Sexual and reproductive health in crisis

We have heard a lot about abortion recently. At federal level Senator Barnett is trying to have a Medicare item removed to reduce funding for abortion; and in Victoria, the parliament recently had a conscience vote on reforming their abortion laws. During this debate, many members of the Victorian Parliament asked: what is being done to prevent unplanned pregnancy?

The answer? Not enough.

The estimated national abortion rate of 19.7 per 1,000 females of reproductive age (15-44 years) is indeed high compared with other industrialised countries such as Germany (7.7) or the Netherlands (8.7).

But it gets worse.

The rate of births to teenagers in Australia is also high at 18.4 per 1,000 females of reproductive age, compared with Korea (2.9) or Switzerland (5.5), although lower than the UK (29.7) and the USA (51.1). Teenage motherhood is associated with a range of poor social, economic and health outcomes.

In Australia over the last decade, rates of chlamydia have increased more than four-fold and rates of gonorrhoea have almost doubled. We have also seen an increase in the number of new cases of HIV in recent years.

In addition, young people who identify as gay or lesbian, or are unsure of their sexuality, experience high levels of distress and depression.

Among sexually active secondary school students surveyed in 2002, 23 per cent of males and 28 per cent of females had experienced unwanted sex. Pressure from partners, drugs and alcohol were all factors. In addition, among women over the age of 15 years, almost 20 per cent have experienced sexual violence, with younger women experiencing the highest rates.

Over a quarter of females and around 5 per cent of males in Australia were sexually abused as children.

Health outcomes like this in a country like Australia are unacceptable.

Sexual and reproductive health issues cover the whole lifespan for all genders and sexualities. Sexuality should be a positive, healthy part of life, not an issue only considered in the context of abortion or disease. Conservative social attitudes often inhibit discussion of this in public life. The recent removal of abortion from the Crimes Act by the Victorian Parliament was a courageous and positive move which has brought these issues to the fore. It is an opportunity to do more and we must not let it pass us by.

In the 1980s in the early stages of the HIV-AIDS epidemic, the Australian Government worked with all levels of government, stakeholders, researchers and affected communities and showed strong leadership in not allowing local or parochial views to undermine the first National HIV-AIDS strategy. This partnership, preventive and human rights approach was recognised as best practice at the time, and is needed again now.