Young Deadly Free: impact evaluation of a sexual health youth peer education program in remote Australian communities
Roanna Lobo A , Belinda D’Costa
A E , Linda Forbes B and James Ward B C D
A Sexual Health and Blood-borne Virus Applied Research and Evaluation Network, Collaboration for Evidence, Research and Impact in Public Health, School of Public Health, Curtin University, GPO Box U1987, Perth, WA 6845, Australia.
B Wardliparingga Aboriginal Health Equity, South Australian Health and Medical Research Institute, PO Box 11060, Adelaide, SA 5001, Australia.
C College of Medicine and Public Health, Flinders University, GPO Box 2100, Adelaide, SA 5001, Australia.
D UQ Poche Centre for Indigenous Health, School of Public Health, The University of Queensland, Brisbane, Qld 4072, Australia.
E Corresponding author. Email: belinda.dcosta@curtin.edu.au
Sexual Health 17(5) 397-404 https://doi.org/10.1071/SH20069
Submitted: 4 May 2020 Accepted: 16 July 2020 Published: 12 November 2020
Abstract
Background: Aboriginal and Torres Strait Islander people in remote and very remote communities in Australia experience high rates of sexually transmissible infections (STIs), 4- to 29-fold the rates reported for non-Aboriginal people living in remote areas. Young people aged 16–29 years are particularly vulnerable to STIs. The Young Deadly Free (YDF) sexual health youth peer education program was implemented in 15 remote or very remote communities in four Australian jurisdictions in an effort to address endemic STI rates in these communities. The present study sought to evaluate the effect of YDF for Aboriginal young people. Methods: Young people (n = 128) participated in youth peer educator training to deliver peer education sessions on sexual health topics to other young people in their communities. Pre and post surveys were used to examine changes in STI knowledge, attitudes and behavioural intentions of the young people attending the peer education sessions. GHRANITE software extracted deidentified STI testing data for young people attending 13 community health services. Results: Young people (n = 426) attended peer education sessions delivered by trained youth peer educators. Pre and post surveys were completed by 174 and 172 young people respectively (median age 20 years). Gains were reported in STI knowledge, intentions to test (χ2 = 10.58, d.f. = 4, n = 142, P < 0.001) and number of STI tests (50.8% increase from baseline). Feelings of shame associated with STI testing remained high (39.5% post survey). Conclusions: Peer education can enhance the sexual health literacy of young Aboriginal people residing in remote communities. The extent to which knowledge gains result in behaviours that prevent STI transmission requires further evaluation. Normalising STI testing among Aboriginal young people would help reduce feelings of shame.
Keywords: interventions, program evaluation, sexually transmissible infections (STIs).
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