THREATS TO (HETERO)SEXUAL HEALTH IN AOTEAROA/NEW ZEALAND: PROFESSIONAL PERSPECTIVES

1. Dr Virginia Braun The University of Auckland, Aotearoa/New Zealand • 1. Lack of government priority & funding • Sexual health is not ‘sexy’: not a health funding priority • There are thirteen areas that have been identified as [public health]priorities and sexual health isn’t one of them (Sexual Health Promoter) • Sexual health has long-term broader health & societal impacts: • - significant financial, health & social costs of poor (and under-funded) sexual health (e.g., infertility) • short-sighted not to fund • [Sexual health] doesn’t seem to be a particular [health funding] priority I mean all up no it’s not, it doesn’t it doesn’t hit the radar […] I think it should […] if you’ve got a problem that grows rather than doesn’t then it’s sensible to handle it when it’s smaller rather than it’s larger (Sexual Health Physician) • 2. Conservative social attitudes • Towards sex, sexuality & sex education (‘Victorian’ attitudes): • In New Zealand you know we like to think that we’re quite liberal and there’s lots of healthy discussion about most things, but we’re actually, when it comes to stuff around sexuality, sexual health, we’re actually really quite conservative in a lot of ways, particularly around talking openly about specific stuff (Sexual Health Educator) • Silence around sex & sexual health created by our:“basic inability to talk about sex” (Sexual Health Physician) • Towards sexuality education: • Sexuality education […] it’s controversial, for sure (FPA Sexuality Education) • Risk of Christian ‘values’ & ‘abstinence only’: • I look at what’s happening in the States at the moment with the abstinence-only programmes, anything that went down that track very very scary, […] the Destiny Church and the what they’re talking about (Sexuality Educator) THREATS TO (HETERO)SEXUAL HEALTH IN AOTEAROA/NEW ZEALAND: PROFESSIONAL PERSPECTIVES • Aims • Broad project aimed to examine the broad social contexts of risk around STI transmission in heterosexual sex • This poster reports professional views on threats to sexual health • Method • Data collection: • semi-structured interviews • audio-recorded & transcribed • Participants: • 32 key informants (KIs) • 1-40 years experience in sexual health • Professional perspectives included nurses, doctors, educators, health promoters, managers, researchers • Analysis: • Thematic analysis • Identifies patterns across participants’ responses • 3. Inadequate sex(uality) education • Lack of adequate information (at all ages): • about bodies & reproductive health • about the ‘threat’ and prevalence of STIs • School sexual health curriculum variably delivered: • It’s still not consistent across schools (Sexual Health Physician) • need standardised curriculum/adequate information • Curriculum often inadequate: • I’ve seen it [sex ed/promotion] done really badly and really unsafe for a lot of kids and really inappropriately […] it’s not realistic (Peer Educator) • needs to relate to youth, their ‘real lives’, & their concerns (e.g., relationships) Introduction/context Sexual health is ‘under threat’ in Aotearoa/New Zealand (NZ) Sexually transmitted infections (STIs) are “a major cause of morbidity”1 Almost all (STIs) have increased in recent years: regional laboratory surveillance show population rate increases of 51% for chlamydia and 57% for gonorrhoea (2001-2005)2 2004-5: national sexual health campaign:- “no rubba, no hubba hubba”- focus on individual behaviour change (condom use) • 4. NZ cultural attitudes & behaviour • NZers have a ‘laid-back’ attitude in general, & about sex • Adolescents in, because of their stage of development are bullet proof […] but I think it’s added to by the she’ll be right approach that New Zealanders do have (Sexual Health Physician) • Do not worry about risks & dangers around sex: • People just think oh bugger this, don’t worry, it’ll be alright (Sexual Health Service Dr) • do not engage in ‘sensible’ (sexual) health promoting behaviours • Binge drinking culture as a risk • our culture’s a pretty interesting thing as well, things like the whole alcohol culture in New Zealand, binge drinking, just getting totally smashed, drug culture, alcohol and drugs, they affect STIs (Sexuality Educator) • Results • NZ often compared to countries seen to do better regarding sexual health (e.g., The Netherlands) • Threats identified were often at broad (structural, systemic, sociocultural) levels • Identified 4 general socio-structural categories: • Government: lack of prioritising (& funding) sexual health • Conservative social attitudes towards sex and sexuality education • Sexuality education: lack of adequate education and information about sexual risk • NZ cultural attitudes and behaviours • Based on other STI prevalence, a heterosexual HIV epidemic is a ‘looming threat’ • Conclusions • ‘Culture’ explanations gel with youth accounts from this study • Emphasis on sociocultural/structural/systemic factors suggests individual behaviour change interventions are not enough • Research, policy and sexual health promotion practice should not focus just on individual or interpersonal factors • They need to attend to systemic, structural and socio-cultural factors which work against sexual health, sexuality education, and sexual health promotion References 1. STI Surveillance Team. (2005). Sexually Transmitted Infections in New Zealand: Annual Surveillance Report 2004. Wellington, New Zealand: Institute of Environmental Science and Research. 2. STI Surveillance Team. (2006). Sexually Transmitted Infections in New Zealand: Annual Surveillance Report 2005. Wellington, New Zealand: Institute of Environmental Science and Research. Contact: v.braun@auckland.ac.nz Thanks to PanteáFarvid for research assistance. Funded by a University of Auckland Vice Chancellor’s Research Excellence Award.