Preventive Sexual Health Services
8.3 Preventive Sexual Health Services
This section of the report examines the role of the public health and school systems in referring students to counseling services as well as providing information to them to prevent HIV and STD and promote sexual health. The criteria for effectiveness listed below are based on several sources.
1. Regular national, provincial/territorial and local assessments of the sexual health behaviours and needs of adolescents are used to guide service development and delivery (Health Canada, 1994; Canadian Public Health Association, 1993; Popham & Hall, nd; World Health Organization, 1997; Suen et al, 1995; Martin et al, 1996; Smith, 1991; Institute of Medicine, 1997).
2 The services emphasize prevention and they are available and accessible to adolescents in all communities (Health Canada, nd; Mackie & Oickle, 1996; World Health Organization, 1998; Canadian Medical Association, 1995; Canadian Public Health Association, 1996; Laboratory Centre for Disease Control, 1998; Martin et al, 1996).
3. Community-based organizations can be involved effectively in the delivery of preventive sexual health services (World Health Organization, 1997; Canadian Public Health Association, 1993).
4. Public health staff are qualified to work in sexual health, with youth and schools (Canadian Public health Association, 1990, 1993; Smillie, 1992.
5. Availability of services to adolescents is publicized to youth as well as youth-service agencies, schools and other professionals to encourage access by youth (Laboratory Centre for Disease Control, 1998; American Association for Counseling Development et al, 1990; Baskerville, 1991).
6. Young people will be more often referred to sexual health services if the referral process is clearly understood, encouraged and widely used by teachers and counselors (Thomas & Texidor, 1987; American Association for Counseling & Development et al, 1990; World Health Organization, 1997).
7. Adolescents access preventive health services if they are convenient to youth and are coordinated with schools and with public awareness campaigns. School-based health centres in large secondary schools are effective (Kirby et al, 1993; Keyl et al, 1996; Weathersby et al, 1995; World Health Organization, 1997; Dryfoos, 1985; Cohen et al, 1991).
8. Adolescents access the preventive sexual health services more often if the nature of the services has been specifically addressed to their needs (Blum et al, 1996; Laboratory Centre for Disease Control, 1998; American Association for Counseling & Development et al, 1990; Health Canada, 1994; Dryfoos, 1985; Cohen et al, 1991).
9. Specific adaptations to sexual health services can be made to accommodate the needs of young women, youth with disabilities, gay, lesbian and bisexual youth, aboriginal students, and ethnocultural minorities (Health Canada, 1989 & 1996; American Association for Counseling & Development et al, 1990; Scheider & Tremble, 1986; Paroski, 1987; Russell, 1989).
10. By offering a wide range of services, including pamphlets and information, referrals, initial counseling, treatment and follow-up, sexual health clinics can encourage youth to abstain from sexual activity or practise safer sex (Mitka, 1999; Laboratory Centre for Disease Control, 1998; Canadian Public Health Association, 1993; Institute of Medicine, 1997).
11. Sexual health services on HIV/AIDS can be linked to other health risks such as injection drug use, consumption of alcohol, and use of steroids (Jessor & Jessor, 1977; McHutchion, 1996; Stall et al, 1986; Otis, 1996).
12. Public health personnel who have received inservice and pre-service education on working with adolescents and with schools are more effective (American Association for Counseling & Development et al, 1990; Scollo, 1997; Canadian Public Health Association, 1993).
Again, for the convenience of the reader, the contents of this section of the report has been reproduced here.
Well-Planned Service Delivery
This section of the report describes the survey results relating to the planning and funding of preventive sexual health services.
Summary of Results Related to Planned Service Delivery
About one-third of public health respondents indicated that they are regularly disseminating data or research on the sexual health knowledge, attitudes and behaviours of youth. A small minority of health ministries, less than 10%, reported that they regularly funded qualitative studies to guide the development of preventive sexual health services.
Two-thirds of health ministries and over one-half of public health units said that they regularly promote model activities of adolescent health service delivery related to HIV/sexuality. As well, about 25% of health ministries reported that they regularly provide incentive grants to encourage implementation of sexual health services.
Over 80% of health ministries and almost 70% of public health units said that they regularly fund the delivery of adolescent sexual health services in clinics. Over 80% of health ministries also reported that they funded sexuality or AIDS groups to also deliver services.
About 25% of health ministries reported that they regularly promote pre-service education for public health staff by funding the development of certificate courses or additional qualifications.