In the UK and in Wales, in particularly, messages about sex are mixed. On one hand, adolescents are affected by advertising and entertainment industry which direct a lot of sexualised messages to all the people. As 14-19 year-old teenagers’ consciousness is much weaker than adults’; thus, it is quite easy to affect it. Because of that they tend to try what attracts them not seeing the risks and pitfalls. On the other hand, parents and public establishments are often reluctant to share information on this subject with young people. It is necessary for them to know that sexual health is a relevant part of general health and directed to avoid unwanted pregnancies and sexually transmitted diseases. However, many adolescents seem to chase their physical satisfactions and neglect the condition of their health before starting to have sex. It is important for young people to know and understand the peculiarities and dangers of early sexual relations. Furthermore, young people should get an education about sex. Parents should not avoid this subject, especially if their teenager child shows some interest in it. School education programmes on sex and relationships can provide the youth with such information as well. However, some teenagers prefer to find out everything about sexual relationships on their own looking up the information in the internet or discussing current subject with their somehow experienced friends.
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The main problem of having early sexual relationships is that teenagers lose their virginity in the state of being drunk, stoned or pressurised into having sex without using any kind of contraception. Drugs and alcohol have quite strong effect on teenagers’ willpower, inhibitions and mental condition right up to the possibility of losing partially memory.
Teenage Pregnancy and Abortion
It should be noted that it can be a positive experience for some young people to become a parent since this experience can provide the impulsion to do well and provide a good life for their children. However, lack of health and social education often result in teenage pregnancy. Young mothers are assumed to suffer more postnatal depression and not complete their education.
As Sexual Health and Wellbeing Action Plan for Wales states a number of risk factors have been identified that increase the likelihood of teenage pregnancy such as early onset of sexual behaviour, poor contraceptive use, a mental health problem, conduct disorder and/or involvement in crime, alcohol and substance misuse, already a teen mother or had an abortion, low educational attainment, disengaged from school, living in care, daughter of a teenage mum, low parental aspirations for their children and belonging to a particular ethnic group (Sexual Health and Wellbeing Action Plan for Wales 2010-2015).
Since most adolescents do not use protection during sexual acts, majority of teenage pregnancies is unwanted and young girls usually terminate it. Abortion is a stress for a woman’s body and may cause harm to her reproductive system including infertility. However, most teenage girls who got pregnant are not ready to the responsibility of being a mother that is why they use abortion as a way of termination the pregnancy. If abortion has to take place, the best choice would be to do the surgery in a gynaecological clinic. Nevertheless, even after the professional termination of pregnancy there is a risk of infertility.
Sexually Transmitted Diseases (STD) and Treatment
The most widespread sexually transmitted diseases are HIV, syphilis, gonorrhoea and genital chlamydia. They are spread both among adults and teenagers. In fact, sexually transmitted diseases in teen age can lead to the serious consequences and health problems for further individuals’ lives. It is vital to detect the disease as soon as possible in order to prevent transmitting it to a sex partner and before it gets to the last stage that would be the hardest to cure.
In the Wales HIV keeps its high rates as one of the most relevant transmissible diseases. It is an infection connected with significant mortality, serious morbidity, high number of potential years of life lost and high costs of care and treatment. Despite the fact that this disease is still incurable, the Food and Drug Administration approved some antiretroviral medicines that treat HIV infection nowadays. However, these methods of treatment do not cure people of HIV or AIDS. They rather suppress the virus, even to levels that are hard to detect, but they do not dispose HIV to the fullest from the body. y eliminating the amount of virus in the body, people who have HIV can now live longer and healthier. Furthermore, they can still transmit the virus and must take antiretroviral medicines all the time in order to maintain quality of their health.
Syphilis is caused by a spirochete that is the bacteria-like organism. In the UK, syphilis infection has become more common in recent years. On its early stages (if the person has had it for less than a year) syphilis can be easily cured by a single intramuscular injection of penicillin. Additional doses are needed in order to treat someone who has had syphilis for longer than a year. For people who are allergic to penicillin, other antibiotics are available. People who receive syphilis treatment must abstain from sexual contact with new partners until the syphilis sores are completely healed (Centers for Disease Control and Prevention).
Genital chlamydia is the most commonly diagnosed bacterial STD in the UK, including Wales. In particular, this STD is widespread among young people. Genital chlamydial infection is an important reproductive health problem because 10-30% of untreated infected women develop pelvic inflammatory disease (PID) (GIG Cymru NHS Wales 2011). Chlamydia treatment should be provided promptly for all people testing positive for infection; delays in receiving chlamydia treatment have been associated with complications in a limited proportion of chlamydia infected subjects. Recommended medicines of chlamydia are azithromycin or doxycycline. Alternatives can be erythromycin, erythromycin ethylsuccinate, levofloxacin, ofloxacin. All the medicines except azithromycin should be taken for 7 days (Centers for Disease Control and Prevention).
Gonorrhoea is a sexual acquired infection caused by a bacterium. After genital chlamydia, it is the second most common bacterial sexually transmitted disease in the UK. It can be caught through unprotected sex with an infected partner. Untreated gonorrhoea can have especially serious effects for young women such as pelvic inflammatory disease can develop which is hard to treat and can cause further complications such as infertility and a higher risk of ectopic pregnancy. Gonorrhoea can usually be treated with an antibiotic like ceftinaxone, cefixime or spectinomycin. They are now often given as a single dose (Public Health Wales Health Protection Division 2012).
Besides the fact that these diseases are sexually transmitted there is a possibility to get infected in other ways. In order to prevent STD, teenagers should limit their number of partners. The fewer partners young people have sex with, the less the possibility to contract a sexually transmitted disease. Adolescents who lead active sexual life must do check-ups every year. Taking tests on STDs is also recommended. And of course, sex should not be had without protection and contraception.
Contraception plays a relevant role in sexual health. It is free for most people in Wales. Contraceptive methods allow choose when and whether a woman wants to have a baby. However, they do not protect from sexually transmitted diseases. Condoms help protect against STD and pregnancy, so whatever other method of contraception are used to prevent pregnancy; moreover, condoms need to be used as well to protect both partners’ health.
There are 15 methods of contraception to be chosen. They are caps, combined pills, male and female condoms, contraceptive implants, injections and patches, diaphragms, intrauterine devices and systems, natural family planning, progestogen-only pills and vaginal rings. Permanent methods of contraception are female and male sterilisation (NHS 2011). Contraceptive method that is the most commonly used among teenagers is condom. However, young people should not rely on this method as the only one. Despite that, it is the only contraception that protects both from STD and pregnancy; there is a possibility that it might tear and lose all protecting qualities. Unfortunately, not all of the listed above contraceptive methods are affordable for adolescents. They usually content themselves with condoms and pills.
Sexual Health Provision
The Assembly Government in Wales reckons that sex and relationships education (SRE) are an important part of growing up, and the youth needs to understand the emotional and physical aspects of sexual relations. Schools are supposed to play a relevant role in promoting young people’s sexual health. There are policies and programmes in Wales which promote the emotional welfare of teenagers and make a crucial contribution in sex and relationship education.
Sex and relationships education provision in schools can be a benefit in terms of sexual health behaviour. For example, it may delay sexual activity, reduce the number of partners and increase awareness about availability and methods of contraception.
Moving confidently from childhood into adulthood through adolescence, the youth needs to understand that school-based sex and relationships programmes are important and sensitive to their needs and reflect the character of the school.
According to Welsh government, primary schools are required to have a policy on sex education. Governing bodies should consult parents/care givers and the wider community to ensure that the policy take account of parental wishes and meet the needs of the community the school serves. Primary schools should provide sex education as contained within the national curriculum for Wales, for example in science (Sexual Health and Wellbeing Action Plan for Wales, 2010-2015). However, it should be only on the level of social and emotional sides of relationships.
Secondary schools and other educational establishments should have an up-to-date policy on sex education: moreover, include sex education for all registered pupils. Since SRE is generally delivered through personal and social education and science, it is conductive to teenagers’ welfare. Furthermore, it helps acquire the skills and knowledge to make secure and liable choices regarding their sexual demeanour. Sex and relationships education should meet the needs of all adolescents and schools need to take in account pupils’ views on what content they require at different key stages. The main values that SRE presents should be SRE gender equality, mutual respect, rights and responsibilities and acceptance of diversity.
SRE in schools needs to supplement with the wider provision of information. Parents and other professionals whose work is to support personal development of young population should support and advice adolescents on sex and relationships.
Some parents show the desire to discuss sex and relationships with their children, however they start to feel uncomfortable and embarrassed about it. It needs to be considered how best to support parents who wish to talk about sex and relationships with their children but are not confident in the ability how to do it.
Some of adolescents who are the most liable to early sexual ill health or pregnancy may not go to school or may be taught better in an institution based on community. Governing bodies should develop training and guidance in order to support providing SRE outside the school establishment. Further and Higher Education settings, Young Offenders Institutions, residential homes, and the youth sector are the best examples of such organisations.
In Wales as in any other country, the age of young people when they start having sexual relations gets lower. The education on sex and relationships should be provided for all the adolescents by schools, health services and their parents. Moreover, it is important for parents to take part in their teen age children’s full development. As well as it is no less relevant for teenagers themselves.
Schools and health services should provide educational programmes on sex and relationships. In addition, they should show that it is highly necessary knowledge for young people. Health services should also provide information on how and where teenagers can find specialised help in case of sexual health problems.
Welsh government should establish more sexual healthcare institutions and attract teenagers for education on sex and relationships. This actually may keep adolescents from risks and consequences that early sexual life can cause, e.g. sexually transmitted diseases and unintended pregnancy. The more teenagers are aware of these risks, the more they are careful with sexual relationships.
The relevance of children protection cannot be questioned and school nurses have a duty to perform their public health responsibilities to the whole school. However, this inspection only touches on the surface of assessing pupil’s knowledge on sexual health. Possible methods of rating SRE could concentrate on case studies, creative writing, formal quizzes and drama productions. Teenagers’ healthy sex life should be assessed and maintained with the help of sexual health services.