Unit 108 Support Young People in Relation to Sexual Health and Risk of Pregnancy

You are required to research and complete the following questions:- Please ensure that you reference your research and include a bibliography at the end of the assignment.
(1.1) Explain the issues affecting young people in relation to sexual health and risk of pregnancy, include the following:
There are many issues facing young people in relation to sexual health and the risk of pregnancies. I will explain what the issues are, and if possible, explain if and how they can be addressed to increase the chances of young people being able to make own informed decision making. Some young people may feel that they are ready, where as they may also push others into believing that they are also ready. In terms of peer pressure amongst teenagers, some young people may feel as that they are being pushed into having sex (NHS, 2013), and such peer pressure could be coming from a boyfriend or girlfriend, films and TV [programs] (NHS, 2013) or perhaps friends who have become obsessed about when everyone will lose their virginity (NHS, 2013). Due to peer pressure, some young people may also be afraid of being labelled or socially excluded by peers for not yet having sex and this can be a motivation for mostly boys to go through with sexual intercourse before actually realising whether or not they are actually mentally ready for it. Lack of advice and awareness for young people from adults about how to stand up to the peer pressure (NHS, 2013) can also lead to young people being unable to stand up and say 'no', which in turn may therefore lead to a young person feeling like they need sexual activity to avoid being labelled or socially excluded by peers. There is a risk of health problems as a result of experiencing pregnancy at such an early age as a result of unprotected sexual activity. Adults, such as parents and/or carers, teachers, other professionals such as doctors and youth support workers who have a duty to maintain confidentiality can help adolescents and young people develop [and maintain] the confidence, self-esteem and resilience to resist peer pressure to be sexually active until they feel ready to make safe (SGCYP, 2011) and informed decisions. It is just as important to ensure that adolescents and young people also know how to access help to begin with from others in order to be able to mentally resist peer pressure and make mature and informed choices.

Unit 108 Support Young People in Relation to Sexual Health and Risk of Pregnancy
It is my understanding that while adolescents and young people experience puberty, it is possible that some adolescents have consensual sexual relationships (SAHM, 2004) with their fellow peers or are thinking about consenting during secondary school education. The issue here is that not all young people and adolescents may receive the information on sexual health and well-being that they need from either their parents, other adults and professionals and therefore lack knowledge to make informed decisions on own sexual health and well-being, and so they may be at risk as many young people may be unaware or uneducated on contraception and this in turn leads to many unwanted pregnancies, many that occur while the mother to be is still in secondary school education. Many young people may not be educated or informed about the idea of using protection such as a condom to prevent an unwanted pregnancy or to prevent the spread of a sexually transmitted disease and this is another issue. It is an issue that can be corrected providing young people receive education in these areas. The same can also be said of young females who may not know what procedures to undertake following unprotected sex, such as the use of contraception. This is an area that can be helped providing young people are informed through sex education, advice from parents and even perhaps someone that they feel that they can talk to in confidence such as a health care professional i.e. doctor. It is important that young people realise the importance of protection and contraception as pregnancies at a young age, and sexually transmitted diseases perhaps even an undiagnosed STI - can lead to even more health problems and it is important that young people understand the importance of being checked for potential diseases or health issues following unprotected sex. I would be easy to also assume that young people, particularly females unaware of the importance of using contraception more commonly known as 'the pill' - in the event of unsafe sex, will be unsure what options to undertake in the event of a pregnancy test that turns out to be positive. Unwanted pregnancies may lead to all kinds of other issues such as physical, personal, social and emotional problems. Young females may not know who to turn to, and perhaps feel that cannot even turn to their own parents for advice on what routes to go down following the diagnosis. On top of all of this, huge life changing decisions must be made whether or not to go through with the pregnancy, or to undergo a termination. Either way, a family as a whole would be going through a very emotionally stressful time regardless of the outcome. Even with the advice, knowledge or information on sexual health and well-being, and unwanted early pregnancies, it is also illegal even for young couples of similar age to engage in consensual sexual activity. In the United Kingdom, it is illegal for anyone, including young couples under the age of sixteen, or between a young adult that is eighteen and an under sixteen to consensually engage in

Unit 108 Support Young People in Relation to Sexual Health and Risk of Pregnancy
sexual activity under government legislation such as the 'Sexual Offences (Amendment) Act 2000' and the 'Sexual Offences Act 2003'. The legislation 'Sexual Offences (Amendment) Act 2000' states under section 3 entitled abuse of position of trust (Great Britain, 3, 2000) that if it is proven to that a sexual relationship existed between them (Great Britain, 3, 2000) then a person guilty of an offence under this section shall be liable (Great Britain, 3, 2000) for conviction of anything between a fine and up to six months in prison, or both. It is however unlikely that young couples of similar age are prosecuted unless abuse or exploitation is suspected.

(1.2) Explain how the following can affect attitudes and behaviour in relation to sexual activity, sexual health and pregnancy:
The age of a person may affect the attitude and behaviour towards sexual activity, health and pregnancy but just like children, people of the same age are all different and will therefore develop physically, and mature socially and emotionally at a different times than their peers. Many young people during secondary school will have received the education and advice to help them make their own informed decisions in regards to sexual activity, health, use of contraception, and pregnancies through different means, i.e. sex education classes, advice from those with more maturity and life experiences, adults such as parents and family members. However, many young people within the same age bracket, may not be as mentally, emotionally or socially mature to make these decisions on their own, or seek advice and therefore some will take longer than others to mature which will have an affect on own attitudes and behaviour in regards to sexual activity, health and pregnancy. For some young people, it may be a case of actually deciding 'yeah, let's do it' without thinking it through first, and then having to learn from such experience through dealing with the consequences such as the risks - in itself in order to become more mature and promote informed future decision making. Many young people may also be aware or unaware that it is illegal for anyone, including young couples under the age of sixteen, or between a young adult that is eighteen and an under sixteen to consensually engage in sexual activity in the United Kingdom. Being aware of the law could have a positive affect towards attitude and behaviour. There are ethnic groups and cultures that approach sexual activity, sexual health and pregnancy with different beliefs, behaviour and attitudes than those of other cultural backgrounds. In countries within the middle-east, Africa and Asia where

Unit 108 Support Young People in Relation to Sexual Health and Risk of Pregnancy
Islam is the pre-dominant religion, Muslim sexual ethics forbid sex outside marriage (BBC, 2009) and so engaging in sex before or outside of a marriage is viewed as adultery, and therefore is a crime that is punishable in a country governed by Muslim law. In some Muslim majority countries, homosexuality is also a crime that carries the death penalty in five officially Muslim nations: Saudi Arabia, Iran, Mauritania, Sudan, and Yemen (Religion Facts, 2013). In countries governed by Muslim law, contraception is widely accepted when used appropriately such as preserving the health of the mother or the well-being of the family (BBC, 2009), but is not acceptable to attempt to have a permanently child-free marriage (BBC, 2009). In Muslim countries abortion is viewed as acceptable in special cases, for example continuing the pregnancy would put the mother's life in real danger [or if the] foetus suffers from a defect that can't be treated and that will cause great suffering to the child in life (BBC, 2009). In some countries such as those under Muslim law, women do not have equal rights to make independent decisions about choice of (marriage) partner, getting a divorce and custody of their children (Safra Project, 2011), and therefore male's play such a dominant role in society in these countries and expect women to be obedient wives and mothers staying within the family environment (Safra Project, 2011), an attitude towards women that is embodied in Muslim law and is embedded in Muslim societies (Safra Project, 2011) and therefore has an affect on attitudes to sexual activity and beliefs. In Islamic culture, wives are expected to fulfil the sexual desires of their husband's. The husband decides when they do or don't want sex, the wife does not get a say if she doesn't feel like it and therefore the rights and views of women are affected in relation to sexual activity due to their gender. In European countries regardless of personal and religious beliefs such as those from a bible or a country who's religious majority practices own religious and cultural beliefs, adultery, sex before marriage, and homosexuality, gender reassignment are entirely legal. Malta is the only country in Europe with a ban on abortion however countries across Europe will have varying restrictions where the abortion can only take place under certain conditions, i.e. if such a pregnancy poses a risk to the mothers health, and before a certain amount of weeks of pregnancy. Women's social and human rights are protected and promoted in European countries, in stark contrast to those living under laws of other religions, cultures and belief systems where men are seen as dominant due to a cultural and religious belief system and females rights are not protected by law, which in turn influences attitudes towards many aspects of life, including sexual activity. In many countries, such as those with a Christian majority and even though the holy bible states that it is a 'sin', it is an accepted common part of society to engage in sexual activity before marriage, as long as it is between those of the legal age of consent.

(1.3) Explain the social, health and educational risk factors associated with early sexual activity or teenage pregnancy?
There are risks and possible consequences that are associated with early sexual activity which can in turn lead to teenage pregnancy. Sexual activity amongst teenagers, as covered previously, is linked to peer pressure amongst teenagers still in education. Not many teenagers may know how or perhaps lack the education to counter-act pressure from peers to resist sexual activity while young, and at the same time, may feel like

Unit 108 Support Young People in Relation to Sexual Health and Risk of Pregnancy
losing one's virginity is such a big deal. This can lead to early sexual activity amongst teenagers, and due to a lack of education, may not be aware of contraceptive methods and risks, one of those risks would be of becoming pregnant too early. Lack of education and guidance on sexual activity from teachers, peers, family members could be associated with pupils engaging in sexual activity at such an early age, thus being unaware of the consequences of their own actions. Sufficient education from parents, teachers and peers should be enough to alter attitudes towards sexual activity and the possible risks at such an early age. Social risk factors associated include certain pupils and peers, or what you could refer to as the 'wrong crowd' at school finding out about sexual activity between fellow pupils, and thus both pupils could be made a target, labelled or bullied by peers, which could in turn also lead to those two pupils experiencing social and emotional problems, which can prevent them from being able to concentrate and learn. The male pupil involved may find it okay to brag about it to his peers, being unaware of the knock on effects this may have towards the female pupil. The female, should be become pregnant, may find that those they regarded as friends, could distance themselves by not wanting to become associated by a pupil that is pregnant or labelled. Being pregnant, labelled and bullied by peers could lead to a teenager dropping out of education to get away from the bullies, having an impact on education as well as socially, and facing up to the possibility of life as a single mother, should the father also distance himself. There is also the risk of pregnancy if unaware or forgetful of contraceptive, protection and withdrawal methods, and the risk of a sexually transmitted infections from sexual activity. There are also risk factors associated with being pregnant at such a young age for both mother and child. Research shows that teenage females who become pregnant are at an increased risk for complications, such as premature labour and other consequences (Swierzewski, III, M.D., 2013). According to studies in the United States, it is not just social, health and educational risks linked to teenage pregnancies, but also economic factors such as a lower annual income for the mother [due to] teenage mothers [dropping] out of school (Swierzewski, III, M.D., 2013).

Task Two : Understanding how to support young people

(2.1) Describe relevant sources of information, guidance and support and the range of health services available to these young people?
There are different ways of accessing sources of information, guidance and support, as well as there being a range of health services available to young people in relation to sexual activity, sexual health and teenage pregnancies. During school, pupils will learn about some of the aspects of sexual health, puberty and growing up through classes such as sex education, however in some cases this may not be sufficient enough information to deter young people from sexual intercourse at such a young age. Parents should feel that they are able to provide information, guidance and advice to their children in regards to sexual health, contraception and the risks of

Unit 108 Support Young People in Relation to Sexual Health and Risk of Pregnancy
unprotected sex, and provide support in the event of a sexually transmitted disease or teenage pregnancy. It is important to consider that some young people may be afraid of discussing topics such as sexual health, pregnancy and may therefore experience embarrassment, shame, lack of information and fear about the confidentiality of services ( Devon PCT, 2008) being compromised. Therefore young people need to be feel encouraged, enabled, and reassured first that these are professional people and services who they can access who will maintain and respect full confidentiality while being able to provide the information and services that they need. Sexual health services, advice, guidance and support should be provided through own doctor (general practitioner), and also free of charge through services such as: Sexual Health Clinics (Devon PCT, 2008) Genito-Urinary Medicine Clinics (Devon PCT, 2008) Pharmacies (Devon PCT, 2008)

These services can act as sources of information for young people, providing advice, guidance as well as support in making informed choices in regards to sexual activity, contraception, sex education, sexually transmitted diseases, pregnancies and abortions while maintaining full confidentiality. Libraries can be accessed for books on sexual health, contraception, pregnancies, as well as leaflets in places like children centres, schools, pharmacies and doctors surgery. Websites such as NHS Direct provides information, guidance, advice and support on everything and anything to do with sexual health, pregnancy, abortion, contraception and even offers a search engine for services that can be accessed locally just by the user putting in their post code. NHS Health and Social Care (Pregnancy) http://www.nhs.uk/conditions/pregnancy-and-baby NHS Health and Social Care (Abortion) - http://www.nhs.uk/conditions/Abortion NHS Health and Social Care (Contraception) http://www.nhs.uk/conditions/contraception-guide NHS Health and Social Care (Sexual Health) http://www.nhs.uk/sexualhealth NHS Health and Social Care (Local Services) - http://www.nhs.uk/ServiceSearch/Sexual%20health%20information%20and%20support/LocationSearch/734

Bpas is the UK's leading sexual health care specialist, which offers support, advice and guidance to men, women and young people in all areas of sexual health, from abortions, contraception, and sexually transmitted diseases. They have centres across England, Scotland and Wales, and treatment canbe funded by the NHS. http://www.bpas.org/bpaswoman Bpas Women (Pregnancies, Abortion, Treatments, Advice)

Unit 108 Support Young People in Relation to Sexual Health and Risk of Pregnancy
http://www.bpas.org/bpasman Bpas Men (Vasectomy/Contraception, STI's, Dysfunction Advice) http://www.bpas.org/bpasyoungpeople Young People (Pregnancies, Abortion, Options, Advice)

(2.2) Explain how to support young people to identify their needs and priorities in relation to their sexual health and risk of pregnancy, in a way that is confidential, non-judgemental and sensitive to their individual situation.
Before supporting an individual it is important to be aware of safeguarding and confidentiality policies and procedures in a setting or school. It is then important to be able to create an environment within the setting or school which is safeguarded for young people to participate fully, in order to build positive relationships where students can trust staff members. In turn, this should allow staff members to get to know their pupils really well to the point when they can notice unsettling behaviour or something different about a student. Once positive relationships are formed and trust is built over a period of time between practitioners or teachers and students within the school, if a teacher or practitioner makes it known to the class that if anyone has any issues or personal problems that they can come to them if need be in full confidence, without being judged, then it may then make it much more easier for students to approach their teacher for advice on certain topics, perhaps anything to do with concerns over sexual health or risk of pregnancy. If in the event that a pupil makes a disclosure to a person they feel that they can trust, such as a teacher, then the teacher will most likely want to work together with the pupil to discuss concerns and what course of action the pupil would like to make in order to achieve a positive outcome. If agreed with the pupil, the teacher can involve other professionals while maintaining full confidentiality and sensitivity to the situation, without the pupil being judged, in order to resolve the issue in a way that ensures that information does not leak to those the pupil may not want knowing about it, i.e. peers, parents, doctor etc. In situations like these, a pupil may request that the teacher, practitioner, or professional speak to the parent on their behalf.

(2.3) Describe how you would enable a young person to make informed choices in relation to their identified needs and priorities?
Parents, teachers, practitioners like myself, and other professionals should have the knowledge that would enable a young person to make informed choices in relation to identified needs and priorities such as sexual health, or a risk of pregnancy. It is important that sexual health knowledge is passed on, and this can be done through a number of ways such as leaflets, media such as newspaper stories, case studies, magazines, story lines on popular TV programming, documentaries, sex education during school, and parents being able to discuss sexual health with their children.

Unit 108 Support Young People in Relation to Sexual Health and Risk of Pregnancy
Professionals such as doctors, GP's, sexual health clinics, teachers that find themselves in a position where they can then offer advice to an individual should ensure any sensitive information will be held in utmost confidentiality, and that the individual is reassured that they will not be judged over anything, or thought of any differently is another way of helping and enabling young people to discuss personal issues, in order to make informed decisions regarding needs and priorities. It's important that they feel that they can come to us in a time of need in order for us to help enable them to make informed decisions. If I had children of my own I would find it important that once they come of appropriate age to find time and opportunity to inform and educate them about sexual health, the consequences of unprotected sex, and how to resist pressure from peers to engage in sexual activity below the age of consent in order to eliminate the risk of unplanned pregnancy at such a young age. As well as unplanned pregnancies, there is also the risk of picking up sexually transmitted diseases later on in adult life as well if proper education is not received in order to be enabled to make informed choices. In turn, knowledge is shared in order to ensure that my children, and In turn other young people are given the best opportunity to make the most of their education.

2.4) Describe the codes of practice, relevant professional guidance and/or organisational policies relevant to sexual health of young people and explain their implications for professional conduct, confidentiality and gaining consent when working with this age range.
There are codes of practice, professional guidance and policies that are relevant to sexual health of young people from different organisations and charities within the United Kingdom in relation to sexual health of young people, that also come with implications for professional conduct, confidentiality, and gaining consent when working within a specific age range. General Medical Council The regulator for doctors in the UK, the 'General Medical Council' published an 0-18 years age range guidance for all doctors working within the UK that they must adhere to, otherwise persistent failure to follow this guidance will put [their] registration at risk (GMC, 2007). The guidance begins by stating that doctors must enable patients must be able to trust doctors with their lives and health (GMC, P0, 2007), followed by a list of what is expected of doctors in terms of enabling the public to be able to trust their GP or doctor. It then states that it is important that doctors listen to patients and respond to their concerns and preferences (GMC, P0, 2007) while also being able to respect patients' rights to confidentiality (GMC, P0, 2007). From here, the contents of the guidance covers working in partnership with patients to assess and identify health needs, communication, principles of confidentiality, child protection, sexual activity, contraception, abortion and sexually transmitted diseases followed last of all by prescribing medicines.

Unit 108 Support Young People in Relation to Sexual Health and Risk of Pregnancy
Doctors, under the guidance of the GMC, have a duty to provide contraceptive, abortion and STI advice and treatment, without parental knowledge or consent, to young people without breaking confidentiality. The implications of handling information such as disclosures from patients when working with patients, is that a patients doctor must not disclose this information to anyone else, including parents of young person seeking advice and treatment. GMC guidance states that without the trust that confidentiality brings, children and young people might not seek medical care and advice (GMC, P18, 2007) in order to identify needs, to seek the best advice, treatment and care. Should a doctor feel that disclosing such information to another professional can result in identifying the needs of a patient, the doctor must ask for the patients consent before disclosing information (GMC, P18, 2007). Confidential information will only ever be shared in circumstances such as when it is in the best interests of a child or young person who does not have the maturity or understanding to make a decision about disclosure [and] required by law (GMC, P19, 2007) i.e. a safeguarding or welfare concern where a child or young person is at risk of being harmed, or if they are a risk to others. Doctors must notify an appropriate person or authority when disclosing such information (GMC, P20, 2007). Sexual health concerns will never be disclosed under any circumstances, in accordance to guidance, however safeguarding concerns can be disclosed if thought to be in the best interests of a young person. Patients that are of the age of 16 can be presumed to have the capacity to consent (GMC, P12, 2007) to treatment but for those under the age of 16, there is an implication which means that their maturity and understanding (GMC, P12, 2007) must be assessed first to ensure that they have an understanding of any treatment involved before being allowed to consent and make own informed decision on treatment.

END OF ASSIGNMENT
Reference List Author Year Publisher Book Place

NHS, 2013. National Health Service (NHS) Choices. [Online] London: NHS Employers. Available at http://www.nhs.uk/Livewell/Sexandyoungpeople/Pages/Peerpressure.aspx [Accessed 9th April 2013] SAHM, 2004. Journal Of Adolescent Health 2004 Vol. 35 [Online] US: SAHM. Available at http://www.adolescenthealth.org/AM/Template.cfm? Section=Position_Papers&Template=/CM/ContentDisplay.cfm&ContentID=1484 [Accessed 10th April 2013] Great Britain, 2000. Sexual Offences (Amendment) Act 2000. London: Her Majesty's Stationary Office. Available at: http://www.legislation.gov.uk/ukpga/2000/44/section/3 [Accessed 11th April 2013]

Unit 108 Support Young People in Relation to Sexual Health and Risk of Pregnancy
SGCYP, 2011. Relationships and Sexual Health: Guidance for Youth Support Workers (May 2011). South Gloucestershire: Council. Available at: http://www.sgcyp.org/LinkClick.aspx?fileticket=qrAwag0QSwo%3D&tabid=414 [Accessed 11th April 2013] BBC, 2009. BBC Religions Islamic Views On Contraception (2009). London: BBC Online Services. Available at: http://www.bbc.co.uk/religion/religions/islam/islamethics/contraception.shtml [Accessed 13th April 2013] BBC, 2009. BBC Religions Abortion In Islam (2009). London: BBC Online Services. Available at: http://www.bbc.co.uk/religion/religions/islam/islamethics/abortion_1.shtml [Accessed 13th April 2013] Religion Facts, 2013. Religion Facts - Homosexuality and Islam. Available at: http://www.religionfacts.com/homosexuality/islam.htm [Accessed 13th April 2013] Safra Project, 2011. Sexuality, Gender and Islam. Available at: http://www.safraproject.org/sgi-genderroles.htm [Accessed 13th April 2013] Swierzewski, III, M.D., 2013. Teen Pregnancy, Consequences of Teenage Pregnancy. US: Remedy Health Media. Available at: http://www.healthcommunities.com/teen-pregnancy/children/overview-of-teenpregnancy.shtml#consequences [Accessed 13th April 2013] Devon PCT, 2008. Sexual Health Guidance for Children and Young People in Care in Devon. UK: Devon NHS Primary Care Trust. Available at http://www.devon.gov.uk/sexualhealth-relationships.pdf [Accessed 13th April 2013] GMC, 2007. General Medical Council: 0-18 Guidance for all doctors . UK: London. Available at http://www.gmc-uk.org/static/documents/content/0-18_0510.pdf [Accessed 14th April 2013]