Alarming decline in adolescent sexual health behaviour in Ireland

WHO report reveals high rates of unprotected sex among teenagers across Europe, with significant implications for health and safety

: A report from the WHO Regional Office for Europe reveals condom use among sexually active adolescents has declined significantly since 2014, with rates of unprotected sex worryingly high.

This is putting young people at significant risk of sexually transmitted infections and contributing to unplanned pregnancies with often damaging consequences.

The new data were published as part of the Health Behaviour in School-aged Children (HBSC) study, which surveyed over 242,000 15-year-olds across 42 countries and regions in the period 2014 to 2022.

Key findings:

• The good news is that in the Republic of Ireland, the proportion of 15-year-olds who report having had sexual intercourse is only 10% for both girls and boys, lower than the international average (20% of boys and 15% of girls).

• Girls in Ireland were also more likely than their peers internationally to report contraceptive use.

Dr András Költő, University of Galway researcher and the lead author of the report, said: "Regarding condoms, we see the same trend among youth in Ireland as in the international sample. Over each survey cycle we see less and less adolescents report they or their partner used a condom at last intercourse; in 2010, more than three quarters of young people reported condom use, whereas in 2022, less than half of youth reported condom use."

University of Galway researchers who conducted the study in Ireland warn that unprotected sexual intercourse can have far-reaching consequences for young people, including unintended pregnancies, unsafe abortions, and an increased risk of contracting sexually transmitted infections (STIs).

The high prevalence of unprotected sex indicates significant gaps in age-appropriate comprehensive sexuality education, including sexual health education, and access to contraceptive methods.

• Worrying decline in condom use

Compared to 2014 levels, the new data show a significant decline in the number of adolescents reporting condom use during last sexual intercourse.

From the data, it is clear that the decrease in condom use is pervasive, spanning multiple countries and regions, with some experiencing more dramatic reductions than others.

The report underscores the urgent need for targeted interventions to address these concerning trends and promote safer sexual practices among young people within the wider context of equipping them with the foundation they need for optimal health and well-being.

Findings from the report related to Europe and Ireland:

• Decline in condom use: The proportion of sexually active adolescents who used a condom at last intercourse fell from 70% to 61% among boys and 63% to 57% among girls between 2014 and 2022.

In Ireland, only 50% of boys and 49% of girls reported condom use in 2022.

• Contraceptive pill use: The report indicates that contraceptive pill use during last sexual intercourse has remained relatively stable between 2014 and 2022, with 26% of girls and 25% of boys reporting that they or their partners used the contraceptive pill at their last sexual intercourse.

Compared to the international average, girls in Ireland were more likely to report contraceptive use (41%); while boys were somewhat less likely to state that (21%).

• High rates of unprotected sex: Almost a third of adolescents (30%) reported using neither a condom nor the contraceptive pill at last intercourse, a figure that has barely changed since 2018.

In Ireland, 35% of girls and 38% of boys had no protection at last sex.

The findings underscore the importance of providing comprehensive sexual health education and resources for young people.

Éabha, a 16-year-old from Ireland, said: "As teenagers, having access to accurate information about sexual health is vital. We need education that covers everything from consent to contraception, so we can make informed decisions and protect ourselves."

Dr Költő said: "It is a great news that girls rank highly in international comparison regarding contraceptive pill use at last sexual intercourse. We were delighted to learn that the Free Contraception Scheme was recently extended to 17-year-old girls.

"This action, however, needs to be coupled with a reform of relationships and sexuality education.

"Comprehensive sexuality education is key to closing these gaps and empowering all young people to make informed decisions about sex as they transition from adolescence to adulthood. Sex education must go beyond just providing information. Young people need safe spaces to discuss issues like consent, intimate relationships, gender identity and sexual orientation. Governments, health and education authorities, and civil society organisations as well as parents and teachers should help them develop crucial life skills including transparent, non-judgmental communication and decision-making. We are looking forward to reading the report of National Council for Curriculum and Assessment on the planned reform of Relationships and Sexuality Education in Ireland."

Call to action for policymakers and educators

The WHO Regional Office for Europe calls upon policymakers, educators, and healthcare providers to prioritise adolescent sexual health by:

• Investing in comprehensive sexuality education: Implement and fund evidence-based sexuality education programs in schools that cover a wide range of topics, including contraception, STIs, consent, healthy relationships, gender equality, and LGBTQIA+ issues. In this, the International Technical Guidelines on Sexuality Education (ITGSE), produced by a consortium of United Nations agencies and partners, are key.
• Enhancing access to youth-friendly sexual health services: Ensure that adolescents everywhere have access to confidential, non-judgmental, and affordable sexual health services that meet their specific needs and preferences.
• Promoting open dialogue: Encourage open and honest conversations about sexual health within families, schools, and communities to reduce stigma and increase awareness.
• Training educators: Provide specialised training for teachers and healthcare providers to deliver effective and inclusive sex education. Such resources should be made available in both school and out-of-school settings.
• Conducting further research: Investigate the underlying reasons for the decline in condom use and the variations in sexual health behaviours across different populations to inform targeted interventions. This includes analysing messages and other content adolescents are exposed to across social media and online platforms, given their reach and impact all the more.

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