Background to the Research

• Promoting the health and wellbeing of young people has been a fundamental theme of North and West Belfast Health Action Zone for many years. Sexual health is central to this theme and has led to the development of 'A Strategy to Promote the Sexual Health and Wellbeing of Young People in North and West Belfast'. This report presents one aspect of the work undertaken by the multi agency board established to oversee the implementation of this strategy.
• The survey aimed to identify the gaps in the sexual health services provision to young people in North and West Belfast. It also set out to contribute to an understanding of what young people want from sexual health services and how their needs could be met.
  

Research Approach

• Young people, recruited through organisations that had regular access to young people through their provision of sexual health education and services in North and West Belfast, were approached to complete a survey questionnaire. A total of 279 young people (predominantly service users, most aged 15-17 years, and 57% males and 43% females) completed the questionnaire. Two focus groups were also conducted - one with health professionals and one with young people.
  

Main Findings

• 87% of respondents said they had received information on relationships and sexual health; females (92%) were more likely than males (83%) to say this, and the 9% of respondents who identified as LGBT were significantly less likely to say this (70%).
• The three topics covered most appropriately in sexual health information were related to physical aspects of sexuality, whereas the three worst covered areas related to emotional aspects of sexuality.
• Males were almost four times as likely as females to disagree that it is easy 'to say no to having sex'. One in five LGBT respondents found it difficult to ask for what they wanted in relationships.
• 73% of respondents said they had had sex, with the mean age at first sex being 14.5 years. Over half of all respondents had experienced not only heavy petting, but also sexual intercourse by age 15. At age 18, 96% of respondents said they had experienced sexual intercourse.
• 66% of respondents said they had used contraception when they first had sex. Contraceptive use was significantly lower among those who said they were not heterosexual. Younger respondents were more likely than older respondents to say they had used contraception at first sex; however, they were least likely to use contraception with their current partner. The most commonly used method of contraception was condoms (95%), while 27.1% used the contraceptive pill.
• 40% of respondents said they had used EC; 60% of these had used it once, 30% had used it more than once but less than five times, and 11% had used it more than five times. 79% of respondents got this from Brook, 8% from a chemist, 6% from GPs and 5% from a family planning clinic.
• 58% of respondents said there was adequate sexual health information in their area. Respondents who said they had a disability were slightly less likely to think this. Brook was the main source of contraception and information on sexual infections. Friends, a chemist or partners were the next most often mentioned sources of contraception.
  

Conclusions

• Young women were concluded to take more responsibility for accessing contraception and were more likely to look after their sexual health than males. Young people who identified as LGBT were ten times more likely to have used sexual health services and seven times more likely to use a sexual health helpline.
• The report ends with a series of recommendations to inform current and future policy development.
  • Multi-disciplinary training and protocol development is required for professionals on young people's rights, including the right (or not) to confidentiality.
  • RSE needs to be inclusive of LGBT groups and young people with disabilities. It should be timely, age appropriate and not based solely on a medical model. A core element should be emotional feelings and the ability to develop and maintain safe and satisfying relationships.
  • RSE should include confidence building activities as a priority, particularly for young men who often require assistance to ask for help and support on sexual health issues.
  • While the young people were found to value the sexual health services currently available, improvements should be made with regard to waiting times, location and opening times of services.
  • EC should be available in all pharmacies in North and West Belfast.
  • Sexual health service providers should be more proactive in addressing the needs of young men.
  • Information and training should be provided for young people on their rights including the right (or not) to confidentiality. This will enable them to make informed choices about which services they want to use.
  • An open, inclusive debate on the areas of RSE and sexual health services should be initiated with partners, stakeholders and, in particular, community groups, faith groups, parents and schools.
  • Professional education and training should include an exploration of attitudes and values, together with factual knowledge related to the sexual health of young people.
  • Further research should be conducted to include a more representative sample of young people in North and West Belfast. Appropriate resources should be allocated in these areas to allow the best possible services to be provided to all young people, with particular attention to LGBT groups, young males and young people with disabilities.