girls and boys are increasingly using condoms, psychosexual development is a major challenge that adolescents face and thus some adolescents are inadequately informed and although they might opt to use protective measures such as contraceptives, they might use them wrongly and hence there is a need to educate adolescents on the correct usage of contraceptives and protective measures, along with behavioral measures to prevent adolescents against engaging in risk sexual behaviors (Herrling, 2002). Sexually Transmitted Infections in Australian Adolescents As Kirby Institute (2013) indicates, Sexually Transmitted Infections are among the most common infections among adolescents in Australia and the incident of the STIs is rising among this age-group. Chlamydia genital infection is among the most common notifiable diseases within Australia and most of Chlamydia genital infections are found within the youths aged 25 years and below and because Chlamydia infections are asymptomatic, reported incidence rates are probably underestimates which means in reality the incidence rates are much higher (Health Direct Australia, 2012). Therefore, prevalence data is fundamental when estimating the true burden of disease. The few incidence studies carried out within Australian adolescents indicates that the incidence rate of Chlamydia infection has risen up to 28 percent and these statistics correlate with rates reported in America. In particular, aboriginal adolescents represents a high risk group for both gonococcal and Chlamydia infections. Chlamydia is transmitted from one individual to another through unprotected sex. As Health Direct Australia (2012) indicates, there were around 80,800 Chlamydia infections within Australia in 2011 where youths aged between 15 to 29 years accounted for more than 80 percent of the reported Chlamydia cases (Health Direct Australia, 2012). The health, economic and social effects of sexually transmitted infections and especially repeated infections are significant. For instance, ascending infection has been shown to be the major cause of pelvic inflammatory disease and adolescents are at higher risk of developing this complication as compared to adults. Pelvic inflammatory disease can result to tubal infertility, chronic pelvic pain as well as ectopic pregnancy, which eventually leads to significant drains on public finances in adult years (Kirby Institute, 2013). Preventing Sexually Transmitted Infections among Australian Adolescents Hawkins (2009) explains that STI prevention programs among adolescents should focus on changing behavioral changes to change the conditions in which high risk behaviors are likely to occur as well as promoting prompt treatment of curable STIs and promoting safer sexual practices such as condo use. Within Australia, the level of education adolescents get regarding sexual health is variable. Federal Government has developed an evidence-based curriculum program in high-schools aimed at preventing STIs and HIV/AIDs (Hawkins, 2009). The implementation of the program has occurred within government schools to varying levels within all states. Similarly, in Western Australia, a school-based health promotion program has been implemented in schools. Successful results in changing the behavior of adolescents have been shown using controlled studies within Australia. Behavioural interventions and elevated awareness have been shown to be effective in reducing STIs among adolescents. This is can be done by educating the teenagers regarding STIs at home, school and healthcare institutions as well (Kirby Institute, 2013). However, education alone cannot prevent STIs because it might not result to behavioral changes that lower the risk to STIs and hence it is important to emphasize to adolescents how they can identify symptoms of STIs and be aware the in normally transmission of STIs occurs through asymptomatic partners. Healthcare providers should focus on primary prevention which is reducing the number of new cases of sexually transmitted infections by evading exposure and prevention of infection through correct information regarding STIs, postponing sexual engagement, promoting consistent condom usage as well as implementing suitable vaccination strategies. Likewise, healthcare providers can prevent STIs through secondary prevention by reducing the number of existing STIs cases through early detection, treating and screening as this can be particularly useful in identifying asymptomatic carriers. Tertiary prevention involves reducing the STI sequelae (Kirby, 2008). Behavioural Strategies In preventing STIs, behavioral strategies center on motivation of adolescents to modify the behaviors that increase their risk to STIs and this may include increased condom use r reducing the number of sexual partners. Behavioural approaches may include communication through peer education, school programs or media. The key strength of behavioral approaches is that they incorporate “life skills” factor which centers on development of core sexual communication skills such as negotiating on condom use (Kirby, 2008). The programs are laudable because in spite of adolescents having knowledge on the transmission routes and health effects of sexually transmitted infections and the need to change behavior, some adolescents are often not knowledgeable on how they can negotiate with their sexual partners on how to implement protective behaviors (Lo, 2012). The behavioral approaches can focus on advocating for the following behavior changes among adolescents: Abstinence Only: Abstinence Only programs encourage adolescents to abstain from engaging in sexual activities until marriage and the approach emphasizes that abstaining is the only 100 percent effect way of preventing STIs. However, even though abstain from sex is the only 100 percent effective prevention strategy, abstinence often has been proved as impractical behavior for many individuals because as studies indicate, so many adolescents are engaging in sex. Consequently, abstinence programs have not been successful in reducing incidence of STIs or risky behaviors among adolescents since participants are not able or decide not to abstain from sexual activities. Accordingly, it is important to integrate other behavioral change strategies in abstinence programs to ensure that, the big percentage of individuals who are not able to abstain are targeted during the behavior change process (Markham, 2010). Abstinence Plus (ABC): Abstinence plus programs encourage abstaining as the most effective way of preventing STIs and additionally offer evidence-based information regarding the efficacy of condoms, delayed sexual introduction and reducing number of sexual partners as other effective ways of reducing STIs. Studies indicate that abstinence plus programs have been successful in changing sexual behaviors, such as reducing the number of sexual partners (Mitchell, 2014). Steady Condom Use: These programs promote the consistent usage of condoms and hence can be useful among teenagers who research shows that a big number of them do not use protection during sexual activities. Studies indicate that consistent use of condoms among adolescents has not only been effective in reducing the STIs but also significantly reduced the rate of pregnancies among teenagers. Several programs promoting consistent use of condos have produced successful outcomes in regard to STIs and HIV prevention (Markham, 2010). Access to Health Facilities: Such a behavioral program focuses on encouraging adolescents to visit health facilities where they can access diagnostic and treatment services. The health facilities also provide information regarding STI risk factors and prevention methods. More importantly, visiting health facilities can be important in detecting asymptomatic individuals when screening is done (Mitchell, 2014). Structural Strategies As per Mitchell (2014) explains, structural factors such as political, economic, social and environmental aspects play a big role in the transmission of STIs since they determine and limit people’ sexual behaviors. Structural strategies in preventing STIs focus on changing the conditions in which the people are to make them favorable to STIs prevention (Markham, 2010). For instance, a program aimed at reducing STIs among sexually active adolescents can involve availing condoms to adolescents as well as incorporating a range of interventions and the program being conducted in a setting supporting open discussion of STIs, the risk factors and prevention strategies and including social and political mobilization of the sexually active teenagers (Lo, 2012). The structural approaches to STI prevent can also encompass changing attitudes and reducing social marginalization: for example, teenagers who are sexually active are encouraged to use condoms yet they fear buying condoms and also might also fear accessing health facilities to obtain information regarding safe sex and screening of STIs since mostly adults are have the attitude that at such young age adolescents should not be engaging in sexual activities. Structural approach may also include increasing access to preventative technologies such as availing condoms in schools or offering free healthcare services (Markham, 2010). Biomedical Strategies Various biomedical strategies are successful in prevention of various STIs and they include: Condoms: Condoms provide a barrier to sexual fluids during sexual activities and when used correctly they are 95% effective when used properly and constantly. Therefore, it is important to ensure that condoms are used appropriately and correctly to prevent breakage and spillage which may occur in case a condom is not applied correctly (Wang, 2011). When used correctly, condoms are effective in prevention of STIs such as HIV, gonorrhoea, Chlamydia as well as trichomoniasis. However, condoms are less effective in protecting against ulcerating genital infections since the anatomical protection that condoms offer only covers the penis and does not cover other genital regions such as the scrotum. In addition, condoms do not offer a full barrier in ulcerating STIs transmission since ulcerating STIs are transmitted through contact between infected skin and mucosal surface while condoms prevent STIs that are transmitted via vaginal fluids and semen (Wang, 2011). Vaccination: STIs such as Hepatitis B and HPV can be prevented through vaccination. STIs Treatment to Prevent Curable STIs: A big number of STIs can be treated by administering antibiotics. Treatment of STI carriers gets rid of the risk of a carrier’s partner getting the disease. Nonetheless, adolescents with STI might not seek either due to the fact that they are asymptomatic and do not know if they are infected with an STI or they may find it hard to visit a healthcare facility for STI treatment for instance because they fear or are uncomfortable (Wang, 2011). Identification of STI carriers can therefore ensure that carriers receive treatment. Adolescents should be encouraged not to be embarrassed about going to a healthcare facility for check up in case they think that they might have been exposed to an STI after having a casual unprotected sex. Healthcare providers who come into contact with adolescents with STIs during their general practice should treat them and also offer advice regarding STI prevention to the teenagers (Lo, 2012). Screening of Adolescents because they are High Risk Population: Since several STIs are asymptomatic yet they can be diagnosed with simple tests, it is advisable to have healthcare providers screening patients who they think might be at risk of STIs. Studies indicate that young people aged between 15-29 years are at high risk of having STI and hence in case a healthcare provider encounters adolescents which a risk factor in STI, the general practitioner should screen them for STIs (Mitchell, 2014). Conclusion The incidence of STIs among Australian adolescents is high and as the paper indicates adolescents are engaging in high risk sexual behaviors such as having unprotected sex which increases their risk of contracting STIs. Chlamydia genital infection is among the most common notifiable diseases within Australia and most of Chlamydia genital infections are found within the youths aged between 15 to 29 years. As a result, it is important to come with prevention strategies to reduce the rate of STIs among adolescents to do away with negative consequences of STIs such as inflammatory disease, ectopic pregnancy, tubal-factor infertility and such. Some of the prevention strategies include behavioral programs such as educating adolescents on how to practice safe sex by using condoms and have few sexual partners. Structural approaches may include eliminating barriers that prevent adolescents from maybe practicing safe sex or accessing healthcare facilities. Lastly, biomedical approaches such as vaccination, condom use and screening can also be used in preventing STIs among adolescents. Bibliography 1. Allen C., 2013, Situation Analysis of Adolescent Sexual and Reproductive Health and HIV in the Caribbean, Caribbean: Pan American Health Organization. 2. 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