Sexuality education in Australian Secondary Schools: averting a sexual health crisis among young people

HIV Australia | Vol. 11 No. 1 | March 2013

JAMES MAY reports on the current state of sex education in Australian schools and says it’s time for change.

Sexually transmitted infections (STIs) have risen sharply among young people in Australia in recent years, leading to calls for more effective and targeted approaches to sexual health education in schools.

The Australian Curriculum, Assessment and Reporting Authority (ACARA) is currently conducting consultation on a review of the Australian Curriculum: Health and Physical Education from pre-school to Year 10, which includes content on ‘relationships and sexuality’.¹

Input is currently being sought through an online consultation, which is open for public comment until April 2013.² The revised curriculum is due for publication on the Australian Curriculum website in 2013.³

A review of sexuality education in Australian schools is much needed. While there is evidence to suggest that current sexual health programs in secondary schools are adequate for some young people, there are discrepancies around the quality of material being taught, the targeting of materials and inconsistencies in individual curricula and teaching approaches.

Current sexual health programs for Australian school students are also failing to address the needs of same-sex attracted and gender questioning (SSAGQ) young people.

In some jurisdictions, the involvement of community organisations using trained peer educators is enhancing program quality and providing valuable insights into the benefits of involving sexual health experts and peer educators in both program development and delivery.

Sexuality education – the Australian context

‘Sexual health is a state of physical, mental and social wellbeing 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.’⁴

The World Health Organization (WHO) (1998) asserts that young people need access to specific skills-based education in order to care for their sexual health. Young people must be able to:⁵

make sound decisions about relationships and sexual intercourse and stand up for those decisions
deal with pressures for unwanted sex or drug use
recognise a situation which may turn risky or violent
know how and where to ask for help and support
know how to negotiate protected sex and other forms of safe sex when ready for sexual relationships

These principles are generally supported by education authorities in Australia. However, research suggests that they are not being taught consistently to all students.

Australian secondary students see school programs as some of their most useful sources of information about sexual health and relationships; they are the most popular source of knowledge for both young men (48.5%) and young women (48.8%).⁶

It is therefore essential to provide an effective level of sexuality education in schools to promote the sexual health of all young Australians.⁷ Despite its overwhelming value to young people, sexuality education in Australia has been described as ‘inconsistent and ad hoc’ and poorly resourced within education departments.⁸

Feedback from teachers indicates there is a great variation in teachers’ knowledge about how to teach sexuality education.⁹Young people themselves should also be consulted about the development and implementation of sexual health and sexuality education programs.

As one recent report states: ‘Young people are the best experts on their own experience, and their voices are key to understanding what works and what gaps must be addressed in sexual health education in Australia today.’¹⁰

STIs and young people – a sexual health crisis

Research indicates that young people’s knowledge about STIs and how they are transmitted remains inadequate, even though teachers have usually covered the basics on this subject.¹¹

According to the authors of the Let’s Talk About Sex: National Youth Survey 2012:

‘Australia’s young people are facing a sexual health crisis of epidemic scale, with 75% of all Sexually Transmitted Infections (STIs) in Australia occurring amongst young people, and a 20% increase in the rate of STIs diagnosed amongst people aged 15–29 in the past three years’.¹²

Debate continues around how much information students need about STIs and blood borne viruses but all school programs should at least convey essential sexual health information to students, including:¹³

that they can acquire an STI through particular kinds of sexual behavior
what symptoms they might experience
that symptoms may not always accompany an STI
that testing and treatment is simple for many (but not all) STIs
that untreated STIs have health consequences
where and when to get tested regularly after commencing sexual activity.

Research shows that young Australian students are generally sexually experienced and need sexuality education programs to reflect what is going on in their lives.¹⁴ In surveys conducted in 2008 most students (78%) said they had experienced some form of sexual activity.¹⁵

Although 52% of sexually active students reported having had sex with one partner in the previous year, 45% reported having sex with more than one person.¹⁶

When questioned about the last time they had sexual intercourse, two in five students reported using a condom, but more than one quarter did not. Half the respondents said they ‘always’ used condoms when they had sex in the previous year. 43% said they only used condoms ‘sometimes’, and 7% ‘never’ used condoms when they had sex in the previous year.¹⁷

Of particular concern is that just under one third of the sample reported experiencing unwanted sex as a result of coercion or the influence of drugs and/or alcohol. The majority of students (80%) in this report stated that they had drunk alcohol while almost a quarter of sexually active students in another report said that the last time they had sex they were either drunk or high.¹⁸^, ¹⁹

Education programs need to give young people the ability to negotiate peer pressure to use drugs and alcohol and engage in sex. These issues are clearly linked.

Same-sex attracted and gender questioning youth (SSAGQ)

Up to 11% of any school population will include same-sex attracted students and research indicates that the sexual health of these students is often neglected.²⁰

These students are generally more sexually active than their heterosexual peers; many are more likely to report engaging in sexual risk taking with partners of both sexes during high school and have higher rates of pregnancy and STIs than students that report exclusively heterosexual attraction.²¹

Furthermore, credible sources for information on sex and relationships such as teachers and parents – highly regarded by most young people²² – are often not accessible for same-sex attracted young people, who are compelled to rely on less reliable sources such as the internet.²³

Fourty-four percent of SSAGQ students said that they found school sexuality education not useful at all, 40% felt it was only partly useful, 11% found it moderately useful and 5% found sexuality education very useful.²⁴

Distinguishing features of sexuality education that these students said was valuable included:²

sexuality education that combines a large variety of positive messages
critical thinking and exposure to more fluid constructions of sexuality
wide-reaching inclusion of same-sex attraction and sexual diversity beyond token attempts
anti-discrimination and anti-homophobia efforts
sexuality education that changes the social dynamic at school so that people become more understanding and supportive
teachers who go into detail, are supportive and use diverse resources.

Schools are missing the opportunity to promote equal sexual health outcomes for these students. A recent survey of teachers provided further evidence that the lack of attention paid to SSAGQ students is a significant problem across Australia – one which teachers recognise needs more training and resources.²⁶

The value of sexual health ‘experts’ and peer educators

Research demonstrates that young people want external agencies to play a role in the delivery of sexual health education in schools, with an emphasis on peer education.

Students involved in the recent Let’s Talk About Sex: National Youth Survey 2012 reported that they preferred sexual health peer educators (i.e. trained young people, 68%) and sexual health educators from community organisations (68%) to complement sex education programs in their schools.²⁷ Living Positive Victoria’s Rural HIV and Sexual Health Project is one such program that strives to meet this need through its Positive Speakers’ Bureau.

HIV-positive speakers have been visiting schools for over 20 years, and in 2009 presented to more than 6,000 people across a range of settings and contexts.

The Positive Speakers’ Bureau delivers presentations at secondary schools in both metropolitan and rural areas. The school presentations are to Years 9–12 and are part of the Department of Education’s Catching On Everywhere sexuality education program for Victorian schools.²⁸

Living Positive Victoria reports an increase in requests from rural secondary schools for HIV-positive speakers in the period 2008 to 2009, as well as an increase in requests to provide speakers for hard-to-reach rural populations.

There has been encouraging feedback from secondary school nurses about the impact of HIV-positive speakers in addressing unsafe sex practises amongst students; positive speakers can play an important role as effective sexual health educators.²⁹

Data clearly shows that secondary school nurses, student welfare coordinators and other teachers believe the presentations are a highly informative, dynamic and compelling means of gaining insights into the lived experience of being HIV-positive. They also believe that the presentations are an effective means for young people to gain a greater understanding of sexual health and wellbeing.

Comments include:³⁰ ‘It was good to reinforce the “safe sex” message. The personal stories made it all the more “real” for students and really hit home that their sexual health is their responsibility.’

‘By giving detailed explanations of how their personal experience of unprotected sex occurred, it let the students know that care and planning is required to stay safe.’

‘The presentation is part of our whole school approach to wellbeing and an important, integral part of how we educate our young people. Very, very valuable.’³⁰

Feedback from young people in the Let’s Talk About Sex: National Youth Survey was similar:³¹

‘I have found that external sexual health educators who specialise solely in teaching sexual health education are the most effective, as they immediately have more credibility to the students, who accept their information more readily than from their school teachers.’

‘I prefer trained individuals, qualified to teach according to a range of different situations from a professional, non-biased, nonjudgmental perspective.’

‘I would like sex ed. to sit with lots of people, so that students get a range of opinions and people they can seek out advice from – people that can have an ongoing relationship with young people, and can be trusted by students while still being appropriate to the school and its beliefs.’

Summary

Australia is facing a sexual health crisis among its young people, and is falling well short of the protocols established by the WHO to give them the resources they need to understand and care for their sexual health.

Sexuality education is inconsistent across Australia’s states and territories, with a variety of interest groups producing their own curricula in various government and private schools. Many teachers do not have adequate resources, training or support to provide students with the breadth of information they need to care for their sexual health.

Current information resources do not appear to adequately engage some groups of young people; same-sex attracted youth feel that these resources do not meet their needs at all.

Young people need to have a say in the development of policies and sexual health education programs. They need to be empowered with adequate information to manage their choices and behavior with regards to their sexual health.

Strong partnerships with external agencies such as Living Positive Victoria are highly regarded by secondary students, who value the knowledge of peer educators. We already face a dire situation in terms of negative sexual health outcomes for young people in Australia; schools need to act urgently and implement comprehensive sexuality education programs to reduce further harm and protect those at risk.

References

1 The draft curriculum for consultation is available at: http://consultation.australiancurriculum.edu.au

2 T o participate in the online consultation visit: http://consultation.australiancurriculum.edu.au/

3 ibid.

4 World Health Organization. (2012.) Health Topics: Sexual Health. Retrieved from: http://www.who.int/topics/sexual_health/en/

5 World Health Organization (WHO). (1998). Force for Change: World AIDS Campaign for Young People. Global Program on AIDS, Geneva. Cited in Mitchell, A., Smith, A., Carman, M., Schlichthorst, M., Walsh, J., Pitts, M. (2011). Sexuality Education in Australia: Australian Research Centre in Sex, Health, Society (ARCSHS). ARCSHS, La Trobe University, Melbourne, 5. Retrieved from: www.latrobe.edu.au (PDF).

6 Mitchell, A., et al. (2011), op cit.

7 ibid., 4

8 Smith, A., Schlichthorst, M., Mitchell, A., Walsh, J., Lyons, A., Blackman, P., Pitts, M. (2011). Sexuality Education in Australian Secondary Schools: Results of the 1st National Survey of Australian Secondary Teachers of Sexuality Education 2010. ARCSHS, La Trobe University, Melbourne, 51. Retrieved from: www.ashhna.org.au.

9 ibid., 48.

10 Giordana, M., Ross, A. (2012). Let’s Talk About Sex: Young People’s Views on Sex and Sexual Health Information in Australia. Australian Youth Affairs Coalition (AYAC), Sydney, Youth Empowerment Against HIV/AIDS (YEAH), Melbourne, 10. Retrieved from: www.ayac.org.au

11 Smith, A., et al.,(2011), op. cit. Cited in Mitchell, A., et al. (2011), op. cit., 11.

12 Giordana, M., Ross, A., op.cit., 6.

13 Mitchell, A., et al., op.cit. , 12.

14 ibid.

15 ibid.

16 ibid., 14.

17 ibid.

18 Ibid.

19 Smith, A., Agius, P., Mitchell, A., Barrett, C., Pitts, M. (2009). Secondary Students and Sexual Health 2008: Results of the Fourth National Survey of Secondary Students HIV/AIDS and Sexual Health. ARCSHS, La Trobe University, Melbourne.

20 Various studies, as cited in Mitchell, A., et al., op. cit., 16.

21 ibid.

22 Smith, A., et al.,(2009). Cited in Mitchell, A., et al., op.cit., 11.

23 Hillier, L., Jones, T., Monagle, M., Overton, N., Gahan, L., Blackman, J., Mitchell, A. (2010). Writing Themselves In 3. ARCSHS, La Trobe University, Melbourne. Cited in Mitchell, A., et al., op.cit., 11.

24 Mitchell, A., et al., op. cit., 16.

25 Hillier, L., et al., op. cit., 86.

26 Smith, A., Schlichthorst, M., Mitchell, A., Walsh, J., Lyons, A., Blackman, P., Pitts, M. (2011). Sexuality Education in Australian Secondary Schools: 2010, Monograph Series No. 80. ARCSHS, La Trobe University, Melbourne.

27 Giordana, M., Ross, A., (2012), op.cit.

28 Niggl, M., Delaney, L., Glare, E. (2010). Report and Evaluation of the HIV and Sexual Health Rural Project: Melbourne. People Living With HIV/AIDS (PLWHA) Victoria.

29 Niggl, M. (2003). HIV-Positive Speakers’ Rural HIV and Sexual Health Program. PLWHA Victoria, Melbourne.

30 Niggl, M., op.cit., 14-15.

31 Giordana, M., Ross, A., (2012), op.cit., 23–24.

James May is a freelance writer, based in Melbourne, who regularly contributes work to the HIV sector in Victoria. He has written for various magazines including MCV, Positive Living and HIV Australia.