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Insight: essential youth sector analysis and reflection Issue 2, 1 September 2010

01 September 2010

Sexually transmitted infections – new figures released show an increase in STIs among 15-to-24-year-olds

New Health Protection Agency (HPA) figures reveal that diagnoses of sexually transmitted infections (STIs) - the most common being chlamydia, gonorrhoea and genital warts - are on the increase again, and reached almost half a million in the UK in 2009.  This is the highest number in the 30 years the figures have been collated. Young people, as in previous years, are worst affected: around two thirds of new STI diagnoses in women and over half in men were in those under 25. The data also shows an increase in re-infection – one in ten of all 15 to 24-year-olds diagnosed with an STI will become re-infected within a year.

So why are STIs among young people still on the increase?

The HPA figures suggest that poor sexual health remains a serious problem for young people in the UK, particularly for young women.  The increase can be partly explained by more sensitive tests, and the recent expansion of chlamydia screening of young adults in community settings through the National Chlamydia Screening Programme. It is estimated that around 30% of 15 to 24-year-olds were tested in 2009/10. The increase in diagnoses amongst young women may be due to more young women than young men opting for chlamydia screening because the potentially serious effect on women’s long-term health. 

A National Audit Office (NAO) report was critical of the chlamydia screening campaign for wasting money, including offering tests at music festivals and in nightclubs. It found that in 2008/09, only half of PCTs reached a target 26%, the minimum annual testing percentage needed in order to significantly reduce the prevalence of chlamydia in young people.  However, the NAO concluded that screening was crucial to improving young people's sexual health. The recent figures certainly suggest that young people are taking advantage of the screening programme (although young women greatly outnumber young men), where they may not have accessed similar services previously. The NAO found that young people who have had a chlamydia test report positive feelings about the experience, however, 40% of those tested said that they had not received advice on issues such as contraception and safer sex when tested.  It concludes ‘the test should be used as an opportunity to provide wider guidance and promote safer sex, so helping to reduce infection rates in the long-term’.

Data also suggests that urban and deprived areas have the highest rates of STIs.  The relationship between the increase in STIs and social and economic deprivation maybe influenced by a range of factors such as the provision of and access to sexual health services, education, health awareness and sexual behaviour. The Daily Mail is reporting that the new data also suggests that ‘infections are increasing among the middle class, with wealthy London boroughs such as Kensington and Chelsea and Westminster experiencing some of the highest rates’.

Findings from UNICEF indicate that fear of pregnancy is often the main driver behind safe sexual practises amongst young people – many feel ‘safe’ if they are using the contraceptive pill.  However, with pregnancy the number one issue on their agenda it can often overshadow all other concerns and lead to an increase in the number of young people having unprotected sex by not using condoms - over a third of young people who have had sex reported that they only sometimes (28%) or never (13%) used a condom. And 70% of those that had had unprotected sex did not feel that they needed to visit a sexual health service.

Recently published research also suggests that some young people may lack the skills and confidence to negotiate safer sex, due to weaknesses in some school-based sexual health programmes.

What reactions have there been to the increase in STIs among young people?

The Daily Telegraph voiced the line adopted by many right-leaning papers, blaming the increase in the prevalence of STIs on expanded sex education programmes and free contraception for young people. Conservative MP Stewart Jackson also appears to have blamed the rise in STIs on sex education, claiming via his Twitter account that £300m had been ‘blown’ on sex education. However, Health Minister Paul Burstow said: ‘We're going to look at what more can be done to increase young people's awareness of risks, to prevent infection and to access screening and treatment.’

BBC coverage differs.  An article for the BBC Radio 4 Today Programme suggests that young people ‘don’t really care’ about STIs because of a ‘here and now’ attitude, and that young people’s behaviour will change only if sex education is improved.   

Health professionals appear to agree that the answer remains in sexual health education.  Natika Halil, from fpa, said: ‘The message from this data to the new government is that they mustn't be tempted to cut services and campaigns in sexual health, or ignore the urgent need for statutory sex and relationships education in schools.’  Simon Blake, national director of charity Brook has called for more emphasis on sex and relationship education (SRE): ‘Young people tell us their SRE is too little, too late and too biological and it needs to address emotions and relationships more effectively. Done well, SRE provides an important antidote to the confusing sexual messages they receive in the playground and from the media day in day out.’

Social mobility

In August, the Coalition Government announced that Deputy Prime Minister Nick Clegg would lead government efforts to improve social mobility, describing it as the Coalition’s ‘long-term policy goal’.  It also confirmed that former Labour MP Alan Milburn had been appointed to carry out independent, annual reviews of progress.

So what is social mobility? And why does the Coalition think its important?

Social mobility refers to the degree to which an individual or group's status is able to change in terms of position in the social hierarchy. It most commonly refers to material wealth and the ability of an individual to move up the class system. Social mobility goes beyond poverty reduction and social inclusion.  In its Programme for Government, the Coalition stated that there are ‘many barriers to social mobility and equal opportunities in Britain today, with too many children held back because of their social background, and too many people of all ages held back because of their gender, race, religion or sexuality.’

Social mobility is not a new political concern. The National Equality Panel was set up by the previous government in 2008 to investigate inequalities.  It concluded that social class still determines life chances and ‘deep-seated and systematic differences’ remain between social classes.  However, the Panel’s report also called Labour's record on tackling inequality into question, saying it failed to plug the gulf that existed between the poorest and richest in society in the 1980s.  Labour responded by reiterating the importance of public policy intervention at key stages in people’s lives and highlighted its record in improving outcomes for children and young people through investing in Sure Start, supporting families, tackling child poverty and narrowing gaps in educational attainment. The previous government also established the Panel on Fair Access to Professions, chaired by Alan Milburn.  The report made over 80 recommendations including a national network of careers mentors; a campaign to encourage more young people to aspire to a professional career; an overhaul of work experience in schools; and a network of young professional ambassadors who would work with schools to raise awareness of career opportunities for young people.

However, think tank Civitas claims social mobility is not a problem, concluding that Britain is actually an open and meritocratic society in which more than half of the population are in a different class to the one in which they were born.

What plans are there to achieve a more socially mobile society?

Nick Clegg said that the Government’s focus would be on ‘inter-generational social mobility - the extent to which a person’s income or social class is influenced by the income or social class of their parents’.  He identified the key barriers to social mobility for young people as: different experiences in pre-school years; educational inequalities; levels of parental involvement; the gap between Further and Higher Education; and the difficulty for young people from disadvantaged backgrounds entering the professions.

In education, the Government intends to focus resources on the most disadvantaged. The Pupil Premium will give extra funding to schools taking disadvantaged pupils. The additional funding will be aimed at raising the achievement of disadvantaged pupils, with schools free to choose how the money should be spent. However, the extent to which extra pupil funding contributes to better outcomes is not proven.  As one commentator has pointed out, the funding system under the previous government already provided for a ‘considerable premium’ for children on free school meals, and there are many other factors that impact on a child’s life chances which lie outside of school. 

The introduction of free schools and expansion of academies is intended to enable interested groups to set up new schools, and to give more institutions more freedom, including freedom from following the National Curriculum. The Coalition’s aim is to improve the quality of education, particularly for the most disadvantaged. However, NUT general secretary Christine Blower said: ‘Rather than providing opportunities to all parents, it will privilege the few at the expense of the many’.

This year, the new A* grade was introduced for A levels to challenge the brightest students, give them a chance to demonstrate the depth of their knowledge and to help universities choose the best students.  Nationally, only 8% of A level papers were awarded the grade. However, this rose to nearly 20% for private school pupils. Indeed, 6% of students at such schools achieved three A* amongst their results. There is also concern that the introduction of the A* will make it harder for pupils from disadvantaged homes to get to university. Indeed, many of those students awarded the A* this year have missed out on the university place of their choice and only a dozen or so universities built the A* into their admissions systems for this year.

Is social mobility really achievable for young people?

The recession and the associated fall in job opportunities has had a disproportionate effect on young people.  The OECD warns of bleak job prospects for young people in the wake of the recession.  GCSE and A level results continue to rise, but universities have fewer places and competition is fierce. The Prince’s Trust concurs, finding that young people from workless families are significantly more likely to struggle to find a job themselves, as well as feeling far less confident about their future.  The Sutton Trust, which works to improve educational opportunities for young people from non-privileged backgrounds, also agrees that the aspirations of parents are key to educational and occupational outcomes for their children.  It sets out among its current priorities: Boosting provision for gifted and talented students from non-privileged backgrounds; and access to highly selective universities and courses and the professions.

Careers England believes that progress can be made by providing high quality careers services and calls on the government to directly commission and fund a careers guidance service for young people. It highlights previous research pointing to the links between a dedicated careers advice service and improved social mobility.  The Audit Commission agrees, recommending that all local partners working with young people collaborate with Connexions.  However, the report from the Panel on Fair Access to Professions criticised Connexions, concluding ‘that its focus on the minority of vulnerable young people is distracting it from offering proper careers advice and guidance to the majority of young people’.  It called for schools and colleges to be given direct responsibility, working with local authorities, for making their own decisions about IAG, giving schools and colleges the budgets and powers to commission careers brokerage and advice.

The Coalition Government has so far focused on educational reforms to help improve social mobility for young people.  However, there are a number of other key policy areas in the social mobility agenda yet to be addressed such as health inequality, young people’s aspirations and community empowerment.  For instance, CPAG commented that ‘It is deeply concerning that Nick Clegg failed to mention the government’s child poverty targets today. He has overlooked the evidence that developed countries with the greatest social mobility are those with the lowest inequality and the lowest child poverty.  In a fairer and more equal society for all in which child poverty is a thing of the past, social mobility will always follow.’

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