1. Youth Sexual Health Facts and Figures Dr Lewis Marshall Sexual Health Physician Fremantle Hospital

2. Who’s doing what? 34% males and 43% females in secondary school have ever had sexual intercourse 1 (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. 4 th National Survey of Australian Secondary Students, HIV and Sexual Health

3. 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

4. Number of chlamydia notifications by sex, WA, 2002 to 2011 Source: Epidemiology and Surveillance Program, Communicable Disease Control Directorate (CDCD)

5. Number of gonorrhoea notifications by sex, WA, 2002 to 2011 Source: Epidemiology and Surveillance Program, Communicable Disease Control Directorate (CDCD)

6. 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

7. Number and proportion of chlamydia in 15-24 year olds, WA, 2002 to 2011 Source: Epidemiology and Surveillance Program, Communicable Disease Control Directorate (CDCD)

8. 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

9. Source: Epidemiology and Surveillance Program, Communicable Disease Control Directorate (CDCD) STI, BBV and HIV Aboriginal: Non- Aboriginal rate ratios 1, WA, 2011

10. Source: Epidemiology and Surveillance Program, Communicable Disease Control Directorate (CDCD) Chlamydia and gonorrhoea age-standardised notification rates 1 by region, WA, 2011

11. Teenage Births in WA

12. 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). YearNTTASQLDWANSWSAVICACTAUST 200068.826.3223.021.216.915.211.010.617.7 200171.032.722.619.417.114.511.59.817.7 200263.328.322.318.816.515.511.311.117.2 200363.526.121.418.515.014.710.28.616.1 200456.424.921.619.615.013.510.37.816.0 200561.426.820.420.513.418.59.79.115.7 200663.526.519.719.613.216.79.79.115.3 200758.827.423.020.512.317.510.010.316.0 200851.927.524.722.713.918.310.68.017.2 200948.027.126.720.113.015.99.99.716.7 201048.121.524.019.112.915.38.58.915.5

13. Teenage births WA 2011 13yrs1 14yrs12 15yrs40 16yrs126 17yrs252 18yrs389

14. Induced abortions in WA 2006200720082009 Under 1536253744 15-191628163116091551

15. 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

16. State services RPH FH KEMH EDs Public Health units –Community health

17. Gonorrhoea Management site AboriginalNon Aboriginal Public Hospital Community Health 38%4% Sexual Health Family Planning 4%25% AMS42%1% GP9%64% Other7%

18. 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

21. 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

22. 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