In Australia, since 1992, we have been fortunate to have, every five years, a monitoring survey of the sexual knowledge and behaviour of our young people. The survey is funded by the Commonwealth Department of Health and Ageing and conducted by researchers at the Australian Research Centre In Sex, Health and Society at La Trobe University in Melbourne1. This ongoing series has not simply allowed us to have up to date evidence on which to base our health promotion and sex education planning, but has also allowed us to monitor change over time and see trends emerge while they are relatively new.

The data collected in previous surveys has been widely used throughout Australia to inform educational policy and practice in the sexual health areas and by health departments to plan interventions for young people. Many sexual health and youth health services draw on these data for evidence-based service planning and opportunistic health promotion.

The 1997 study informed the development of the national policy framework Talking Sexual Health, and the supporting classroom resources, professional development manual and parents‘ guide. More recently, following the release of the 2002 data, states and territories have produced a range of curricula and resources to support best practice programs in schools and a whole school approach to promoting positive sexual health.

The data from the fourth survey was collected in 2008 and released in July. The full report can be downloaded from http://www.latrobe.edu.au/arcshs/download_reports.html. This study uses a representative random sample based on Australian Bureau of Statistics data on the school population and in 2008 sampled nearly 3000 Year 10 and Year 12 students from more than 100 secondary schools from the Government, Catholic and Independent school systems and from every jurisdiction in Australia.

Student knowledge
While students have always been quite knowledgeable about HIV, their knowledge of sexually transmitted infections (STIs) has been much poorer. In 2008 we found an increase in STI knowledge, particularly about Chlamydia, which suggests schools are doing their job well. Nevertheless the improvement is coming off a low base and there is still a long way to go in this area. Fewer than 1 in 10 students believed they were at risk of infection with HIV/AIDS, an STI, hepatitis B or hepatitis C. However, it was good to see that students who were sexually active and had more sexual partners were more likely to believe they were at risk of infection with STIs.

Sexual behaviour
The majority of students (78%) have experienced some form of sexual activity and over one quarter of Year 10 students and just over half of Year 12 students had experienced sexual intercourse. This was an increase from 35% of all students in 2002 to 40% in 2008. This is a trend we have observed since the surveys began and a reality which has not always been reflected in the provision of timely and appropriate sexuality education in Australian schools. It is also important to note here that around 20% of students have not experienced any kind of sexual activity and also need to be supported in their choices.

While student condom use has remained stable between 2002 and 2008 surveys, it is notable that only 69% of students reported using a condom the last time they had sex and only half the sample of sexually active students “always” used a condom when they had sex in the previous year. Fewer students in the 2008 survey reported using no contraception the last time they had sex.

Use of the birth control pill (37% vs. 50%) and morning after pill (4% vs. 8%) increased between 2002 and 2008. This is still too low for us to conclude that there is a safe sex culture amongst young people. This sits beside the finding that a considerable proportion of sexually active students have sex with three or more people in a year, and this proportion had increased significantly in 2008. Between the 2002 and 2008 surveys the proportion of students reporting three or more sexual partners increased from 20% to 30%.

Over the time of the surveys, we have seen an increase in oral sex with just under half of the students reporting having experienced it in 2008. Although most of those students reported having oral sex with one partner in the previous year, a considerable proportion (28%) had oral sex with three or more people. This proportion had increased appreciably since the 2002 study (19%). Oral sex is now clearly a part of the sexual repertoire of young people, having entered the realm of foreplay for many and is now one of the more sensitive areas our school programs need to cover.

Unwanted intercourse
In the context of increased sexual activity, we have, unfortunately, also seen a marked increase, particularly for young women, in the experience of unwanted sex. In 2002 28% of young women reported ever having unwanted sex and in 2008 this figure had increased to 38%. Nevertheless, 19% of young men also reported having unwanted sex, indicating the kinds of pressures and expectations that exist in social situations for our young people. Despite this, most students report positive feelings after having sex.

Same sex attraction
The proportion of students reporting a sexual attraction exclusively to those of the opposite sex declined between 2002 and 2008 surveys. This decline was most marked for young men in Year 12, with the proportion of students reporting heterosexual sexual attraction dropping from 96% to 90%. There was also a marked increase in the number of students from this group who were unsure of their sexual attraction. This may well be indicative of schools dealing better with the issues and students feeling more comfortable to sit with their uncertainty rather than feeling rushed to a decision. Almost one in 10 students surveyed reported their most recent sexual encounter was with someone of the same sex. For young men, the likelihood of having a same sex encounter at the most recent sexual experience had increased from 2% in 2002 to 8% in 2008.

Alcohol use
Over the years, we have observed an increase in the role played by alcohol, particularly for young women, in sexual encounters. In 2008 there has been a reduction in experience of alcohol consumption overall but students continue to drink considerable amounts of alcohol.

Although most students (38%) drank alcohol “once a month or less”, 21% reported drinking either weekly or more frequently. In particular, young women in Year 12 reported higher rates of binge drinking in 2008 compared to 2002.

In 2002 approximately two-thirds of young women in Year 12 reported drinking “three or more drinks” on any one occasion – this figure had increased considerably to 84% in 2008.

As being drunk is the major reason students cited for having unwanted sex and a quarter of sexually active students reported being drunk or high at their last sexual encounter, these results remain a cause for some concern. Too often in schools, alcohol and drug education is divorced from sexuality education so that students miss out on a chance to explore and discuss the whole context of social events and sexual encounters.

Finding out about sexual health
Most students (88%) had sought information regarding sexual health. Students most commonly sought information from their mothers (56%), female friends (55%), and the school sexual health program (49%). These were trusted and well used sources, and a great vote of confidence in schools which are addressing these issues well. Despite not being used as frequently by students, doctors (39%) were the most trusted source of information on sexual health, and finding ways to assist students to access them more readily would be a useful inclusion in any school program.

The value of mothers as sexual health educators has been strong in all the surveys and this time it was pleasing to note that there has been an increase in student confidence with respect to talking with their parents about sex and sexual health related matters.

Family/school partnerships are the ideal way for supporting young people to develop sexual health literacy and a personal ethic to guide their behaviour, and such partnerships appear to be strengthening.

It‘s not all bad news
The release of these data frequently gives rise to publicity around the more negative aspects of the findings and to community concern arising from them. It is therefore important to note that young people, in the main, manage their sexual health very well.

They generally make good decisions about their sexual behaviour. If they are sexually active, they generally participate in safe sexual encounters about which they are largely pleased with and about which they are well informed.

It is important that policy makers and educators drawing on these data for future work are mindful of this conclusion. School programs which are currently in place are working well and valued by students; support given to young people to make their own decisions is well rewarded. Teachers and parents generally appear to be addressing this frequently challenging area with some success.

Full report
1    Smith, A., Agius, P., Mitchell, A, Barrett, C & Pitts, M (2009) Secondary students and sexual health 2008: Results of the 4th national survey of Australian Secondary students. Australian Research Centre in Sex, Health and Society. Latrobe University. Melbourne. Victoria.