Tanja Tyden & Maria Ekstrand
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Tanja Tyden & Maria Ekstrand



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Tanja Tyden & Maria Ekstrand Presentation Transcript

  • 1. Sexual and reproductive health among teenagers and young adults in Sweden Tanja Tydén and Maria Ekstrand Uppsala University
  • 2. What is sexuality? Lars Forsstedt
  • 3. What is Sexual health ?
    • A state of physical, emotional, mental and social well-being in relation to sexuality
    • Sexual health requires a positive and respectful approach to sexuality and sexual relationships, as well as the possibility of having pleasurable and safe sexual experiences, free of discrimination and violence
  • 4. Sexual rights include the right of all persons to…
    • Having access to sexual and reproductive health care services
    • Having access to sexuality education
    • Decide whether to be sexually active or not
    • Choose their partner
    • Decide whether or not, and when, to have children
  • 5. Adolescence
    • High levels of sex hormones
    • Curiosity
    • Invulnerability
    • Looking for somebody to love
    • Stretching boundaries
    • Peer pressure
    • Parents less significant than friends
  • 6. In lust we trust -the Swedish approach to adolescent sexuality
  • 7. Strategies in establishing good sexual and reproductive health
    • National guidelines and public health policies concerning SRH-issues
    • National reporting system for Chlamydia - including partner notification, contact tracing, testing and free antibiotic treatment
    • Long tradition of compulsory sexual education in schools
    • Good access to sexual and reproductive health care services
  • 8. Sexual and reproductive health care services
    • Youth-friendly Youth clinics in all cities
    • Contraceptives – subsidized for teenagers and easily accessible
    • Counselling and STI-testing - confidential and free of charge
    • ECP sold over-the-counter and available free of charge at youth clinics on week-days
    • Abortion - free of demand until 18th week of gestation
  • 9. Sexual and reproductive health in Sweden – what's it like today?
    • The mean age of first sexual intercourse is 16 years
    • 75% of 18 year olds have had sexual intercourse
    • Almost all boys have watched pornography and this has some negative impact on sexual health
  • 10. Sexual behaviour among male and female high school students
    • Males
    • 70% positive with the first intercourse
    • > 90% positive with the latest intercourse
    • 67% used contraception at the first intercourse
    • 3% reported an STI
    • 11% reported an abortion
    • Females
    • 50% positive with the first intercourse
    • > 90% positive with the latest intercourse
    • 75% used contraception at the first intercourse
    • 8% reported an STI
    • 7% reported an abortion
  • 11. Fertility rate among Swedish women
    • Decreased fertility rate in combination with older first time mothers - changes over time
    • Women's mean age at first baby is 29 years (2007)
    • Too few babies are born; the fertility rate is 1.9
  • 12. What are the attitudes among university students to having children?
    • Nearly all students wanted children in the future (both sexes wanted 2 - 3 children)
    • Women more uncertain regarding the probability to get the desired number of children
    • Women more concerned of the status on the labor market in combination with having children
    • 63% of the men and 33% of the women wanted to postpone childbearing till after the age of 30
  • 13. Sexual and reproductive health – heading in the wrong direction?
    • Increased abortion rates among teenagers
    • Increased incidences of sexually transmitted infections
    • In combination with delayed parenthood
  • 14. Abortions in Sweden 1975-2006 Källa: Socialstyrelsen
  • 15. Abortion rate in the Nordic countries (per 1000 women) 1995-2002 10 12 14 16 18 20 22 24 26 1995 1996 1997 1998 1999 2000 2001 2002 Year Abortions / 1000 Norway Denmark Finland Sweden
  • 16. Abortions in the Nordic countries (per 1000 women) 2006-2007 14.5 15.9 16.1 24.4 9.2 13.3 12.2 20.2 0 5 10 15 20 25 30 Finland Norway Denmark Sweden 15-49 15-19
  • 17. Abortion statistics among Swedish teenage girls Number of abortions among girls aged 15-17, 1995-2004
  • 18. Incidence of Chlamydia infection per 1000 inhabitants 1995-2006 Source: Centre of Epidemiology, Sweden
  • 19. What's behind increased sexual risk taking?
    • Underestimation of risk
    • Inconsistent contraceptive use
    • Negative attitudes towards condoms
    • Fear of hormonal contraceptives
    • Contraceptive use – (“still”) the woman’s responsibility
  • 20. Underestimation of risk... Inconsisten contraceptive use... Fear of hormones... You are perfectly aware that you put yourself at risk, but still..you kind of think that nothing will happen... I thought I might be sterile. Nothing had happened before, so I was actually a bit worried that I couldn´t get pregnant... It´s hard to keep track of what the risks are really, but basically, hormones aren´t good for you...
  • 21. I´ve only had sex while being sober once... It´s common...you get Chlamydia...condyloma... You just take penicillin and it´s gone. It´s not that serious really. I mean HIV, some people in Africa´s got it but....seriously...– it feels like it wont happen to me. I took it off once mostly because couldn´t sense anything and because it started to get soft...the worst thing that could ever happen to a man! Underestimation of risk... Inconsisten contraceptive use... Negative attitudes towards condom use...
  • 22. Contraceptive use – “still” a girls´ issue Afterwards he said ’You’re on the Pill, right ?!? You kind of assume the girl will take morning-after-pills the day after... She´d have to bring i up if I were to use a condom. I´d never do it...
  • 23. “ Changing up the gear” Suggestions for the future…
    • Enhanced primary prevention strategies (i.e. schools, tools for teachers)
    • (Even) better ECP and contraceptive access with extended opening hours at youth clinics
    • Empowering boys/men to take greater sexual and reproductive responsibility
    • “ Male friendly” youth clinics
  • 24. Important to remember…
    • Teaching abstinence has never worked…
    • … and never will!
  • 25. Prevention of unintended pregnancies - National Guidelines
    • “… to strive towards a society where as many pregnancies as possible should be desired...” National Institute for Public Health (FHI)
    • “… ways of achieving this goal include efforts of knowledge raising, behavioural-influencing and availability of contraception and counseling.”
    • National Institute for Public Health (FHI)
  • 26. Important to remember… Teaching abstinence has never worked… … and never will!