Second National Sexually Transmissible Infections Strategy 2010 - 2013

6.1 Health promotion and prevention

Page last updated: July 2010

Sexual health promotion is defined by the World Health Organization as the holistic process of enabling individuals and communities to increase control over the determinants of sexual health, and thereby managing and improving it through their lifetime. Effectively and sustainably addressing STIs in priority populations requires a range of interventions, as no single one can deliver sustained changes in health outcomes. Complex behavioural change, such as increasing use of condoms and reducing unsafe sex, requires an integrated and sustained health promotion approach.

Broad community engagement and social marketing which presents the issues and consequences of STIs in Australia, is a priority activity of this strategy. A broad approach to informing and raising the awareness of priority and non-target populations such as individuals at very low risk of STIs, (e.g. individuals in long-term monogamous relationships), is an important precursor to community discussion, debate and cultural change about STIs and other related matters for priority populations.29, 30 Previous community awareness programs fundamental to cultural and behavioural change have used this approach. It is most effective when activities are developed and implemented incrementally over a number of years, but with stand-alone and integrated components.31

Implementation planning for this strategy also needs to consider opportunities for health promotion, prevention, testing, diagnosis and treatment of STIs in a range of settings, including custodial settings. Whether in adult prison or juvenile detention, people who are incarcerated are at risk for STI and BBVs.32, 33, 34 As many incarcerated people come from priority populations, the risks can be seen to be multiplied. However, custodial settings can provide people at high risk of infection with access to education, screening, diagnosis and treatment as well as vaccination where recommended.35 The continuation of sexual health screening in routine encounters, such as the Aboriginal and Torres Strait Islander adolescent and Adult Health Check, is supported.

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29 Nicoll A, Hughes G, Donnelly M, et al., 2001, ‘Assessing the impact of national anti-HIV sexual health campaigns: trends in the transmission of HIV and other sexually transmitted infections in England, Sexually Transmitted Infections’, 77: pp. 242–247, viewed 13 September 2009, <http://www.pubmedcentral.nih.gov/picrender.fcgi?artid=1744349&blobtype=pdf>.
30 Smith A, Agius P, Mitchell A, Barrett C & Pitts M, 2009, ‘Secondary Students and Sexual Health 2008’, monograph series no. 70, Melbourne: Australian Research Centre, Sex, Health and Society, La Trobe University, viewed 7 August 2009, <http://www.latrobe.edu.au>.
31 Downing J, Jones L, Cook A & Bellis MA, ‘Prevention of STIs: a review of reviews into the effectiveness of non—clinical interventions’, evidence briefing update, 2006, <http://www.nice.org.uk/media/ABC/87/STIEvidenceBriefingFinal.pdf>.
32 Richters, J, Butler, T, Yap, L, Kirkwood, K, Grant, L, Smith, A, Schneider, K & Donovan, B, 2008, ‘Sexual health and behaviour of New South Wales prisoners’, Sydney: School of Public Health and Community Medicine, University of New South Wales, 2008.
33 Butler T, Ritchters J, Yap L, Papanastasiou C, Richards A, Schneider K, Grant L, Smith AMA & Donovan B, 2009, ‘Sexual health and behaviour of Queensland prisoners - with Queensland and New South Wales comparisons’, In Press, National Drug Research Institute and School of Public Health and Community Medicine, University of New South Wales), ISBN: 978-0-9807054-0-9.
34 Butler T & Milner L, ‘The 2001 New South Wales Inmate Health Survey’, 2003 Corrections Health Service, Sydney, ISBN: 0 7347 3560 X.
35Yap L, Butler T, Richters J, Kirkwood K, Grant L, Saxby M, Ropp F & Donovan B, ‘Do condoms cause rape and mayhem? The long-term effects of condoms in New South Wales prisons’, Sexually Transmitted Infections, 2007; 83: pp. 219–222.