Queensland Health Queensland Sexual Health Strategy 2016-2021 Queensland Sexual Health Strategy 2016 Disclaimer: The content presented in this publication is distributed by the Published by the State of Queensland (Queensland Health), 2016 Queensland Government as an information source only. The State of Queensland makes no statements, representations or warranties about the accuracy, completeness or reliability of any information contained in this publication. The State of Queensland disclaims all responsibility and all liability (including without limitation for liability in negligence) for all This document is licensed under a Creative Commons expenses, losses, damages and costs you might incur as a result Attribution 3.0 Australia licence. To view a copy of this licence, of the information being inaccurate or incomplete in any way, visit creativecommons.org/licenses/by/3.0/au and for any reason reliance was placed on such information. © State of Queensland (Queensland Health) 2016 You are free to copy, communicate and adapt the work, as long as you attribute the State of Queensland (Queensland Health). For more information contact: You are free to copy, communicate and adapt the work, as long as you attribute the State of Queensland (Queensland Health). For more information contact: Strategic Policy Unit, Department of Health, GPO Box 48, Brisbane QLD 4001, email [email protected], phone 07 3234 0406. SC1900293 2 Contents Foreword 4 1. Improving Community awareness, information and prevention across the lifespan 12 Introduction 5 Sexually transmissible infections (STIs) 13 Why do we need a sexual health strategy? 5 Human immunodeficiency virus (HIV) 14 What is sexual health? 5 Viral hepatitis 15 How does the Sexual Health Strategy link with other strategies? 6 Reproductive health 16 Developing and implementing this Strategy 6 Healthy ageing 17 About this Strategy 6 Contraception 17 Pregnancy 18 The strategy 7 Human papillomavirus (HPV) vaccination program 19 Vision 7 Cervical screening 19 Principles 7 Psychosexual counselling 19 Strategic directions and priority actions 7 Consent to sexual activity 19 Success factors 11 Sexual assault 20 2. Improving education and support for children and young people 22 Child sexual abuse 24 Gender dysphoria 25 Female genital mutilation/cutting (FGM/C) 25 3. Responding to the needs of specific population groups 26 Aboriginal and Torres Strait Islander people 26 Sexually transmissible infections (STIs) 27 Culturally and linguistically diverse people 28 People with disability 28 Lesbian, Gay, Bisexual, Transgender and Intersex (LGBTI) people 29 Risk occupation or location groups 31 People in correctional centres 32 4. The service system 33 Accessibility 33 Partnerships and collaboration 34 Service profile 34 Workforce profile 36 eHealth, metrics and evidence 38 References 40 Queensland Sexual Health Strategy 2016–2021 3 Foreword Queensland has a proud tradition of being the first This is why the Palaszczuk Government committed to jurisdiction in Australia to tackle challenging issues. For develop a statewide sexual health strategy in partnership example, Queensland pioneered the state secondary with community organisations to ensure the mix of education system in the early 1860s when the community education and clinical services best meets the government subsidised municipalities to set up grammar needs of all Queenslanders including at-risk populations. schools—the first free education in Australia. In keeping This commitment includes $18.5 million of which $5.27 with this proud tradition, Queensland is the first state million over four years is allocated to implement the in Australia to develop a comprehensive sexual and priority actions of this Strategy, and $13.24 million to reproductive health strategy—the Queensland Sexual revitalising sexual health services at Biala, Metro North Health Strategy 2016–2021 (Strategy). A Strategy for all Hospital and Health Service. Queenslanders at all stages of life. This Strategy is another element to our vision for health Good sexual and reproductive health is fundamental in Queensland outlined in My health, Queensland’s to our overall health and wellbeing. It is one of the future: Advancing health 2026—by 2026 foundations upon which our society relies upon Queenslanders will be among the healthiest people in to exist and is an important element in successful the world. Achieving optimal sexual and reproductive human relationships. There is, however, a number health can be realised in the everyday lives of all of challenges that we face as a community including Queenslanders. Through working collaboratively, we reproductive health issues, rising rates of sexually can realise our vision. transmissible infections, increasing numbers of people living with human immunodeficiency virus (HIV), and the discrimination and stigmatisation that is often associated with sexual health issues. While I acknowledge these challenges, this government is committed to creating an equal and fair Queensland—a Queensland where good health outcomes are shared equally across population groups, diversity is celebrated through social cohesion and The Hon Cameron Dick MP inclusiveness, individual sexuality can be expressed without fear of discrimination and stigma, and where Minister for Health and education is empowering. Minister for Ambulance Services Queensland Sexual Health Strategy 2016–2021 Introduction Why do we need a sexual What is sexual health? health strategy? Sexual health is defined by the World Health Organization Good sexual and reproductive health is fundamental to our as ‘a state of physical, emotional, mental and social overall health and wellbeing. It is one of the foundations wellbeing in relation to sexuality…not merely the absence upon which our society relies upon to exist and is an of disease, dysfunction, or infirmity. Sexual health important element in successful human relationships. requires a positive and respectful approach to sexuality and sexual relationships, as well as the possibility of Queenslanders are generally healthy compared to having pleasurable and safe sexual experiences, free of people in other parts of Australia and the world. coercion, discrimination, and violence.’ However, there are still a range of sexual and reproductive health challenges that need to be ‘Sexual health incorporates sexual development and addressed. The rate of sexually transmissible infections reproductive health, as well as the ability to develop (STIs) is growing, and there are substantial inequalities and maintain meaningful interpersonal relationships; in health status among specific population groups. appreciate one’s body; interact with both genders in respectful and appropriate ways; and express This Strategy aims to support healthy and safe sexual affection, love, and intimacy in ways consistent with experiences and optimal reproductive health, and one’s own values’. Sexuality means more than the provide a service system that is responsive to the physical act—it encompasses psychological, biological needs of all Queenslanders. In doing, so we will realise and social aspects, and is influenced by individual the vision of this Strategy: that ‘all Queenslanders values and attitudes. experience optimal sexual and reproductive health’. A person’s sexuality develops throughout childhood This Strategy also provides an overarching framework and adolescence, and is a key part of a person’s for action in other key areas thereby providing a holistic identity. The way each person understands and and coordinated approach to specific challenges. The interprets their sexuality varies significantly, and often action plans under this Strategy include the North changes over time. Healthy self-esteem and respect Queensland Aboriginal and Torres Strait Islander for self and others are important factors in developing Sexually Transmissible Infections Action Plan 2016– positive sexuality. 2021, the Human Immunodeficiency Virus Action Plan 2016–2021, the Hepatitis B Action Plan 2016–2021 and the Hepatitis C Action Plan 2016–2021; all of which play an integral part in achieving the vision. Queensland Sexual Health Strategy 2016–2021 5 How does the Sexual Health The delivery of sexual and reproductive healthcare Strategy link with other across the lifespan is underpinned by provision of comprehensive primary healthcare with the support strategies? of specialised care when required. The acquisition of sexual and reproductive health knowledge and skills by Queensland has on overarching vision for health: staff at every stage of the care continuum will contribute My health, Queensland’s future: Advancing health toward the delivery and place. 2026 (Advancing Health 2026) states that ‘by 2026 Queenslanders will be among the healthiest people in Public sector health services have the lead responsibility the world’. This vision is supported by five principles of for implementing this Strategy, in partnership with other sustainability, compassion, inclusion, excellence and government, non-government and community sector empowerment. In particular, the principle regarding services. The Strategy will guide services to provide inclusion requires us to respond to the needs of all appropriate and timely clinical service responses Queenslanders, regardless of their circumstances, to and referral to meet the needs of all Queenslanders, deliver the most appropriate care and service. This not particularly specific population groups. only benefits the individual but contributes