01.12.2014 Views

Curriculum for General Practice - The Royal New Zealand College ...

Curriculum for General Practice - The Royal New Zealand College ...

Curriculum for General Practice - The Royal New Zealand College ...

SHOW MORE
SHOW LESS

Create successful ePaper yourself

Turn your PDF publications into a flip-book with our unique Google optimized e-Paper software.

Sexual Health<br />

S<br />

Sexual Health<br />

‘Sexual health encompasses a total sense<br />

of wellbeing in relation to one’s sexuality<br />

and sense of sexual self.’ 1<br />

This sense of wellbeing is relevant to<br />

everyone, regardless of age, gender,<br />

ethnicity, sexual orientation, mental or<br />

physical ability, living circumstances or any<br />

other determinant of health. It is, however,<br />

an area often complicated by conflicting<br />

personal beliefs and values, and public or<br />

political controversy.<br />

Older age groups are not exempt from poor sexual health<br />

outcomes as life expectancy increases and people remain<br />

well <strong>for</strong> longer. Rates of sexually transmitted infections such<br />

as chlamydia, gonorrhoea, syphilis, herpes and warts, and HIV<br />

are increasing at a greater rate in those over 40 than under<br />

40. 2 Patients over 50 are one-sixth as likely to use condoms,<br />

one-fifth as likely to have an HIV test and more likely to be<br />

misin<strong>for</strong>med about sexually transmitted infections. 3<br />

<strong>The</strong> age of first sexual intercourse is lowering markedly in<br />

<strong>New</strong> <strong>Zealand</strong> 4 and sexual activity is increasingly beginning at<br />

a younger age <strong>for</strong> many <strong>New</strong> <strong>Zealand</strong>ers. One study of 654<br />

Hawkes Bay students found up to 40 percent of young people<br />

had engaged in intercourse by age 14. Of these, 20 percent<br />

had experienced more than five partners, with Māori girls three<br />

times more likely to be sexually active at 14 than their non-<br />

Māori counterparts. 5 Not surprisingly, <strong>New</strong> <strong>Zealand</strong> has high<br />

rates of teen pregnancy, unintended pregnancy and sexually<br />

transmitted infections, particularly chlamydia, gonorrhea<br />

and HIV. 6 Global travel and internet relationships bring new<br />

challenges, as does the changing structure of families.<br />

Sexual and reproductive health services are provided by a<br />

range of organisations throughout <strong>New</strong> <strong>Zealand</strong>, sometimes<br />

targeting particular demographic groups. Variations in funding<br />

arrangements and heightened concerns about confidentiality<br />

can affect access to these services.<br />

1<br />

<strong>The</strong> Collaborative <strong>for</strong> Research and Training in Youth Health and Development Trust. 2011. “Youth Health”.<br />

2<br />

Bodley-Tickell A T, Olowokure B, Bahaduri S, White D J, Ward D, Ross J D C, et al. 2008. Trends in sexually transmitted infections (other than HIV) in older people:<br />

analysis of data from an enhanced surveillance system. Sexually Transmitted Diseases, 84:312-317.<br />

3<br />

Levy B R, Ding L, Lakra D, Kosteas J, Niccolai L. 2007. Older persons’ exclusion from sexually transmitted disease risk-reduction clinical trials. Sexually Transmitted<br />

Diseases 34(8):541-544<br />

4<br />

Ministry of Health. 2001. Sexual and Reproductive Health Strategy.<br />

5<br />

Fenwick R, Purdie G. 2000. <strong>The</strong> sexual activity of 654 Hawkes Bay fourth <strong>for</strong>m students. NZ Med J 460-3.<br />

6<br />

Ministry of Health. 2001. Sexual and Reproductive Health Strategy.<br />

www.rnzcgp.org.nz<br />

<strong>Curriculum</strong> <strong>for</strong> <strong>General</strong> <strong>Practice</strong><br />

143

Hooray! Your file is uploaded and ready to be published.

Saved successfully!

Ooh no, something went wrong!