Alcohol misuse: tackling the UK epidemic - London

38
Interventions in adolescent sexual health
The health of the nation: a strategy for health in England, published in 1992, identified HIV/AIDS and sexual
health as one of five priority areas, with specific objectives and targets being set. Objectives included
reducing the incidence of HIV infection and gonorrhoea and halving the rate of conception among girls
under 16 by 2000. Five years after the strategy was published, the gonorrhoea target had been achieved
but most other sexually transmitted infections had increased and pregnancy rates had not decreased. 3
In June 1999 the Social Exclusion Unit published a report Teenage pregnancy examining teenage pregnancy
and assessing interventions. The report’s 10-year action plan for England included a national campaign,
‘joined up action’, better prevention and better support for pregnant teenagers and teenage parents. The
prevention element includes better education in and out of school, access to contraception and targeting
of at-risk groups, with a new focus on reaching young men. 162
Following the report, a Teenage Pregnancy
Unit was established at the Department of Heath to coordinate action across government to reduce
teenage pregnancy in England. 162
Also in 1999, The National Assembly for Wales published A strategic framework for promoting sexual health in
Wales. 181
In Scotland the white paper Towards a healthier Scotland identified sexual health and the
development of a sexual health strategy as a public health priority. 96
The English government published its sexual health and HIV strategy for consultation in July 2001. This
set out plans to:
• reduce the transmission of HIV and STIs
• reduce the prevalence of undiagnosed HIV and STIs
• reduce unintended pregnancy rates
• improve health and social care for people living with HIV
• reduce the stigma associated with HIV and STIs.
In response to the consultation a 27 point action plan was published in June 2002. 182
This strategy is now
being implemented. Key elements include a model for sexual health services that can be delivered by every
primary care trust and the evaluation of new one-stop sexual health services. A national information
campaign has been launched, more money has been allocated to GUM and abortion services, and a
chlamydia screening programme is under way. Despite these commitments, concern has already been
expressed that the allocated resources are insufficient. 183
Current policy in the UK aims to halve the conception rate of under 18s and set a downward trend in the
rate for under 16s by 2010. It also aims, in the light of evidence of poor social, economic and health
outcomes for mother and child, to achieve a reduction in the risk of long term social exclusion of teenage
parents and their children. 163
This involves a multifaceted approach which includes helping young people
resist pressure to have early sex through improved sex and relationship education, increasing uptake of
contraceptive advice through the development of easily accessible youth friendly advice services and
support for parents in talking to their children about sex and relationship issues.
A similar approach has been adopted in Wales through its Sexual Health Strategy. In Northern Ireland
Myths and reality: teenage pregnancy and parenthood was published in 2000. The only country in the UK which
has so far not set out its plans to reduce teenage pregnancy in a strategic document is Scotland, although
this is currently under consideration. Scotland did set a target in 1994, reaffirmed in 1999, to reduce the
pregnancy rate among 13 to 15 year olds by 20 per cent between 1995 and 2010. 4
The Sex and relationship education guidance for the national teaching curriculum in schools, states that sex
and relationship education (SRE) should be firmly rooted within the framework for Personal, Social and
Health Education (PSHE) and Citizenship. During key stages 3 and 4 (from 11 to 16 years), pupils should
be given knowledge, understanding and the ability to recognise the physical and emotional changes that
British Medical Association Adolescent health