Sexually transmitted diseases (STD) have recently increased among young people in Australia between the ages of 15 to 24 years old. This exemplified that chlamydia is the most common STI contracted by young people. The rate of chlamydia has tripled since 2001, increasing from 130 notifications per 100,000 to 435 cases per 100,000 (ABS, 2012). This population accounts for 50% of all STDs, despite representing approximately 25 percent of the sexually active population (CDC, 2017). STDs are an infection transmitted through unprotected sexual contact and subsequently, have severe consequences beyond the immediate impact of the infection itself (WHO, 2019). With 1 in 4 young people contracting an STD, the World Health Organization (WHO) estimates by the time individuals are 25 years old, half the sexually active population will have an STD (WHO, 2019). This epidemic has been caused due to the lack of awareness in adolescents who have been insufficiently educated about safe sex practices and the risks associated with sexual intercourse. The WHO asserts that young people need access to a sex education, specifically regarding STDs, to gain this skills-based education in order to care for their sexual health. However, the Australian schooling system is failing to address this issue. Thus, schools need to implement a more effective targeted intervention to approaches sexual health to adolescents within the education system. This lack of education, coupled with a societal attitude that is becoming increasing liberal, has led to more of the young-adult demographic taking greater risks with regards to not practicing safe sex (Rissel, 2012). This was demonstrated in a recent study by Rissel et al., who found that sexual attitudes of Australians largely approve of premarital sex and this is consistent with the age of first intercourse in Australia being lower than ever before. This correlates with higher levels of liberalism, which are associated with greater sexual adventurism and health risk taking, for example, only 36.7% of women aged 16-19 believe that oral sex is equivalent to vaginal intercourse versus 75.4% of women aged 50-59. This change in attitudes regarding sexual behavior can be attributed to different historical upbringings and changing social norms (Rissel, 2012).
STDs occur through contact with infected bodily fluids, usually through sexual interaction, for example, vaginal, anal or oral sex. Many STDs are non-symptomatic and are easily spread due to lack of knowledge or detection, such as HPV and HSV, which are estimated to affect 300 million and 500 million people worldwide, respectively and 240 million people are living with chronic hepatitis B globally. STDs have a profound impact on sexual and reproductive health worldwide and while many STDs have few short-term effects, the long-term effects can be devastating. For example, it is estimated that undiagnosed STDs cause 24,000 women to become infertile each year, and the HPV virus is the leading cause of cervical cancer in women (ABS, 2018). Syphilis is a type of STD that in 2016 affected 88 000 pregnant women, resulting in over 350 000 adverse birth outcomes, including 200 000 stillbirths and newborn deaths (ABS, 2019). In conjunction, in 2012, the highest gonorrhea rates were highest among adolescents and young adults, with six in 10 chlamydia and gonorrhea diagnoses are in those under 25 years of age (AYAC, 2018). With one in two sexually active people will contract an SDI by age 25 (Cates JR, 2004). These world and Australian health issues are having a large impact on adolescent’s sexual health. STD statistics in Australia are increasing each year, since less than half of adults ages 18 to 44 have never been tested for an STD and more young people are engaging in sexual activity than ever before. A national survey by La Trobe University is carried out every six years and found that the sexual activity of Australian teenagers has increased to 27.4% for Year 10 students and 56.1% for Year 12 students, from 25.8% of Year 10 students and 46.8% of Tear 12 students six years earlier. Therefore, the lack of sex education in Pacific to STDs is the primary cause for this epidemic.
With Australian society’s attitudes towards young people’s sexual relationships becoming increasingly liberal, young people are at an increased risk of participating within risk taking activity. These risk-taking behaviors include unprotected sex and multiple sex partners as a result of a lack of sufficient sex education and relaxed liberalistic attitudes towards sexual relationships. Thus, placing them at a higher susceptibility to contracting an STD than any other societal group. For example, in Australia 18,588 cases of gonorrhea were detected in 2015, up from 8,388 cases in 2006, the Kirby group has suggested that the increase in STD transmission is largely due to incorrect or lack of condom use and a lack of treatment seeking behaviors (Mayo Clinic, 2018). A report from the Centre for Social Research in Health found 68 percent of gay and bisexual men in this age group surveyed in 2013 always used condoms, compared to 47 percent in 2016 (Mayo Clinic, 2018). The lack of treatment seeking behaviors can also be linked to the social stigma surrounding STDs, that causes adolescents to feel abnormal and embarrassed, resulting in young people not seeking treatment due to the fear of being judged. Young people account for half of new STD cases, however only 12% were tested for STDs in the last year (CDC, 2018). As a consequence, STDs are vastly spread due to lack of treatment being access, hence why more than 1 million STD are acquired every day worldwide (WHO, 2019).
Liberal attitude changes have also led to an increase in alcohol and drug use. Substance abuse has consistently been linked with sexual risk taking, with recent study demonstrating that one third of adolescents reported experiencing unwanted sex as a consequence of the influence of drugs and/or alcohol. It is important to note that 80 percent of sexually active students stated that the last time they had sex they were either drunk or high (May, 2013). Thus, the effect of alcohol and drug intoxication leads to individuals making decisions that they wouldn’t usually be inclined to make. Henceforth, adolescents are partaking in risk taking behavior that are detrimental to their sexual health. In surveys conducted recently, 78 percent of students stated they are sexually active, however when questioned about the last time they had sexual intercourse, less than half the students reported using a condom as a form of contraception (May, 2013). Sexual health care services advice people engaging in sexually active, should use a barrier contraceptive such as a condom, as when used correctly and consistently, condoms offer one of the most effective methods of protection against STDs, including HIV (WHO, 2019). However, “68 percent of young people don't use condoms, and those who used condoms were much more likely to cite pregnancy than STDs as their main concern; 54 percent said that their single reason for using protection was birth control, while just 6 percent cited STDs as their sole reason” (Steinmetz, 2013). Today’s society are much freer to experiment sexually, with the majority of young girls becoming sexually active by the age of 16 (Rissel, 2012). Consequently, young people are partaking in risks that they do not know the consequence off, leading young people to be at heightened risk than any other societal group of contracting an STD because young people account for 50% of all STDs (Bhargava, 2018). With STDs sharply rising amongst Australian youth there is a need for a more effective and targeted approach to sexual health education in schools to utilize the reach of the target audience that can be archived within a school.
With STD rates on the rise, the need to implement a mandatory education in schools which includes safe sex and STDs has become apparent. As it stands, sexual education is included in the current Australian curriculum, but it is not mandatory for all schools (AFAO, 2013). This intervention is critical as it brings awareness to students concerning symptoms and prevention options. This will have a more significant effect on the awareness of safe sexual practices in today’s society due to a large portion of the population becoming educated on STDs. Educational interventions are vital as Susanne Legena CEO of Plan International states, “adolescent girls around the world are at a heightened risk for sexually transmitted diseases” (Legena, 2018) as one in four sexually active adolescent females has an STD (CDC). Australian young people are already experiencing sexual health crisis of epidemic scale, with 75% of all STDs in Australia occurring amongst young people, and a 20% increase in the rate of STDs diagnosed amongst people aged 15–29 in the past three years (AYAC, 2018). As such, unsafe sex remains the primary route of infection for this population. With prevention methods and STD content not being mandatory within the Australia curriculum, there is an increased rate of STDs seen throughout young people. To address this issue to the targeted to this audient, the National HIV/AIDS Strategy urges the importance for implemented education regarding STDs, transmission, and prevention options to be incorporated into all educational environments. WHO asserts that young people need access to specific skills-based education in order to care for their sexual health (WHO, 2019). Research shows that Australian young people are generally sexually experienced and need sexuality education programs to reflect what is going on in their lives (May, 2013). By implementing an education program that covers the skill-based education that provides students by promoting student learning on their health, and their current and future relationships will not be hindered across their lifespan. With the current lack of literacy on inclusive sex education, students are at a higher risk of STDs, unplanned pregnancy, risky sexual behavior, across their relationship lifespan. Recent studies measured the impact of curriculum-based sex education and STD prevention programs on sexual behavior and mediating factors among youth under 25 years. The principles of STDs, awareness and prevention methods need to be supported by education authorities in Australia, since studies suggest that they are not being taught consistently to all students, thus not being effective as research indicates that young people’s knowledge about STDs and how they are transmitted remains inadequate. It was found the 65% of the programs had significantly improved sexual decision-making skills (Widman, 2018). Henceforth, the evidence is strong that programs delay and decrease sexual behavior, as well as increasing the use of condom and other contraceptive use (Hagerman, 2015). In conjunction, an adolescent who received the skill-based intervention were significantly less likely to have an STD. Despite the sexual health level of value to young people, sexuality education in Australia has been described as ‘inconsistent and ad hoc’ and poorly resourced within education departments (May, 2013). Therefore, it is essential to provide an adequate level of sexuality education in schools to promote a positive sexual health to all young Australians, to further see a decrease in STDs among Australian adolescents. The 2003 study by Rissel found that higher levels of education were associated with increased liberalist values, as was having had more than one sexual partner in the year before interview, having had heterosexual anal intercourse, smoking tobacco, drinking alcohol and taking drugs. It is therefore important to note that a higher quality and more consistent sexual education program could lead to better health outcomes for young people in the future (Rissel, 2012)
Young people are at an increased risk of participating within risk taking activity, including unprotected sex and mutable sex partners, due to a lack of sufficient sex education and societal sexual freedom. Thus, placing them at a higher susceptibility to contracting an STD than any other societal group, as 20 million new STDs occur each year and half of those are amongst young people aged 15–24. With young people being at a heightened risk for having an STD, specific skills-based education must be implemented in order to care for young people’s sexual health and consequently see a decrease of STDs.