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Young People’s Sexual health

Royal College of PhysiciansLondon29 June 2009

Robert MadelinDirector General forHealth and Consumers European Commission

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Context

Action

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Definitions of Sexual Health

WHO: Sexual health is not only the absence of sexually transmitted diseases (STDs) but a state of physical, emotional, mental and social well- being related to sexuality

Council of Europe : the Right to sexual health implies the ability to establish a mutually satisfying and safe relationship free from coercion, violence or fear of STDs or unwanted pregnancies

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ContextEU committed to achieving a high level of health protection stimulate and /or complement MS activitiesIncreasing numbers of sexually transmitted infections, particularly in young people, all over EuropeMobilitySexual health / overall life skills

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DriversSocio-economic factors

poverty educationemployment

Demographic factorsage structuresmobility and migration, urban/rural movementsocial disruption

Social influenceinfluence of communications social normscultural background

Prevention and therapyaccess to prevention services and meansaccess to treatment

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Legal Framework : EU Role in health policyArt. 152 of the EC Treaty:

A high level of human health protection shall be ensured in the definition and implementation of all Community policies and activitiesCommunity action, which shall complement national policies, shall be directed towards improving public health, preventing illness …Such action shall cover the fight against major health scourges, by promoting research into their causes, their transmission and prevention as well as health information and education.Community shall encourage cooperation between Member States and lend, if necessary support to their actionCommunity action shall fully respect the responsibilities of Member States for organisation and delivery of health services

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Chlamydia infection in selected European countries

Fenton, K A et al. Sex Transm Infect 2004;80:255-263

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Chlamydia : Age distribution

9 of 23Source: HBSC study University of Utrecht, The Netherlands

10 of 23Source: HBSC study, University of Utrecht, The Netherlands

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0

10

20

30

40

50

60

70

80

90

100

Year of birth

% o

f w

om

en

(3

-ye

ar

rolli

ng

av

era

ge

s)

First intercoursebefore 18Conception before 18

Birth before 18/9

Abortion before 18

Sexual and reproductive trends in young people(Women aged 18/9-44; Natsal 2000)

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Births per 1000 women aged under 20

0

10

20

30

40

50

60

Denmark

France

Germany

Netherlands

Switzerland

UK

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EU action

Round Table on Safer Sex for young people, 2006-2007 with youth organisations, commercial advertisers, Durex, and some Member StatesEstablishment of a Forum on Sexual Health 2008 – youth, communication experts, several Member StatesIntegrate sexual health as a priority in the EU Research Programme and the Public Health Programme

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Sexual health policy at EU level

Target young people

Focuspositive health aspects

of a full sexual lifeImpact

general health status of next generation(s)

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Challenges

Sexual Health is a sensitive issue Sexual health is a new theme for the CommissionTraditional messages from the „Nanny state“, „Don‘t do because ….“ do not stick any more Address young people in correct environment, tone, style and appropriate communication means, use relevant messages e.g. relating to their looks, love lives and their future Create a message that is effective for mixed groups as a whole, sensitive to cultural differences

Involve young people at all levels of analysis, design and response

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Contents of the approachCreate sound knowledge base - Increased research on socio-economic settings & sexual behaviour of youth- collect and analyse behavioural strategies –ECDC, Research Programme- surveillance and epidemiology of STDs – ECDC- Eurobarometer survey on young people‘s knowledge of sexual and reproductive health in several Member States

Create a Sexual Health Forum that provides a platform for different stakeholders, governments, civil society, youth

Objectives:

Raise awareness of the topicImprove methods and means of communication with young peopleDevelop clear, strong and positive common messages Cooperate on access to a broad sexuality education and improved low threshold affordable services of quality

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Structure and process

projects

Clear & positive messages

Ep

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gy

Beh

avio

ral

rese

arch

Sex

ual

hea

lth

Pla

tfo

rm

com

mu

nic

atio

n

coo

per

atio

n

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EU funding

Health programme

SAFE, SAFF II in negotiation, ESSTI

ECDCbehavioural surveillance for HIV and STIEuropean guidelines for Chlamydia control (June 2009)STI surveillance - including all MS, data collection will start this summer

RTD Call 2010Presently elaborated

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ProjectsUnder the public Health Programme 2 big projects:European Partnership project – SAFE- to promote the sexual health and rights of young people. The project developed new and innovative ways to reach young people with information and services on sexual health and rights and inform, support and advance policy development. It developed recommendations .On a scientific level the Commission supported two projects on reproductive health indicators in European Union in 2001 - REPROSTAT 1 and REPROSTAT 2 in 2007. REPROSTAT 2 assesses the usefulness of a comprehensive set of reproductive health indicators designed for the enlarged European Union, with particular emphasis on the reproductive health of adolescents and young adult (Phase 2) In 2009 call 6 projects proposed on Youth Sexual violence, strategies for European sex education, youth communication and reaching of youth with a migration backgroundUnder the Research Programme RTDFocus on sexual and reproductive health in international co-operation (Africa, China)

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ProcessBottom-up:• Use results of:

– Health Programme projects on sexual health– Youth forum on 9/10 July– Policy debate

Top down• Continue calls for project proposals• Expand Sexual Health Forum to exchange

experiences and commit to a responsible way to address young people’s sexuality

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Member States Youth

Formal education

Advertisers, Broadcaster, Media

EU Sexual Health

PlatformMedical profession,

social worker

Non formal education

International Organisations, WHO,IOM

Business producing for young people

Stakeholders

Research

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Added value of a European Strategy?

Shared vision of young people’s healthHigher awareness in Member StatesBlueprint for Member States to act Empowerment of young people resulting in responsible behaviourDecrease of STDs and early pregnancies across EuropeSustainable improvement of young people’s sexual health and general health status

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Thank you!