Youth Sexual HealthFacts 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 intercourse1 (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. 4th 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)

0

2,000

4,000

6,000

8,000

10,000

12,000

14,000

2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Year

Nu

mb

er o

f n

oti

fica

tio

ns

-

Male Female WA (Total)

Number of gonorrhoea notifications by sex, WA,

2002 to 2011

Source: Epidemiology and Surveillance Program, Communicable Disease Control Directorate (CDCD)

0

200

400

600

800

1,000

1,200

1,400

1,600

1,800

2,000

2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Year

Nu

mb

er o

f n

oti

fica

tio

ns

-

Male Female WA (Total)

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

0

500

1,000

1,500

2,000

2,500

3,000

0-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50+

Age group (Years)

Nu

mb

er o

f n

oti

fica

tio

ns

-

Male Female

Number and proportion of chlamydia in 15-24 year olds, WA, 2002 to 2011

Source: Epidemiology and Surveillance Program, Communicable Disease Control Directorate (CDCD)

64%65%64%

65%

65%66%

63%63%

63%

66%

0

2,000

4,000

6,000

8,000

10,000

12,000

14,000

2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Year

Nu

mb

er o

f n

oti

fica

tio

ns

-

15-24 years WA (Total)

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

0

50

100

150

200

250

300

0-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50+

Age group (Years)

Nu

mb

er o

f n

oti

fica

tio

ns

-

Male Female

Source: Epidemiology and Surveillance Program, Communicable Disease Control Directorate (CDCD)

STI, BBV and HIV Aboriginal: Non-Aboriginal

rate ratios1, WA, 2011

Chlamydia 4:1

Gonorrhoea 41:1

Infectious syphilis 8:1

Hepatitis B (Total) 4:1

Hepatitis C (Total) 5:1

HIV2 (2007-2011)

Males 0.7:1

Females 1.9:11 Ratio of age-standardised notification rates2 Ratio of crude notification rates

InfectionAboriginal:Non-

Aboriginal Rate Ratio

Source: Epidemiology and Surveillance Program, Communicable Disease Control Directorate (CDCD)

Region Chlamydia Gonorrhoea

Goldfields 675 244

Great Southern 389 24

Kimberley 1,663 1,542

Midwest 758 167

North Metropolitan 413 33

Pilbara 749 455

South Metropolitan 478 38

South West 386 12Wheatbelt 331 18

WA2 (Total) 480 761 Rate per 100,000 population. Age-standardised to the Australian 2001 population2 WA (Total) includes unknown/other regions

Chlamydia and gonorrhoea age-standardised notification rates1 by region, WA, 2011

Teenage Births in WA

700

750

800

850

900

950

1000

2007 2008 2009 2010 2011

Births 18 & under

Births

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).

Year NT TAS QLD WA NSW SA VIC ACT AUST

2000 68.8 26.3 223.0 21.2 16.9 15.2 11.0 10.6 17.7

2001 71.0 32.7 22.6 19.4 17.1 14.5 11.5 9.8 17.7

2002 63.3 28.3 22.3 18.8 16.5 15.5 11.3 11.1 17.2

2003 63.5 26.1 21.4 18.5 15.0 14.7 10.2 8.6 16.1

2004 56.4 24.9 21.6 19.6 15.0 13.5 10.3 7.8 16.0

2005 61.4 26.8 20.4 20.5 13.4 18.5 9.7 9.1 15.7

2006 63.5 26.5 19.7 19.6 13.2 16.7 9.7 9.1 15.3

2007 58.8 27.4 23.0 20.5 12.3 17.5 10.0 10.3 16.0

2008 51.9 27.5 24.7 22.7 13.9 18.3 10.6 8.0 17.2

2009 48.0 27.1 26.7 20.1 13.0 15.9 9.9 9.7 16.7

2010 48.1 21.5 24.0 19.1 12.9 15.3 8.5 8.9 15.5

Teenage births WA 2011

13yrs 1

14yrs 12

15yrs 40

16yrs 126

17yrs 252

18yrs 389

Induced abortions in WA

2006 2007 2008 2009

Under 15 36 25 37 44

15-19 1628 1631 1609 1551

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

GonorrhoeaManagement site

Aboriginal Non Aboriginal

Public Hospital

Community Health38% 4%

Sexual Health

Family Planning4% 25%

AMS 42% 1%

GP 9% 64%

Other 7% 7%

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