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 ...
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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 />
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