Sexual health practices of 16 to 19 year olds in New Zealand: an exploratory study
Sonja J. Ellis 1 3 , Robyn Aitken 21 Te Kura toi Tangata (School of Education), The University of Waikato, Hamilton, New Zealand
2 Menzies School of Health Research, Charles Darwin University Australia; Top End Health Service, Darwin, NT, Australia
3 Corresponding author. Email: sonja.ellis@waikato.ac.nz
Journal of Primary Health Care 12(1) 64-71 https://doi.org/10.1071/HC19037
Published: 5 March 2020
Journal Compilation © Royal New Zealand College of General Practitioners 2020 This is an open access article licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License
Abstract
INTRODUCTION: New Zealand sexual health surveillance data suggest that young people aged 15–19 years are at considerable risk of contracting sexually transmitted infections. Although there is an established body of international research around sexual behaviours and sexual health practices among teenagers, there is a dearth of local research focusing on this age group.
AIM: The aim of this study was to explore the sexual repertoires and sexual health practices among teenagers in New Zealand with a view to better understanding levels of risk in this age group.
METHODS: This study comprised a cross-sectional online survey designed to ask questions about sexual behaviours. A convenience sample of young people (n = 52) aged 16–19 years living in New Zealand completed the survey.
RESULTS: Most participants (71.2%) were sexually active, reporting engagement in a range of sexual practices. The most commonly reported sexual behaviours were penis-in-vagina sex (86.5%) and oral sex with a person-with-a-penis (81.1%). Infrequent and inconsistent use of barrier protection across all types of sexual behaviour was also reported.
DISCUSSION: The findings of this study highlight the importance of ensuring that young people have access to sexual health education that routinely includes health information and advice addressing the full range of sexual practices, regardless of the identity classifications they may use, or that may be attributed to them.
KEYwords: Young people; sexual behaviour; sexual health; STI prevention; New Zealand
References
[1] Institute of Environmental Science and Research. Sexually transmitted infections in New Zealand: Annual Surveillance Report. Porirua, New Zealand: Ministry of Health; 2018. [cited 2019 February 18]. Available from https://surv.esr.cri.nz/PDF_surveillance/STISurvRpt/2015/FINAL2015AnnualSTIReport.pdf[2] Normansell R, Drennan VM, Oakeshott P. Exploring access and attitudes to regular sexually transmitted infection screening: the views of young, multi‐ethnic, inner‐city, female students. Health Expect. 2016; 19 322–30.
| Exploring access and attitudes to regular sexually transmitted infection screening: the views of young, multi‐ethnic, inner‐city, female students.Crossref | GoogleScholarGoogle Scholar | 25703741PubMed |
[3] Connor J, Psutka R, Cousins K, et al. Risky drinking, risky sex: a national study of New Zealand university students. Alcohol Clin Exp Res 2013; 37 1971–8.
| Risky drinking, risky sex: a national study of New Zealand university students.Crossref | GoogleScholarGoogle Scholar | 23895314PubMed |
[4] Denison HJ, Bromhead C, Grainger R, et al. Barriers to sexually transmitted infection testing in New Zealand: a qualitative study. Aust N Z J Public Health. 2017; 41 432–7.
| Barriers to sexually transmitted infection testing in New Zealand: a qualitative study.Crossref | GoogleScholarGoogle Scholar | 28664644PubMed |
[5] Psutka R, Connor J, Cousins K, Kypri K. Sexual health, risks, and experiences of New Zealand university students: findings from a national cross-sectional study. N Z Med J. 2012; 125 62–73.
| 22960717PubMed |
[6] Mitchell A, Patrick K, Heywood W, et al. National survey of Australian secondary students and sexual health 2013. Melbourne: Australian Research Centre in Sex Health and Society & La Trobe University; 2014. [Cited 2019 November 19]. Available from: https://yeah.org.au/wp-content/uploads/2014/10/31631-ARCSHS_NSASSSH_FINAL-A-3.pdf
[7] Lewis R, Marston C, Wellings K. Bases, stages and ‘working your way up’: young people’s talk about non-coital practices and ‘normal’ sexual trajectories. Sociol Res Online. 2013; 18 233–41.
| Bases, stages and ‘working your way up’: young people’s talk about non-coital practices and ‘normal’ sexual trajectories.Crossref | GoogleScholarGoogle Scholar |
[8] Fortenberry JD, Schick V, Herbenick D, et al. Sexual behaviors and condom use at last vaginal intercourse: a national sample of adolescents ages 14 to 17 years. J Sex Med. 2010; 7 305–14.
| Sexual behaviors and condom use at last vaginal intercourse: a national sample of adolescents ages 14 to 17 years.Crossref | GoogleScholarGoogle Scholar | 21029387PubMed |
[9] Lewis R, Marston C. Oral sex, young people, and gendered narratives of reciprocity. J Sex Res. 2016; 53 776–87.
| Oral sex, young people, and gendered narratives of reciprocity.Crossref | GoogleScholarGoogle Scholar | 26849152PubMed |
[10] Lewis R, Tanton C, Mercer CH, et al. Heterosexual practices among young people in Britain: evidence from three national surveys of sexual attitudes and lifestyles. J Adolesc Health. 2017; 61 694–702.
| Heterosexual practices among young people in Britain: evidence from three national surveys of sexual attitudes and lifestyles.Crossref | GoogleScholarGoogle Scholar | 29169520PubMed |
[11] Clark TC, Lucassen MF, Fleming T, et al. Changes in the sexual health behaviours of New Zealand secondary school students, 2001–2012: findings from a national survey series. Aust N Z J Public Health. 2016; 40 329–36.
| Changes in the sexual health behaviours of New Zealand secondary school students, 2001–2012: findings from a national survey series.Crossref | GoogleScholarGoogle Scholar | 27372062PubMed |
[12] Manning WD, Flanigan CM, Giordano PC, Longmore MA. Relationship dynamics and consistency of condom use among adolescents. Perspect Sex Reprod Health. 2009; 41 181–90.
| Relationship dynamics and consistency of condom use among adolescents.Crossref | GoogleScholarGoogle Scholar | 19740237PubMed |
[13] Prendergast LE, Leung RK, Toumbourou JW, et al. Sexual behaviour in early adolescence: a cross‐national comparison of Australian and United States youth. Aust J Psychol. 2017; 69 3–11.
| Sexual behaviour in early adolescence: a cross‐national comparison of Australian and United States youth.Crossref | GoogleScholarGoogle Scholar | 28713170PubMed |
[14] Holway GV, Hernandez SM. Oral sex and condom use in a US national sample of adolescents and young adults. J Adolesc Health. 2018; 62 402–10.
| Oral sex and condom use in a US national sample of adolescents and young adults.Crossref | GoogleScholarGoogle Scholar | 29174873PubMed |
[15] Hensel DJ, Fortenberry JD, Orr DP. Factors associated with event level anal sex and condom use during anal sex among adolescent women. J Adolesc Health. 2010; 46 232–7.
| Factors associated with event level anal sex and condom use during anal sex among adolescent women.Crossref | GoogleScholarGoogle Scholar | 20159499PubMed |
[16] Rowen TS, Breyer BN, Lin TC, et al. Use of barrier protection for sexual activity among women who have sex with women. Int J Gynaecol Obstet. 2013; 120 42–5.
| Use of barrier protection for sexual activity among women who have sex with women.Crossref | GoogleScholarGoogle Scholar | 23106842PubMed |
[17] Neville S, Adams J, Moorley C, Jackson D. The condom imperative in anal sex - one size may not fit all: a qualitative descriptive study of men who have sex with men. J Clin Nurs. 2016; 25 3589–96.
| The condom imperative in anal sex - one size may not fit all: a qualitative descriptive study of men who have sex with men.Crossref | GoogleScholarGoogle Scholar | 27539386PubMed |
[18] Wood J, Crann S, Cunningham S, et al. A cross-sectional survey of sex toy use, characteristics of sex toy use hygiene behaviours, and vulvovaginal health outcomes in Canada. Can J Hum Sex. 2017; 26 196–204.
| A cross-sectional survey of sex toy use, characteristics of sex toy use hygiene behaviours, and vulvovaginal health outcomes in Canada.Crossref | GoogleScholarGoogle Scholar |
[19] Bauman LJ, Karasz A, Hamilton A. Understanding failure of condom use intention among adolescents: completing an intensive preventive intervention. J Adolesc Res. 2007; 22 248–74.
| Understanding failure of condom use intention among adolescents: completing an intensive preventive intervention.Crossref | GoogleScholarGoogle Scholar |
[20] Mustanski B, DuBois LZ, Prescott TL, Ybarra ML. A mixed-methods study of condom use and decision making among adolescent gay and bisexual males. AIDS Behav. 2014; 18 1955–69.
| A mixed-methods study of condom use and decision making among adolescent gay and bisexual males.Crossref | GoogleScholarGoogle Scholar | 24906532PubMed |
[21] Bell J. Why embarrassment inhibits the acquisition and use of condoms: a qualitative approach to understanding risky sexual behaviour. J Adolesc. 2009; 32 379–91.
| Why embarrassment inhibits the acquisition and use of condoms: a qualitative approach to understanding risky sexual behaviour.Crossref | GoogleScholarGoogle Scholar | 18691747PubMed |
[22] Haley T, Puskar K, Terhorst L, et al. Condom use among sexually active rural high school adolescents personal, environmental, and behavioral predictors. J Sch Nurs. 2013; 29 212–24.
| Condom use among sexually active rural high school adolescents personal, environmental, and behavioral predictors.Crossref | GoogleScholarGoogle Scholar | 23008185PubMed |
[23] Johansson K, Persson KI, Deogan C, El-Khatib Z. Factors associated with condom use and HIV testing among young men who have sex with men: a cross-sectional survey in a random online sample in Sweden. Sex Transm Infect. 2018; 94 427–33.
| Factors associated with condom use and HIV testing among young men who have sex with men: a cross-sectional survey in a random online sample in Sweden.Crossref | GoogleScholarGoogle Scholar | 29773663PubMed |
[24] Vasilenko SA, Kreager DA, Lefkowitz ES. Gender, contraceptive attitudes, and condom use in adolescent romantic relationships: a dyadic approach. J Res Adolesc. 2015; 25 51–62.
| Gender, contraceptive attitudes, and condom use in adolescent romantic relationships: a dyadic approach.Crossref | GoogleScholarGoogle Scholar | 25750492PubMed |
[25] Potard C, Courtois R, Samedy ML, et al. Determinants of the intention to use condoms in a sample of French adolescents. Eur J Contracep Reprod Health Care. 2012; 17 55–64.
| Determinants of the intention to use condoms in a sample of French adolescents.Crossref | GoogleScholarGoogle Scholar |
[26] Abel G, Fitzgerald L. ‘When you come to it you feel like a dork asking a guy to put a condom on’: is sex education addressing young people’s understandings of risk? Sex Educ. 2006; 6 105–19.
| ‘When you come to it you feel like a dork asking a guy to put a condom on’: is sex education addressing young people’s understandings of risk?Crossref | GoogleScholarGoogle Scholar |
[27] McPhillips K, Braun V, Gavey N. Defining (hetero) sex: how imperative is the “coital imperative”? Women Stud Int Forum. 2001; 24 229–40.
| Defining (hetero) sex: how imperative is the “coital imperative”?Crossref | GoogleScholarGoogle Scholar |
[28] Agius P, Taft A, Hemphill S, et al. Excessive alcohol use and its association with risky sexual behaviour: a cross-sectional analysis of data from Victorian secondary school students. Aust N Z J Public Health. 2013; 37 76–82.
| Excessive alcohol use and its association with risky sexual behaviour: a cross-sectional analysis of data from Victorian secondary school students.Crossref | GoogleScholarGoogle Scholar | 23379810PubMed |
[29] Atkins R, Sulik MJ, Hart D, et al. The effects of school poverty on adolescents’ sexual health knowledge. Res Nurs Health. 2012; 35 231–41.
| The effects of school poverty on adolescents’ sexual health knowledge.Crossref | GoogleScholarGoogle Scholar | 22431188PubMed |
[30] Garrido M, Sufrinko N, Max J, Cortes N. Where youth live, learn, and play matters: tackling the social determinants of health in adolescent sexual and reproductive health. Am J Sex Educ. 2018; 13 269–82.
| Where youth live, learn, and play matters: tackling the social determinants of health in adolescent sexual and reproductive health.Crossref | GoogleScholarGoogle Scholar |