National Survey of Secondary Students and Sexual Health
The following are the key findings of the National Survey of Secondary Students and Sexual Health released in July 2008.
They are arranged under the key themes of knowledge, behaviour and health. These findings help inform PDHPE programs in schools.
HIV knowledge remains relatively high and comparable to the levels found in 2002. There has been a marked improvement in student sexually transmissible infection (STI) knowledge compared with previous surveys. More than 10% of students did not know that wearing a condom helps to protect against HIV; almost 20% did not know that a pregnant HIV positive woman could pass on HIV to her baby; and just over 15% did not know that someone who looks very healthy could pass on HIV.
Knowledge about sexually transmissible infections (STI) is varied, but has improved somewhat in the past five years. Hepatitis A, B and C knowledge remains relatively poor, but there has been some improvement in student knowledge regarding hepatitis B and C. Despite generally poor student knowledge of chlamydia, knowledge of this infection has improved significantly since 2002.
The depth of knowledge about human papilloma virus (HPV) was poor. It was the first time that questions on HPV have been asked; in most cases more than half the sample reported being ‘unsure’ of correct answers to HPV knowledge questions. Students exhibited better knowledge of HPV in terms of how the virus is spread by sexual contact (49%), that the risk of transmission is reduced by condom use during sex (56%) and that vaccine for HPV does not have the effect of giving the person the virus (45%). Only 11% of students were able to identify that the virus does not just affect females.
Sexual behaviour, beliefs and perceptions
The majority of young people in Years 10 and 12 have experienced one or more forms of sexual activity. The number of students that have experienced sexual intercourse increased between the 2002 and 2008 surveys from 35% to 40% in 2008. The sexual activities reported by the students were deep kissing (79%); sexual touching (65%); oral sex (44%); sex without a condom (27%); and sex with a condom (40%).
Student condom use has remained stable between 2002 and 2008 surveys. The majority of students (69%) reported that when they had sex the last time, a condom was available. Young men (77%) were more likely to report a condom was available at the last sexual encounter compared to young women (65%). Being unprepared and not expecting sex (‘it just happened’, 39%), trusting a partner (31%) and knowing a partner’s sexual history (27%) were the most common reasons stated for failing to use a condom at the last sexual encounter.
Fewer students (88%) reported having oral sex but not intercourse in the past year. Students were also less likely to have oral sex but not intercourse with multiple partners.
Just under one third of the sample reported ever having experienced unwanted sex. This has significantly increased in young women to 38% compared to 19% in 2002. Young women (38%) were more likely than young men (19%) to have experienced sex when they did not want to. There were no differences in rates of unwanted sex by year level. Students cited being too drunk (17%) or pressure from their partner (18%) as the most common reasons for having sex when they did not want to.
When responding about their most recent sexual encounter, the majority of sexually active students (60%) reported their most recent sexual encounter was with their current steady girlfriend or boyfriend. A smaller number of students (28%) stated that they had sex with someone that they have known for a while and approximately 10% of students had sex with someone that they had not met before.
Almost 10% of students surveyed reported their most recent sexual encounter was with someone of the same sex. For young men, the likelihood of having a same sex encounter at the most recent sexual experience had increased since 2002.
The majority of students reported positive feelings after having sex, however for young women; there is some evidence of a decline in more positive feelings between 2002 and 2008.
Before they had sex, students were most likely to discuss using a condom (70%), avoiding pregnancy (56%) and how to gain sexual pleasure without having intercourse (34%). Less frequently discussed by students before they had sex was how to avoid becoming infected by HIV (17%) and STIs (20%). Compared to their year 12 counterparts, year 10 students were significantly more likely to discuss with their last sex partner about avoiding HIV (22% vs. 13%) and STIs (26% vs. 16%) and a greater proportion also discussed using a condom (75% vs. 67%).
Fewer students in the 2008 survey reported using no contraception the last time they had sex. Despite this, use of the birth control pill and morning after pill increased between 2002 and 2008.
Between 2002 and 2008, there has been an increase in student confidence with respect to talking with their parents about sex and sexual health related matters. Students in year 12 demonstrated higher levels of confidence in discussing sex related matters compared with those in year 10, and were significantly more likely to report being confident or very confident when talking to parents about contraception (62% vs. 44%), STIs/HIV (63% vs. 51%) and sex (53% vs. 43%).
The self-reported general health of students was generally high, with the majority of the sample (90%) rating their health as either ‘good’ or better. 3% of sexually active students had ever been diagnosed with an STI. Of the STIs that were reported the most common were chlamydia, genital herpes and pubic lice. A small proportion of students (1.3%) have been diagnosed with hepatitis, although a larger proportion (6%) reported uncertainty as to whether or not they had ever been diagnosed as suffering from hepatitis.
More students reported that they had been vaccinated against hepatitis B (59%) compared with hepatitis A (31%). As was the case in the 2002 survey and indicating a general lack of understanding of the disease, a considerable proportion of students incorrectly claimed they had been vaccinated against hepatitis C (41%).
Alcohol and drug use
The majority of students surveyed (80%) reported that they had drunk alcohol. Year 12 students were more likely to drink alcohol (90%) than their year 10 counterparts (71%).
Students were asked how often they drank alcohol, on average, in the two weeks prior to being surveyed. The majority of students reported drinking alcohol at least once per month (38%) or less but a considerable proportion (21%) reported drinking either weekly or more frequently. Students in year 12 (28%) were more likely than those in year 10 (16%) to drink alcohol one day a week or more.
The students who drank alcohol reported that when they drank, they consumed large quantities of alcohol. Over half the sample reported drinking 3 or more drinks when they last drank alcohol, with year 12 students more likely to drink 3 or more drinks when they last drank than year 10 students (74% vs. 42%). Young women and young men reported similar rates of alcohol consumption, with more than half the sample in each group drinking 3 or more drinks typically when they drank (young women: 58%, young men: 53%).
Almost a quarter of the students reported using marijuana in the past 12 months. Although most students reported using marijuana either once or twice in the past year, a considerable proportion (12%) had smoked the drug 3 or more times. Students in year 12 (29%) were more likely to have used marijuana in the past year compared with those in year 10 (20%).
Cervical Cancer vaccination
The large majority (86%) of young women reported being vaccinated for cervical cancer. 3% of young women and 12% of young men were unsure of whether they had received the vaccination. Of the young women who said they were unsure or had not had the vaccination, 59% of them stated that they would want to be vaccinated against cervical cancer.
Sources of information
Most students had sought information regarding sexual health. Students most commonly sought information from their mothers, female friends, the school sexual health program and pamphlets. Despite not being used as frequently by students, doctors were the most trusted source of information on sexual health.
Compared to young male students, young women were more likely to consult their doctor (44% vs. 30%), their mother (62% vs. 44%) and female friends (63% vs. 38%) for sexual health information. In contrast, young men typically were more likely than young women to confide in either their father (40% vs. 27%) or a male friend (41% vs. 31%) for advice regarding sexual health.
Generally, it was more common for young women (91%) to seek advice regarding sexual health than it was for young men (82%). Year 12 students were generally more likely to seek advice for matters relating to sexual health than those in year 10.
Members of the school community, along with parents, friends and siblings, are important sources of advice regarding HIV, STIs and contraception. It is clear that school programs continue to be highly valued as an information source for young people. They have become a source of information most used by young people. While the use of the Internet is nearly universal, young people are appropriately dubious of the quality of internet-based information regarding sexuality or sexual health.
Acknowledgements and further information
This article has been reproduced with the permission of the authors Anthony Smith, Paul Agius, Sue Dyson, Anne Mitchell and Marian Pitts from the Australian Research Centre in Sex, Health and Society.
Copies of the full report are available at no cost from:
Australian Research Centre in Sex, Health and Society,
La Trobe University
Level 1, 215 Franklin St,
Melbourne 3000 Australia.