Over the last 25 years sexual health has become one of the most important areas of health care across the world a global pandemic of HIV, the rapid worldwide spread of other sexually transmitted infections and an increasing awareness of sexual health issues by the public globally have all increased enormously the needs of those dealing with sexual health problems to have access to information on theory and practice that can help them adverse the diversity of issues they now face Miller and Green (2002). According to WHO Sexual health is a state of complete physical, emotional, mental and social well-being related to sexuality; it is not merely the absence of disease, dysfunction or infirmity. Sexual health requires a positive and respectful approach to sexuality and sexual relationships, as well as the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination and violence. For sexual health to be attained and maintained, the sexual rights of all persons must be respected, protected and fulfilled WHO (2002). This essay focuses to describe about sexual health, importance of sexual health promotion in teenagers, different levels of interventions, sexual health policies, theories and different sexual health strategies.
AIM OF THIS ESSAY
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According to formally family planning association sexual health defined as the capacity and freedom to enjoy and express sexuality without fear of exploitation, repression physical and emotional harm FPA (2007). Rising STI rates and increasing termination rates DH (2008) indicate there is now a real need to address both issues through progressive work in sexual health care. Indeed, the HPA (2008) highlighted a clear need for people to be aware of how they can protect themselves from unplanned pregnancy and STIs, and the importance of sexual health promotion.
The essay will begin with a brief overview of sexual health promotion in young men and women in UK. The UK has the worst sexual health record in Western Europe while the teenage pregnancy rates and sexually transmitted infections including HIV and sexual violence are increasing. So the importance of sexual health promotion is increasing within young men and women. The aim of this essay is to highlights the need to reduce sexually transmitted infections among teenagers both girls and boys DH (2010) .young people reflects concerns about unintended teenage pregnancies and sexually transmitted infections .Researches are showing that how being young influences sexual behaviours exploring issues including teenage negotiation of contraception and the influence of gender and peer norms both UK and internationally ( Widdice et al. 2006).High rates of sexually transmitted continue to be reported in UK,especially among young people, men who have sex with men and some ethnic minority populations these groups remain at greatest risk infection Miles (2006). I choose the group teenagers (young men and young women) with the age group of 14 to 24for this essay. I selected the teenagers for this assignment because now the rate of teenage pregnancies, sexually transmitted infections, HIV and sexual violence is increasing in UK.
IMPORTANCE OF SEXUAL HEALTH PROMOTION
The Importance of sexual health promotion in teenagers is to reduce teenage pregnancies and sexually transmitted infections. Health care providers play a valuable role in educating their patients, and accuracy and completeness of information are the accepted standards in medicine Santelli (2008) Clinicians are held to professional standards involving medical and public health ethics, and are guided by professional health organizations. Guidelines in preventive medicine for HIV, other STIs and unintended pregnancy support the delivery of needed services, including counselling on condom and contraceptive use. Although recognition of evidence-based medicine has been increasing, wide variation exists in medical practices; often, the provider’s judgment is a component in determining patient care. Make awareness about the supportive clinics and provide counselling to the teenagers parents as well AMA (2009).
Sexuality is an important part of one’s health and, quality of life and general well being. Sexuality is an integral part of the total person, affecting the way each individual from birth to death to every single person. A healthy sense of sexuality can provide numerous benefits including a link with the future through procreation, a means of pleasure and physical release, a sense of connection with others and a contribution of self identity Norbun and Rosenfeld (2004). A teenager may go through many physical, mental, emotional, and social changes. The biggest change is puberty that means becoming sexually mature. It usually happens between ages 10 and 14 for girls and ages 12 and 16 for boys. As their body changes, the teenagers may have questions about sex and sexual health. During this time, they start to develop their own unique personality and opinions. Some changes that they might notice including, increased independence from their parents, more concerns about body image and clothes, more influence from peers, Greater ability to sense right and wrong. All of these changes can sometimes seem overwhelming Medline plus (2011).
LEGAL ISSUES OF SEXUAL HEALTH PROMOTION
In the past there has been a confused legal response to creating a balance between protecting vulnerable members of society, and giving people the right to access support for sexual health problems. The legal structure in the UK divides into civil law and criminal law. Legislation can place boundaries on the extent to which health care workers may become involved in promoting the sexual health of an individual. The introduction of the Human Rights Act (2000) has an impact on the rights of the individual and the provision of health care. Criminal law governs people’s sexual behaviour by making some activities unlawful. The purpose of the legislation is to prohibit certain sexual activities and prevent exploitation .To provide young people with the knowledge, skills and confidence to resist any pressure to have inappropriate, early or unwanted sexual relationships and to manage their sexual health .To use discussion about sex and relationships to help young people develop their self-esteem and self-awareness. .To allow young people space to explore their values and attitudes .To encourage young people to make informed decisions about their behaviour, personal relationships and sexual health .To use discussion about sex and relationships to help young people develop their self-esteem and self-awareness Mellor and Williams (2005).
SEXUAL HEALTH PROMOTION THEORIES
This implies that whether an individual puts protection that is contraception and condoms) into practice depends on the susceptibility to pregnancy or STI infection, severity of that occurrence, the result of implementation of self protection, and the barriers to implementation (Abraham and Sheeran 2005) The motivation theory is a more complex model that contains lots of components such as perceptions of severity, response costs, vulnerability, pleasure and social approval. It also includes belief that the suggested behaviour will reduce the threat and self-efficacy. Self-efficacy is a person’s belief that they can be successful in carrying out the suggested behaviour (Norman et al. 2005)
The theory of planned behaviour is a complex theory. An individual’s perceived behavioural control is the expectation that behaviour is within their control, and therefore is linked to efficacy and autonomy. Within perceived behavioural control lie several factors, including information and skill (Conner and Norman 2005).
Social cognition theory focuses on individual motivation and action based on three types of expectancy. These are the situation outcome, action outcome and perceived self-efficacy. The theories are complex and therefore need further study before putting them into practice NICE (2007) recommended that trained in sexual health care professionals put the theories into practice in one-to-one structured discussions with clients.
SEXUAL HEALTH STRATEGIES
Increase the contribution of youth mothers in education, guidance or work to decrease the danger of long term social elimination. The national strategy for sexual health and HIV accepted that the consequences of poor sexual health can be severe leading to amongst other outcomes unwanted pregnancy and termination. The strategy has established a number of key indicators including to increase access to sexual health services, including contraception, particularly to young people. To increase the percentage of young people aged 15-24 accepting screening for Chlamydia. To provide access to Genito-Urinary Medicine clinics within 48 hours DH (2001) .The legal age for young people to consent to have sex is still 16, whether they are straight, gay or bisexual. The aim of sexual offences act 2003 is to protect the rights and interests of young people, and make it easier to prosecute people who pressure or force others into having sex they don’t want. Although the age of consent remains at 16, the law is not intended to prosecute mutually agreed teenage sexual activity between two young people of a similar age, unless it involves abuse or exploitation. Young people, including those under 13 will continue to have the right to confidential advice on contraception, condoms, pregnancy and abortion Mellor and Williams (2005).
To remove the main barriers of sexual health care is to provide health education and that teaches about the sexual health care and care giving clinics. studies show that training in the area of human sexuality and taking sexual histories increases comfort and with addressing sexual health Nussbaum and Rosenfeld (2004).Sex education is offered in many schools, but don’t count on classroom instruction alone. Sex education needs to happen at home, too. Sex education basics may be covered in health class, but the teenagers might not hear or understand everything he or she needs to know to make tough choices about sex. Awkward as it may be, sex education is a parent’s responsibility. By reinforcing and supplementing what the teen learns in school, teachers can set the stage for a lifetime of healthy sexuality. Various factors peer pressure, curiosity and loneliness, to name a few steer some teenagers into early sexual activity. But there’s no rush. Sex is an adult behaviour. In the meantime, there are many other ways to express affection intimate talks, long walks, holding hands, listening to music, dancing, kissing, touching and hugging. If you’re teen becomes sexually active — whether you think he or she is ready or not it may be more important than ever to keep the conversation going. State your feelings openly and honestly. Remind the teenagers that you expect him or her to take sex and the associated responsibilities seriously.
Stress the importance of safe sex, and make sure your teen understands how to get and use contraception. You might talk about keeping a sexual relationship exclusive, not only as a matter of trust and respect but also to reduce the risk of sexually transmitted infections. Also set and enforce reasonable boundaries, such as curfews and rules about visits from friends of the opposite sex.Teenager’s doctor can help, too. A routine check-up can give teen the opportunity to address sexual activity and other behaviours in a supportive, confidential atmosphere — as well as learn about contraception and safe sex. For girls, the doctor may also stress the importance of routine human papilloma virus (HPV) vaccination to help prevent genital warts and cervical cancer MFMER (2009).
Now we are failing young people in their sexual health needs, given an increasing trend in sexually transmitted infections and unplanned teenage pregnancies .significant changes can achieve by numerous endeavours including, equipping young people with the right knowledge, reaching their aspects of themselves which hold significant value in their present day lives to get focus and attention, providing solid basement of self esteem and self preservations in the first place. This must be delivered by open minded, unbiased and non judgemental professionals in a relaxed and friendly atmosphere.HPA (2008). A number of government education initiatives over the last 10 years including the healthy schools status programme. The aim of this curriculum is to support the young people as individual and to improve their concept about sexual health in society. But in some schools trained staff refused to implement this strategies and this act as a barrier of communication with young people DH (2005) sexual relationship education in school by trained confident and up to date professionals, employing straight forward language can make an awareness of pupils existing knowledge Ingham et al (2009).young people’s sexual health clinics are available and confidentiality of service is very important. Condom distribution services are also available locally for young people. Now the sexual health campaigns for teenagers are changed from use of condoms and condom essential campaigns to a new campaign. It aims to improve the knowledge and encourage open communication about relationships among young people, their parents and professionals DH and DCSF (2009).
.the UK is still predominantly a patriarchal society. Gender imbalance can create a negative imbalance in our society. It has a reverse role when it comes to a sexual health provision. Young people’s contraceptive clinics habitually target young females. This stems from a political system desiring to protect itself from the negative consequences of un planned pregnancies ,neglecting young male services to the determent of their sexual health and well being Evans(2008).teenage pregnancy is increasing in UK among highest in Europe by year by year. There are two goals, to decrease teenage conceptions among under18 and get more teenagers parents for education, training and employment to reduce the risk. These goals were accomplished through government media voluntary and private sectors to change young peoples to sexual behaviour DCSF (2010).Health promotion programmes should be adaptable and innovative and offering different methods for feelings and expressions,and opportunities to help build self esteem. There are various economic and social influences contribute hopelessness in young people .young people are trying to express their individuality and find their position in the world Cater and Coleman (2006).According to Department of Health(2009)risk assessment is carried out by three tyre approach they are primary ,secondary and tertiary approach. In primary ,risk to teenagers that means unwanted pregnancy, sexually transmitted infections including HIV ,secondary risk is undiagnosed and un
Symptomatic sexually transmitted infections, infertility and pelvic inflammatory infections etc Territory risk is known as collateral risk to another chronic illness like exacerbation to DM depression or leukaemia .these three approaches allows for effective evaluation of both sexual and holistic consequences of risk taking behaviour among young men and women.
Another example of health promotion planning support is the effective sexual health promotion tool kit. It provides supportive toolkit for the professionals working with young people on sexual health promotion including practical tips for building self esteem and effective health promotion delivery DH (2002). Dating violence is a serious problem among adolescents and young adults. Understanding teens’ reaction to dating violence offer the potential to understand the factors that lead to perpetration of violent behaviour and to elucidate prevention strategies Dating violence, that is, violence between non-cohabitating, but courting individuals includes physical abuse, psychological abuse, and sexual abuse and has been recognized as an international and national public health problem of major proportion A great deal of current research indicates that dating violence is a serious problem among adolescents and young adults today Reyburn(2007).
Using contraception also reduces the chance of pregnancy, but the type of contraception matters, and some methods are typically more effective than others. This essential fact is the key element of the analyses reported by the research team. The investigators guess how an enormous deal of the decrease in teen pregnancy rates might be credited to better contraception by probing shifts in the types of method used at last sex combined with the typical failure rates of these methods. How shifts in contraceptive use might give to declines in pregnancy rates have not been used beforehand improves on previous attempts to estimate the behaviours fundamental changing pregnancy rates. While more teenagers are doing the right thing adults continue to debate whether the reduction in accidental pregnancies is the result of efforts to encourage abstinence or to promote improved contraceptive protection. The analyses offered here cannot distinguish the factors and motives behind reductions in sexual risk taking among teenagers SAM (2004).
The counselling with young people for their sexual health problems, and the importance of sexual health promotion will also help tanagers to get a positive approach to the area of sexual health (Lopez et al. 2008) .Thoughtful, comprehensive approaches from providers are important, given that much of the information adolescents receive on sexuality and sexual risk is erroneous and unhealthy for them (Teitelman et al. 2009). Although this study has explored the content of preventive care received by adolescents at high risk, access to care is also critical, because most adolescents—particularly low-income adolescents, who are at highest risk of pregnancy and STIs do not make normal preventive care visits. For the at-risk adolescents who do present for a clinic visit, it is all the more important to provide effective prevention counselling (Chandra et al. 2008).Pre teenage education and counselling about the prevention of un wanted teenage pregnancies, STIs and HIV to teenagers is very important.
Dual protection refers to strategies that provide guard from unnecessary pregnancy and STIs, as well as HIV. Dual shield can take various forms, including the use of condoms only or the use of condoms with a different form of contraception and the support of emergency contraception, for added safety in opposition to unwanted pregnancy. Except a couple know they are free of HIV and other STIs and are not at risk through sexual activity with others, condoms are the key constituent of double protection. Thus, better interventions are essential which hold up women as
well as men to make use of condoms through sexual intercourse, both for those living with HIV and those who may be in a discordant couple or when one or both partners are engaged in sexual activity with others who may be at risk. Most methods of contraception can be used irrespective of HIV status (Gruskin et al. 2007).
Children and Young People in Wirral are the most significant asset. We should help them all raise into positive and victorious adults. They can do this for themselves but we will help them by ensuring they receive information and services when they are needed and in a way they can best make use of them. We are committed to removing barriers that prevent us from providing the services that children and young people tell us they need Wirral Health and Well Being Charter for Wirral Children and Young People (2008) The aim of the policy is to enable any member of staff to assess and respond appropriately to young people’s needs with regards to sexual health, within their professional boundaries, and from an informed perspective.
To conclude, sexual health promotion in teenagers is a very central matter. Social cultural and political factors can hold back effective communication between health professionals and young people and can put off young people from seeking professionals help regarding sexual health issues. Sexual health promotion will reach the young people at a level that has considerable meaning to achieve change in their sexual practice and to help them to reach their most favourable sexual health and sexual identity. Sexual health promotion in teenagers will assist to reduce the rate of sexually transmitted infections, HIVs, teenage pregnancies and sexual violence.
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