What is sexual health?

1. Sexual Health: Coming of agePresented by: Dan Fraser, Katherine MacGillivray, and Patrick Rodrigue

2. What is sexual health? The world health organization (WHO) defines sexual health as… “a state of physical, mental and social well-being in relation to sexuality. It requires a positive and respectful approach to sexuality and sexual relationships, as well as the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination and violence”

3. Putting a face on youth sexual health issues • Annie is a 13 year old girl who has lived with her father since her mother’s death by a car accident 2 years ago. Annie and her father have a strained relationship. He works late hours and Annie is often left home along for hours each day after school. Annie is an unmotivated student with few extra curricular activities. She suffers from low self-esteem an depression related to her mother’s death.

4. Putting a face on youth sexual health issues • Annie’s two closest friends are 3 years older than she is. They drink regularly, smoke cigarettes and marijuana. Both of her best friends have been sexually active with a variety of partners.

5. Putting a face on youth sexual health issues • One weekend, while Annie’s father is away on business, she decides to go to a party with her friends. The majority of the people at the party are older than Annie and are drinking. Although Annie has never drank before, her friends bought her a bottle of vodka. Annie felt uncomfortable at the party, no one was talking to her and she spent most of the night focused on her vodka.

6. Putting a face on youth sexual health issues • Towards the end of the night, while Annie is very drunk, she is approached by an older guy. She doesn’t want to have her first sexual intercourse with him, but when starts to aggressively toward her, Annie give in. The two end up having unprotected sex in a bathroom.

7. Putting a face on youth sexual health issues • Shortly after this experience, Annie begins to worry about the risk of pregnancy and STIs’. She has little knowledge on these subjects.

8. Putting a face on youth sexual health issues • Anne does not seek out a health care provider and becomes withdrawn and depressed. She begins abusing alcohol and experimenting with various drugs. She father notices a change in her behavior but is too busy to deal with her.

9. Putting a face on youth sexual health issues • Annie makes a new friend, Sally, who is a lesbian. Annie and Sally become very close and secretly engage in an intimate relationship. One day Annie’s father comes home and catches Annie and Sally doing drugs and engaging in sexual activity. Furious, Annie’s father slaps her across the face, calls her a “slut” and kicks her out of the house.

10. Putting a face on sexual health issues • Annie is now 14 years old. She is a homeless and confused about her sexual orientation. She has endured both sexual and physical abuse. She abuses drugs and alcohol. She is concerned she my have contacted and STI and she feels she may be pregnant. Unable to afford the necessities of life, she turns to prostitution.

11. Education The community health nurse(CHN) should educate themselves in manner of law and policies currently in place. Empowers the nurse

12. Legal Consent Sexual Activity without consent is criminal Legal Consent in Canada is 16 years old for all sexual activity including intercourse Exception: 14 years old legal if partner is within 5 years in age. Close in age exception (Department of Justice Canada, 2012)

13. Legal Consent 12-13 may have legal sexual activity only if the partner is within 2 years difference in age and have no power relationship or authority May be criminally charged

14. Lesbian, Gay, Bisexual, Transgender, Intersexed, Queer Nova Scotia is the first Atlantic province to legalize marriage of gay population Implication towards the LGBTIQ, is the social and legal acceptance.

15. Canadian Constitutional Act section 15 state that “Every individual is equal before and under the law and has the right to the equal protection and equal benefit of the law without discrimination and, in particular, without discrimination based on race, national or ethnic origin, colour, religion, sex, age or mental or physical disability.” http://laws-lois.justice.gc.ca/eng/Const/page-15.html?term=same+sex, 2012)

16. Nova Scotia Charter of Human Rights Anyone with a different sexual orientation no matter what it is, are protected from harassment and discrimination. Quebec was the first province to protect the right of LGBTIQ, and adopted a regulation in 1977.

17. LGBTIQ Statistics 1.1% of Canadian consider themselves homosexual 0.9% consider themselves bisexual Stats under reported

18. LGBTIQ Statistics 2006 Census, 90,695 same sex union 22,190, age 14-34 y/o Nova Scotia: 2,515 same sex union, 825 of them age 15-34 y/o

19. Homeless Youth Enhanced surveillance of Canadian street youth 150,000 Homeless youth in Canada Data from age 15-25 y/o Male to female ratio 2:1 Vulnerable population: it is believe that generally they had sex before the age of 13 High risk for STI Half of that population have used injectable drugs Exchange sexual favor for goods Limited interaction with health care system

20. Homeless Youth Statistics 15% reported their families were homeless at some point in time. Rates of gonorrhea and chlamydia 10 times higher then regular youth A quarter reports exchanging sexual favor for goods 80% reports smoking, 40% reports drinking alcohol 95% reports using non injectable drugs 20% reports using injectable drugs

21. Homeless youth Statistics 70.4% had seen a social worker 42.2% had been in foster care 46.7% had been in group home 60% lives in the street In 2003, 26.3% reported an history of STI 78.3% reports having smoked marijuana

22. Halifax homeless report card Reported that 176 youth have stayed in a shelter during the year of 2009.

23. Government Role National Children Agenda: promote and ensure a healthy start, investment of 20 millions dollars over 5 years. 7 million dollars for initiative to prevent family violence through educational awarness In Nova Scotia parents are responsible for their children till the age of 18 If neglect is suspected, reports to welfare services may take away the child after investigation

24. Sexual Exploitation The legal age of consent for sexual exploitation is 18 years old. Exploitation defined by the involvement in prostitution, pornography, or a relationship defined by power for example a teacher and student

25. Canada Laws for Underage Exploitation Acts of Child pornography, sexual exploitation, Incest, Luring a child, exposing, procuring, bestiality, and child sex tourism is criminal. Imprisonment from 6 months to 14 years.

26. Harm reduction vs punitive Illegal to possess drugs in schedule I, II, III. Cannabis in all its shape and form are in schedule II The liberal party of Canada support the legalization of Marijuana Marijuana medical access regulation Important point is to educate, and be aware

27. Education and awarness No Matter what your opinion is, what is important is to be educated and aware.

28. Social Determinants of Health • Income and income distribution • Education/literacy • Unemployment and job security • Employment and working conditions • Early childhooddevelopment ( early life) • Food insecurity • Social safety ( support) networks • Health services • Personal healthpractices and coping skills • Aboriginal status • Housing • Environment ( including social, physical; natural and built environments) • Biology and genetic endowment • Healthy child development • Social exclusion • Social status • Gender • Culture • Race • Disability

29. Social Determinants of Health • Average First sexual intercourse 15.8 years • First Sexual intercourse for vulnerable youth: • Males very early 11yrs, later 12yrs • Females very early 12yrs, later 13yrs

30. Social Determinants of Health • Homeless youth • early sexual intercourse • multiple sexual partners • decreased condom use • increase in sexually transmitted infections

31. Social Determinants of Health • Lesbian, Gay, Bisexual, Transgendered, Intersexed, and Queer youth: • Forced from homes • Marginalized • Misunderstood • Homophobia • Verbal and physical abuse

32. Social Determinants of Health • Students exchanging sex for substances • Higher rates of binge drinking • Use of illicit drugs other than marijuana • Hopelessness • Impulsivity • Depression

33. Canadian Community Health Nursing7 Standards of Practice Health promotion Prevention and health protection Health maintenance and palliation Professional relationships Capacity building Access and equity Professional responsibility and accountability

34. QUESTIONS Thank you !

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