Importance of Sexual Health Promotion in UK: A Detailed Report

This report examines the significance of sexual health promotion in the UK, focusing on its role in reducing teenage pregnancies and sexually transmitted diseases (STDs). The report begins with an introduction to sexual health promotion and its importance, followed by a systematic review of existing research and studies. The methodology section details the research philosophy, inclusion and exclusion criteria, ethical considerations, and data extraction strategies. The results section presents the findings, and the discussion, conclusion, and recommendations sections provide an in-depth analysis of the issues. The report highlights the high rates of teenage pregnancies and STDs in the UK, exploring the underlying causes such as lack of knowledge about contraception, social inequalities, and single parenting. It emphasizes the need for effective strategies, including comprehensive sex education, to improve sexual health outcomes and reduce the associated risks. The report concludes with recommendations for policymakers and healthcare providers to promote sexual health and well-being among teenagers in the UK.

Sexual Health
(To understand the importance of sexual health
promotion in reducing teenage pregnancies and
sexually transmitted diseases in UK)

ABSTRACT
Sexual health promotion is basically concerned with maintaining a person's emotional,
mental and physical well-being so that he/she can perform different activities in day to day life. The
dissertation chapters have discussed various issues related to promotion of sexual health and have
also focussed on the importance of promoting sexual health in UK. First chapter of dissertation is
based on the introductory part which has discussed a brief overview of promotion of sexual health
in UK. Next chapter has systematically reviewed various researches and studies that have been
conducted by different authors. It has helped in completing dissertation in an effective way. Further,
research methodological part have been included which has discussed research philosophy,
inclusion, exclusion criteria, ethical considerations and data extraction strategies that have been
used in the research. The dissertation has been concluded by discussing the results,
recommendations and conclusion.

TABLE OF CONTENTS
1. INTRODUCTION ...........................................................................................................................3
2. SYSTEMATIC REVIEW.................................................................................................................6
3. METHODOLOGY ........................................................................................................................11
3.1 Analysis and justification for Systematic Review (SR)...........................................................11
3.2 SR Protocol..............................................................................................................................11
3.3 Literature Search Strategy........................................................................................................11
3.4 Quality assessment strategies...................................................................................................13
3.5 Positivism philosophy..............................................................................................................14
3.6 Validity and reliability..............................................................................................................14
3.7 Ethical issues............................................................................................................................15
3.8 Data extraction strategy...........................................................................................................15
4. RESULTS ......................................................................................................................................16
5. DISCUSSION, CONCLUSION AND RECOMMENDATIONS..................................................20
Discussion......................................................................................................................................20
Recommendations..........................................................................................................................21
Conclusion.....................................................................................................................................23
REFERENCES...................................................................................................................................26

1. INTRODUCTION
Promotion of sexual health in UK is necessary because it will help in reducing the risk of
sexually transmitted diseases and teenage pregnancies to a high extent (Eldredge and et.al., 2016).
Sexual health is also associated with broad range of health issues which are very important to be
addressed. Hence, it is necessary to encourage service uptakes in promoting sexual health so that
emotional, mental and physical health of all individuals can be restored. According to survey
conducted by health organisation, it has been stated that UK has maximum number of teenage
pregnancies which has also increased the number of individuals suffering from sexually transmitted
disease. During recent times, high number of gonorrhoea and syphilis are detected specially in
teenagers of UK (Nguyen and et.al, 2013). Apart from teenagers, there are many other people who
are at greater risk of encountering serious sexual health issues such as disabled people, individuals
with learning difficulties, refugees and asylum seekers. For promoting health, it is necessary to
adopt various effective strategies so that health and well-being of people can be improved in a better
way. It is important for all people of UK to have prompt access to different types of sexual health
services that are initiated by the UK government. Promotion of sexual health should not only reduce
teenage pregnancies and risk of sexually transmitted disease but it should also increase awareness
and knowledge about promotion of sexual health in UK (Wight and Fullerton, 2013).
For promoting sexual health in UK, it is essential for the government to adopt certain
strategies that can successfully lead to improved health and welfare of citizens. At initial level, it is
necessary to eliminate narrow sexual health inequalities that exist in the nation. Inequalities in UK
are the result of social exclusion, ethnic background and sexual orientation which is directly linked
to teenage pregnancies. It is also essential to take preventive initiatives so that inequalities can be
reduced. For improving general health and sexual health in citizens of UK, it is necessary to impart
sexual health education to youngsters at school so that their awareness can be increased (McNeely,
Nonnemaker and Blum, 2012). This will help in ensuring that all individuals have equal rights to
access information related to sexual health and its relationships. According to a national survey of
sexual attitude and lifestyle, it was reported that 68% of individuals tend to develop sexual
relationships before the age of 16 years. This data also produced a major difference in sexual health
behaviour in both urban and rural areas of various parts of UK. Apart from other nations in Europe,
UK accounts for the highest rates of teenage pregnancies and conceptions in between the age of 15-
19 years. Teenage pregnancies in UK are more than 72% in 2015 which have increased from 68%
in 2011. UK is not only highest in recording teenage pregnancies but it is also reported to have more
than 8% of under-age pregnancies in between 13-15 years (Onwuegbuzie and Leech, 2015). It is
important to reduce the number of teenage pregnancies because it leads to many other heath issues
to both mother and the child. It is noticed that generally a teenage tends to have poor mental and

physical health which has a negative effect on both the individuals.
Also, the child born from teenage mother is reported to be of low weight which increases
the risk of mortality in early years of birth. One of the major drawbacks of teenage pregnancies is
that, chances of dissolving a relationship after pregnancies increases (Galliers and Land, 2007). This
ultimately affects the future of child. The rates of teenage pregnancies in UK are considerably high
as compared to any other nation due to various reasons. One common reason of increased teenage
pregnancies in UK is low expectations in the field of education and job markets. Due to lack of
proper environment and high levels of crime emerging in UK, teenagers pursue having a child at
early age as a positive sign for continuing a relationship. Another reason is lack of knowledge about
contraception and protection during sex. 25% of teenage individuals who become mothers in their
teen years are initially unaware about contraception which is likely to be used during sexual
activities (Benbasat, 2014). Abortion rate in UK has also consistently increased in the recent years.
The rate was 13 terminations per 1000 women which have risen by 2% in 2011 and 5% after the
implementation of Abortion act UK. In Wales, highest rate of abortion ranges from the age group of
20-24 years and the rate or pregnancy termination from 2010 has increased by 12 % and in 2015, it
has crossed to 15%. Based on a survey report, it was concluded that 78 out of 100 terminations were
performed on single mothers whereas only 20 out of 100 were conducted on married women (Petty,
Thomson and Stew, 2012). 50% of mothers were reported to have no earlier children when they
underwent first termination. However, 18% women underwent second abortion. Apart from teenage
pregnancies, there is an increased risk of people encountering sexually transmitted disease in the
early years of life (Jenkins, 2015). More than 25% of total population of UK is infected with
sexually transmitted diseases at the age of less than 25 years. It is not only an issue with youngsters
but it is also common in older men and women at the same rate. Different types of sexually
transmitted diseases in UK are chlamydia, genital wart virus, genital herpes, gonorrhoea and AIDS.
Hence, it is necessary to adopt effective strategies that can help in lowering down the number of
teenage pregnancies and sexually transmitted disease to minimum.
Aim:
To understand the importance of sexual health promotion for reducing teenage pregnancies
and sexually transmitted diseases in UK
Objectives:
 To understand the concept of sexual health promotion.
 To determine the major role of sexual health promotion for reducing teenage pregnancies in
UK.
 To critically analyse the role of sexual health promotion for reducing sexually transmitted

diseases in UK. To suggest different methods to promote sexual health among teenagers in UK.
Research Question
PICO framework will be used to design research question for the ongoing study. It helps in
formulating and answering questions in the desired manner.
 P: Patients (Teenage individuals)
 I: Intervention (Sexual health promotion)
 C: Comparison (None)
 O: Outcome (Reduction in teenage pregnancies and sexually transmitted disease)
1. Why it is important to promote sexual health among teenagers in UK?

2. SYSTEMATIC REVIEW
Increase in teenage pregnancies and adverse sexual health outcomes have been a major
problem in United Kingdom (Bonell and et.al., 2012). More number of medical terminations and
sexually transmitted diseases has been noticed in UK which has lead to decrease in conception
rates. Adolescent pregnancies, birth, abortion and sexually transmitted disease rates are much higher
in both developing and developed countries. According to the government statistics or nationally
representative survey data of UK, it has been reported that UK has the highest rate of teenage
pregnancies, abortion and still births after US. Adolescent childbearing has become more common
and 19% of teenage girls are reported to conceive their first child before the age of 16 years.
Although the government of UK has adopted many interventions in order to reduce this issue but it
has been ineffective to a far extent (Bonell and et.al., 2013). Rather than improving and promoting
sexual health in UK, interventions which have been adopted by various local authorities and
healthcare organisation had made the condition worse. Although lower proportion of teenage
pregnancies is resolved by medical termination in UK but as the rate of teenage pregnancies is high,
rate of abortion is also considerably high.
Even though it is directed in schools to provide sexual health education to pupils so that
awareness increases but the outcome of sexual health promotion has only been limited to the use of
condom. Girma and Paton, (2015) have stated that rather than decreasing the rate of teenage
pregnancies; it has consistently reduced the conception rate due to increase in teenage pregnancies.
This has produced adverse effects on the mental and physical health of all teenage females in UK.
In this article Melnick and et.al., (2016) produced a report on the effects of a theoretically based
teacher who delivered sex education programme (SHARE) which was based on conception and
termination of pregnancies. The research was based on identifying two different groups in which
one group was the case group and the other group was control group. Based on the results, it was
concluded that 95% individuals in between the age group of 16-22 years preferred pregnancy
termination and 274 out of 300 control groups had more than 88% of confidence interval during the
analysis. The results from these studies also concluded that there is an urgent need of adopting
effective strategies so that sex education among teenagers can be increased. Aslam and et.al, 2015
has stated that evidence of effectiveness is mixed but it is important to increase the knowledge so
that teenage pregnancies and sexually transmitted diseases among them will be reduced. Further,
Sorhaindo and et.al., (2016) also revealed that different strategies such as promoting availability,
proper use of condoms and intake of emergency pills do not guarantee the reduction of pregnancies
and medical termination.
In another article, Acosta and et.al., (2014) stated that through proper sex education and
programmes, teenagers are likely to delay their initial experience of sex which will result in positive

outcome. This will also encourage the teenagers of UK to have safe sex so that they would not
encounter sexually transmitted diseases. Maternal involvement in providing sex education also
plays an important role in promoting sexual health in UK. However, it is also necessary to have the
influence of father so that they can safeguard their child from involving in sexual activities until
adulthood. Single parenting also has a negative impact on the growth and development of teenagers
in early years. As compared to any other country apart from UK, there is low rate of single
parenting which has promoted sexual health to a high extent. DeSmet and et.al., (2015) have stated
that UK has been reported to have the largest number of teenagers who are under single parenting.
Due to this, they are not able to get proper knowledge and education related to sex which increases
the rate of teenage pregnancies and sexually transmitted diseases in them (Marston and Lewis,
2014). As Netherlands has the lowest rate of single parenting as compared to other countries in the
world, a collective questionnaire based survey was conducted on teenagers of Netherlands and UK.
Based on the survey, it was concluded that 39% of teenagers in UK were involved in sexual
activities in their initial teenage years because they were not given with any kind of guidance and
knowledge about sex in their growth years (Gascoyne and et.al., 2016). This was also a negative
impact of single parenting which is very common in UK as compared to any other countries of the
world. Sexual health issues are very common in adolescents and young adults because they lack
knowledge related to sex which is necessary in initial teenage years. If parents do not provide sex
education or if schools and education centres are not imparting them proper knowledge then the
chances of teenage pregnancies and termination increases.
Elliott and et.al., (2013) have stated that the age of adolescence is a time when sexual risk
taking and experimentation with life probably increases. But this is also the time when vulnerability
among individuals especially teenagers is increasing day by day. Hence, it is very important for
parents to be alert and aware so that they can help in decreasing the rate of pregnancies termination
and sexually transmitted diseases in youngsters. The chance of a person encountering sexually
transmitted infections from one individual to another certainly increases when a sexual activity is
initiated without taking effective care and precautions. Sonnenberg and et.al., 2013 has included
that when a patient presents a medical issue to a general physician with symptoms of sexually
transmitted infections such as arthritis, hepatitis and rash then it becomes the responsibility of
physician to investigate all risks associated with the infection so that it would not spread further.
Physicians should also ask the patients about sexual risk that can be caused due to unsafe sex during
the beginning of adolescence. Physicians can suggest individuals to undergo the test for sexually
transmitted infections as well as for pregnancies so that it can be reported in the initial period
(Wight and Fullerton, 2013). Generally, it has been noticed that patients do not prefer to undertake
diagnosis for diseases which are caused due to sexual activities but it is the duty of healthcare

professionals to guide them for test so that any infection can be detected at early stage only.
Similarly, O'Brien and et.al., (2014) have stated that knowing the sexual history and consent
of patients for further diagnosis should be core medical skills which should be developed in all the
healthcare professionals so that they can easily convince patients for undergoing various tests for
detecting sexually transmitted diseases. According to the report generated by NHS, UK has been
noticed to have maximum number of unintended pregnancies and infections have consistently
increased in recent years. Rate has increased from 27% in 2012 to 39% in 2015 which has
developed a negative impact on the teenagers of UK (Herrick and et.al., 2014). In such cases, it has
become very important for the health organisations of UK to promote sexual health so that they
would be able to considerably decrease the alarming rate of teenage pregnancies and infections to a
higher extent. In this research, study was based on randomised controlled trials in which random
sample of teenagers and other individuals in the age group of 15-24 years were selected which were
reported to be pregnant in their adolescence. A questionnaire was prepared which helped in
conducting the studies in a successful manner (Lottes, 2013). According to the results drawn from
survey, it was noticed that 7% of teenage individuals were reported to suffer from one or more
sexually transmitted disease and 13% of them were on the extent of encountering these infections
due to unsafe sex.
According to the report generated by world health organisation (WHO), it was stated that
more than 15,000 adults aged 16-74 years participated in the interviews which were conducted from
September 2013 to August 2015 so that data on sexual behaviour, attitude and health can be
presented. From that study, it was reported that 30% of individuals under the age group of 16-24
years revealed that they were involved in sexual activities with someone of opposite sex before the
age of 16 years (Marriott, Hamilton‐Giachritsis and Harrop, 2014). The rate of having first sex at
the age of 24 years has been consistently declined and now the age of first sex in UK has been
recorded to be 16 years. In order to avoid such types of infections and teenage pregnancies, it has
become necessary for the government of UK to adopt various effective strategies so that unintended
pregnancies and transmission of infections can be reduced to minimum (Oliffe and et.al, 2013).
Child sexual exploitation is also one of the major issues which need to be addressed by UK so that
those children would not be neglected. According to the National working group, child sexual
exploitation can be defined as involvement of children below the age group of 18 years in various
sexual activities. This is generally done so that young people can get food, cigarettes, drugs or gifts
in return for this. It is an abuse of power by those exploiting by virtue of their age (Bonell and et.al.,
2013). This issue has been brought into public attention in the recent years because cases of child
sexual exploitation have been consistently increased. For promoting sexual health in UK, British
government and the medical association for sexual health and infections have developed a proforma

so that all healthcare professionals working in primary care centres can easily detect
cases of child sexual exploitation. Although, it is very intrusive to ask questions in cases of sexual
exploitation but it is necessary because it provides a clue about various issues that are linked with
the child sexual exploitation.
In another study, Slater and Robinson, (2014) have stated that sexuality is the integral part of
being human. But sexuality not only has positive impacts but also produces negative impacts on
human beings. An open discussion about sexuality issues have become a more serious concern
because if it is not discussed then it will not help in promoting sexual health in citizens of UK.
Bungay and Vella-Burrows, (2013) revealed that common sexuality problems in people can be
reproductive system disorders, infertility issues, Gynaecologic problems, including endometriosis,
pelvic inflammatory disease and premenstrual syndrome, urinary tract infections, sexually
transmitted disease and sexual dysfunction including erectile dysfunction (ED), painful intercourse
and loss of sexual desire. Other issues can be unusual lifestyles and behaviour among various
individuals. For sexual health promotion, it is necessary for all teenagers and other individuals to
maintain their health by different means (Wellings and Johnson, 2013). There are different ways of
promoting sexual health such as HIV testing, diagnosis and treatment of sexually transmitted
disease and imparting knowledge about sex education so that all individuals would be aware about
various consequences related to sexual issues. Providing information about diet and exercise is also
necessary because this also has both positive and negative impacts on the lifestyle of a person. Also,
it is important to protect the sexual health of women so that chances of unintended pregnancies and
medical termination can be avoided (Bauer and et.al., 2013). In order to promote sexual health in
women, it is necessary to provide them pregnancy testing and counselling so that their knowledge
and awareness would get increased. Routine gynaecological diagnosis is also essential so that it can
help in detecting various medical conditions. Further, PAP Smears, Sexually transmitted infection
screenings, Contraceptive counselling should also be provided to them so that the rate of infections
and other diseases will be minimized. The issues related to sexuality are generally noticed in
teenagers. Hence, it is essential for them to provide information about contraception so that
unwanted pregnancies can be avoided (Cornish and et.al., 2014). This can also help in promoting
sexual health in many ways. There are various barriers which do not allow the promotion of sexual
health in both men and women in UK. In order to remove all those barriers, it is significant to
provide health education in schools and clinics so that more people would become aware about
sexual issues and sexuality in UK. By reinforcing and supplementing various stages of health
promotion, parents and teachers can provide proper education to children. In UK, it is still
predominantly a patriarchal society where gender imbalance and discrimination can create a
negative impact. But when it comes to sexual health promotion, they basically target females

(Pearson and et.al., 2012).
The overall concern of promoting sexual health in UK is to reduce the rate of teenage
pregnancies and sexually transmitted disease so that they can live a better life (Oliffe and et.al.,
2013). Based on the report, it was stated that contraception reduced the chances of pregnancy by
89% but the type of contraception also matters to a high extent. The importance of sexual health
promotion will help all teenagers to get a positive approach so that they can have a healthy sexual
life. There are different types of approaches which can be adopted by all individuals so that sexual
health can be promoted. Dual protection refers to the strategies that can be implemented to
safeguard a person from unnecessary pregnancies and sexually transmitted diseases (Bonell and
et.al, 2013). Further, dual shield strategy can also be adopted which involves use of condoms along
different forms of contraception which can decrease the extent of conception.
A case study was conducted so that comparability can be maximized in order to get more
authentic data on teenage pregnancies and sexually transmitted diseases in citizens of UK. The
report included different tables which were based on teenage sexual behaviour, contraception use,
birth and abortion as well as pregnancy rates (Marriott, Hamilton‐Giachritsis and Harrop, 2014). All
these factors were also differentiated on the basis of socio-economic measures which are present in
the society. Although effective data on all tables was not available but basic information about
sexual behaviour and other aspects were determined. Data on age at first intercourse and age at first
birth of child were also recorded which reported that usually the age of first intercourse in teenagers
in UK is between 15-17 years which is followed by delivery of first child at the age of 19 years
(Wellings and Johnson, 2013). Although 12% of teenagers make use of different contraception at
the end of last intercourse but this percentage is not greater than teenage pregnancies which is
recorded every year. This has also increased the rate of abortion to a considerably high rate.
As children and young people are the most important assets of all parents, it is necessary for
all the parents to safeguard them so that negative impact on their health can be reduced (Bauer and
et.al, 2013). Different policies should be implemented so that it can help all teenagers of UK to
respond to various sexual health issues in a positive manner. Sexual health promotion in teenagers
has become a central matter which should be addressed effectively so that sexual health can be
promoted in a better way. Sexual health promotion will help in achieving the most favourable
sexual health and sexual identity if it is conducted at proper age. This will later on help in reducing
the rate of sexually transmitted infections, HIVs, teenage pregnancies and sexual violence in UK
(Cornish and et.al, 2014). Hence, it can be concluded that is important for the government of UK to
promote sexual health to a higher extent so that people would get safe from all negative
consequences that can occur due to poor sexual health. As the risk of encountering sexually
transmitted disease is higher in females, they should be provided with special guidelines and

awareness so that they would not become prone to different diseases (Pearson and et.al., 2012).