What we know
What information do we have about the Eastern Board area?
What is the result of this on our health locally?
Policies
What is happening in the Eastern Board area?

Sexual health is an important part of physical and mental health, as well as emotional and social wellbeing. Sexual health is not just the absence of disease or sexual or reproductive dysfunction, but also embraces the capacity to enjoy relationships and express sexuality without feeling of guilt or shame; to have pleasurable and safe sexual experiences; to control fertility and to avoid the risk of unintended pregnancy.

Sexual health is important throughout life and does not just affect young people. Different aspects of sexual health may be relevant at different ages. For example ensuring children and young people have relationship and sexuality education appropriate to their age will enable them to understand their bodies, how they are changing and will help them to make sensible and responsible decisions.

Rates of sexually transmitted infections are increasing, particularly amongst young people, and public education about the risks, prevention and treatment services is needed to address the problem.

Many factors adversely impact on people’s sexual health including poverty, unemployment, poor education, poor living and working environments and social exclusion.

The social climate in Northern Ireland is unique. Recent research by the Family Planning Association (FPA) found that young people who were less able to talk to their parents about personal or sexual matters were less likely to use contraception when they first had sex. Over half of all respondents said that sex between men was always or mostly wrong. Young gay people in the survey reported that homophobic bullying was often ignored, accepted or even encouraged.

The social climate can be at odds with the media which continues to present explicit and often misleading images of relationships and sexuality.

Back to top

Sexual Behaviour
The Young People’s Behaviour and Attitudes Survey (2000) showed that of children aged 11-16:

	.27% of pupils had no sexual experience
	36% had a small amount e.g. kissing
	26% had some experience, but no sexual intercourse
	11% reported they had experiences including sexual intercourse, with majority being 14 at first sexual intercourse

No information is available on the sexual behaviour and attitudes of the adult population in Northern Ireland.

Unplanned pregnancy and parenthood can have an important impact on individuals, and in particular, for young people.

In 2001, the known number of abortions performed in England on residents from Northern Ireland was 1,577.

Sexually Transmitted Infections (STIs)
Sexual ill health can affect anyone in the population. However figures show an increasing incidence of STIs among young and gay people.

a) HIV and AIDs
N. Ireland participates in the national HIV/AIDS surveillance programme. By 31st December 2003 61,100 HIV infected individuals had been reported within the United Kingdom since surveillance commenced in the 1980s.

By December 2003 there were 279 reports of HIV infected individuals who were first diagnosed in N. Ireland. This total excludes those initially diagnosed in Great Britain but who have returned to N. Ireland and could be receiving treatment for their infection.

Globally, the main exposure category for HIV infection is via heterosexual intercourse. The main exposure category for HIV infections in N. Ireland remains sex between men and this accounted for 55% of reports, this proportion is very similar to that noted for the UK. The cumulative proportion of cases who acquired their infection through heterosexual intercourse is slowly increasing.

b) Syphilis Outbreak
A syphilis outbreak in Northern Ireland was first identified in October 2001. In 2000 Northern Ireland had 1 case of syphilis, in 2001 20 cases, in 2002 28 cases and 36 cases in 2003. By December 2003 85 cases had been reported since 1st July 2000. All except six were male, and most (69) were men who had sex with men (MSM), three of whom were bisexual. The mean age of the cohort was 36 years, range 17-64 years. Cases were resident in all four Boards in Northern Ireland and 6 were non-N. Ireland residents. 46 of the cases were resident in EHSSB.

c) Other STIs
A recent review indicates that STIs are on the increase in Northern Ireland. In 2001 there were 148 new diagnoses of gonorrhoea and 947 people were treated for chlamydia. The most common conditions include non-specific urethritis, chlamydia and genital warts.

Back to top

Sexual ill health has significant human and economic costs. There is considerable cost both in human terms and to the health service of the morbidity associated with sexual ill health.

Preventing sexual ill health depends on everyone having the information, life skills and access to services to enable them, to make informed choices.

Education and training for health professionals and others is also crucial. Services need to be in place to deal with the consequences of sexual ill health and better research and information would help to plan for the future.

Back to top