Health promotion and education initiatives for the priority population groups identified in this strategy should be strengthened and delivered on an ongoing basis to create the enabling environments, personal empowerment and increased health literacy and behaviour change needed to reduce STIs and BBVs. This should include health promotion and social marketing that respond to the social, cultural and environmental context in which people live. Emphasis should be on increasing health literacy among young people, people in custodial settings, gay men, other men who have sex with men, sistergirls, transgender people, and remote and very remote communities where English is not the first language spoken.
Current models of health promotion provide a rationale for the shift from broad-based prevention activities to targeted initiatives. The overwhelming burden of chronic disease morbidity and mortality in Aboriginal and Torres Strait Islander communities means there is limited capacity in health services and, in particular, primary healthcare services, to develop targeted initiatives focusing on just HIV and hepatitis C. It is therefore generally accepted that health promotion in these communities should focus on all elements essential to health. There is widespread support for ensuring that prevention activities related to HIV and hepatitis C are embedded into broader health promotion programs to ensure maximum impact.
Many health promotion campaigns targeted at the general population in Australia have adopted social marketing techniques to deliver health messages designed to influence the behaviours of specific target groups. Social marketing has been used in health promotion activities targeting Aboriginal and Torres Strait Islander communities with some success, particularly when adapted to local contexts with appropriate language and images. Preventive health education messages improving the health literacy of young people and other priority populations identified in this strategy should be ongoing, and account for relevant cultural contexts and situational factors.
Special consideration should be given to the preventive messages that young people receive given the burden of STIs in this group, the relatively higher fertility rate among Aboriginal and Torres Strait Islander teenagers and because of the population profile of the community. Culturally-specific preventive health and education programs should commence at the age of 10 years, and continue to be delivered within a school or other safe environment. Education and health literacy improvements should place greater emphasis on comprehensive approaches to sexual wellbeing, health and substance use. Furthermore, young people outside of the school environment do not have the same levels of access to health promotion and education and so require to be taught in a way that suits them and responds to their environment.
Priority actions in health promotion and health literacy
- Ensure that comprehensive school-based and out-of-school sexual health and BBV education programs are available, with quality training attached, for delivery by those who work with populations at risk.
- Develop social marketing campaigns in consultation with target groups to ensure local relevance and support.
- Link sexual health education with access to testing and treatment.