SSASH is a survey for young people living in Australia aged 14-18 years.

The survey is relevant for all young people, including young people who have no sexual experience as we want to learn more about what young people know about sexual health and what their education and support needs are.

We are keen to hear from as many young people as possible in all states and territories of Australia. It would be great to include a diversity of young people in the survey, so we do want to hear from people of all genders and sexualities, people living in regional and remote areas of Australia and people from a wide range of cultural, ethnic and religious backgrounds.

SSASH asks young people a range of questions about sexuality, relationships, sexual experiences and sexual health. Specifically, the survey asks the following:

• Some basic demographic information including: age, school year level, school type (eg. Government or catholic school), gender, sexuality, place of birth, religion.
• What young people know about sexually transmissible infections (STIs), HIV and accessing healthcare services for sexual health
• Their opinions on school-based sex education and what they would like to learn more about
• Their sexual experiences and relationship experiences (if any)
• Experience/awareness of pornography or ‘sexting’
• If relevant, experiences of safe sex (eg. Condom use) and accessing sexual health services
• Experiences of unwanted sex and intimate partner violence.

Most of the time, participants will select from a list of answers. There are a few questions where they are asked to type in a short text answer.

If young people do not know the answer or do not want to answer any questions, there is always an option to indicating this, such as a ‘Prefer not to answer’ or ‘Not sure’ response.

We do suggest that young people fill out the survey when they are on their own as we ask questions about sex, relationships, and attitudes that they may not want other people to know.

Throughout the survey, and at the end of the survey, young people will be given more information about the questions asked as well as links to other websites and services where they can access more information or support.

Participation involves completing an online survey.

To get to the survey, people just have to click on the link or QR code. The survey is designed to be completed on any device (phone, ipad, computer) and can be done anytime. It takes about 30 minutes to complete.

Participants will be given information about the study prior to agreeing to participate.

The data young people share will help researchers, educators, sexual health doctors and others who seek to improve the sexual health and well-being of young people in Australia as well as assist with forming national STI policies.

We don’t ask for any information that can identify participants so there isn’t any risk that young people’s answers will be linked to them. Ideally, young people should complete the survey at a time and place where they can have privacy.

Yes, SSASH is an anonymous survey. This means we do not ask for names or other directly identifying information.

Even with non-identifying details, it is important that young people’s information is protected at all times so only staff working on the project will have password-protected access to the data.

All data is stored on La Trobe University’s secure network with access only to those working on the project.

Because we don’t ask identifying information, once a person submits their responses to the survey we cannot retrieve them.

Publications that result from this research will be advertised on the SSASH website in the future at www.ssashsurvey.org.au.

You can also access all reports from the SSASH survey from the website of the Australian Research Centre in Sex, Health and Society, La Trobe University. https://www.latrobe.edu.au/arcshs

If you would like to speak to us or would like further information about SSASH, please contact us at the Australian Research Centre in Sex, Health & Society (ARCSHS) at La Trobe University:

Dr Sylvia Kauer, SSASH Research Fellow, s.kauer@latrobe.edu.au

Dr Jennifer Power, SSASH Principal Investigator, jennifer.power@latrobe.edu.au

If anyone experiences any distress while taking the survey or afterwards, please have them contact Kids Helpline on 1800 55 1800 or at kidshelpline.com.au or Lifeline on 13 11 14 or at lifeline.org.au.

It is possible that young people will have questions about sexual health matters after completing the SSASH survey. We hope that this provides a valuable opportunity to raise some awareness and have sexual health conversation with young people.

There is one section in the survey that tests young people’s knowledge of some key issues. Although we do provide the answers to these questions as part of the survey, young people may also ask you. Below are the answers to the knowledge questions in the survey and some information about consent and sexting. You can also use our list of resources to find helpful, relevant and correct information.

Sexually transmissible infections (STIs) are sometimes called sexually transmitted diseases (STDs). STIs are infections that are transmitted during sexual intercourse or close bodily contact. Common STIs include chlamydia, gonorrhoea, herpes, and human papilloma virus (HPV). Other STIs, that may be less common, include syphilis and human immunodeficiency virus (HIV).

Chlamydia, gonorrhoea and syphilis can be treated with a course of antibiotics. Viral infections, such as herpes and HIV, are not curable but can be treated. For all STIs, prevention is best. Use of condoms during vaginal or anal sex is the best way to prevent STIs. Regular STI screening is also a good way to help prevent transmitting STIs to another person.

You can catch an STI from someone who does not have any signs or symptoms. It is not uncommon for STIs to have no symptoms (asymptomatic). This means a person may not know they have an STI as there are no obvious indications. However, STIs can be transmitted to another person even when no symptoms are present. The best way to check for an STI is to have a sexual health check with a doctor.

The sort of symptoms that might indicate someone has an STI includes an unusual discharge from the vagina or penis, itchy genitals or anus, pain when urinating, lumps near the genitals or anus, unusual vaginal bleeding, blisters or sores in the genital area. You can read more about STIs here: https://www.healthdirect.gov.au/sexually-transmitted-infections-sti

A person who has an STI may not have any symptoms. Some people never develop noticeable symptoms of STIs but can still give it to sexual partners. For people who are sexually active, regular STI screening can be a good idea. You can access STI screening at a health clinic even if you have no symptoms or signs. As well as helping to prevent transmission of STIs to other people, screening for STIs will help ensure you get treatment for asymptomatic STIs. This is important as STIs can cause health problems if they are left for a long time without being treated. You can read more about that here: https://www.healthdirect.gov.au/sexually-transmitted-infections-sti

If left untreated, chlamydia can lead to infertility (not able to have a baby) in women. Chlamydia can lead to pelvic inflammatory disease which can cause infertility in women, even when no symptoms are present. Although less common, chlamydia can also lead to infertility in men if left untreated. You can read more about chlamydia here: https://www.healthdirect.gov.au/chlamydia

Using a condom during sex helps prevent the spread of STIs. Use of condoms during vaginal or anal intercourse is the most effective way to prevent the spread of STIs. Condoms also prevent pregnancy, are cheap, portable, and easy to use.
Other barriers methods, such as use of dental dams during oral sex, may also help prevent STI transmission. You can read more about condoms here: https://www.healthdirect.gov.au/condoms

Gonorrhoea, chlamydia and syphilis can all be treated with medicine. These STIs can be cured using antibiotics, sometimes with a single dose. If you have symptoms or think you may have been exposed, get an STI test. Learn more about STI treatment and testing here: https://www.healthdirect.gov.au/sexually-transmitted-infections-sti

Human papillomavirus (HPV) and hepatitis B can be prevented via vaccines. Over 70% of young people in Australia are vaccinated against HPV and hepatitis B. Other STIs like gonorrhoea, chlamydia and syphilis are readily treated with antibiotics although no vaccines exist for these STIs. You can read more about the HPV vaccine here: https://www.health.gov.au/topics/immunisation/vaccines/human-papillomavirus-hpv-immunisation-service and the hepatitis B vaccine here: https://www.betterhealth.vic.gov.au/health/healthyliving/hepatitis-b-immunisation

Human papillomavirus (HPV), also known as genital warts, can lead to cancer. HPV causes most cervical and anal cancers as well as types of throat, vaginal and penile cancers as well. The vaccine effectively prevents cancer as well as genital warts. Most young people are vaccinated at school. You can read more about the HPV vaccine here: https://www.hpvvaccine.org.au/

and body piercing need to be cleaned and sterilised properly to ensure that no one else’s blood is present and the ink is not contaminated or shared. Australia has very strict guidelines that mean it is very unlikely for this to occur here. However, some people undertake body piercing or tattooing while they are travelling overseas. In countries where the guidelines are less stringent, this can pose a risk for HIV/hepatitis C or B transmission. You can read more about safe body piercing and tattooing here: https://shvic.org.au/stis-and-bbvs/tattoos-and-body-piercing

HIV cannot be cured but treatment now prevents people passing HIV to others through sex. Pre-Exposure Prophylaxis (PrEP) can be taken daily which prevents HIV from being able to infect the person taking it. Post-Exposure Prophylaxis (PEP) can be taken within 48 hours of a risky sexual encounter and works the same as PrEP; in most places PEP is accessible at emergency departments. You can read more about this here: https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/post-exposure-prophylaxis-for-HIV-prevention

HIV cannot be spread through coughing or sneezing near other people. HIV is a blood-borne virus and is not transmitted through the air nor is it found in fluids from the nose or saliva. Blood-borne viruses, like HIV, may be transmitted if blood, semen or vaginal fluids pass from an infected person to someone else. You can read more about HIV transmission here: https://www.health.nsw.gov.au/Infectious/factsheets/Pages/HIV-infection.aspx

Condoms used during vaginal or anal sex help protect people from getting HIV. When condoms (latex or polyurethane) are used correctly, they are highly effective at preventing transmission of HIV. Use of a water-based lubricant can help the condom be more effective by reducing the chance of breaking caused by friction. You can read more about HIV prevention here; https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/hiv-and-aids

You can get your own Medicare card when you turn 15. You can get your own Medicare card if you are 15 years of age or older by creating a my.gov.au account and signing up for a Medicare card. A Medicare card allows you to access medical care in Australia. If you attend a clinic that is ‘bulk billed’ as provide your Medicare, you should not have to pay any out of pocket costs. You can read more about this here: https://www.betterhealth.vic.gov.au/health/servicesandsupport/young-people-and-health-services

Once you turn 14, your parents cannot access your Medicare records. Once you turn 14, Medicare will not tell anyone else listed on your Medicare (ie. parents) details about your medical treatments. Your parents may still know that you saw a doctor, but they will not know what you saw the doctor about. You can read more about young people’s access to medical care here: https://yla.org.au/vic/topics/health-love-and-sex/your-rights-at-the-doctor/

Young people can book an appointment to get an STI test by calling a local sexual health clinic or family planning clinic. STI testing is usually quite quick and pain free. You can read more about STI testing here: https://www.health.gov.au/sti/testing. You can read more here about how to access and pay for a health service as a young person: https://yla.org.au/vic/topics/health-love-and-sex/your-rights-at-the-doctor/

Sexual consent refers to both partners agreeing to take part in sexual activity and understanding what they are agreeing to. Sexual activity includes things like kissing, touching, oral sex or sexual intercourse. Just because someone agrees to one thing (e.g., kissing), they may not agree to another (e.g., sex).

Affirmative consent means that people participating in sexual activity should take steps to check that the other person is consenting to the activity rather than assuming the other person will say ‘no’ if they do not want to do it. Checking in might involve, asking if someone is happy to continue or if they are okay with what is happening (and checking in more than once to make sure they continue to be okay), being aware of body language to make sure the other person seems comfortable and engaged, and communicating clearly about how you are both feeling.

Here are some important things for young people to consider:

• Consent should be freely given.
• Consent should be positive, enthusiastic, and active. Both body language and verbal agreement should give the same message.
• No means no. Silence, a lack of response or negative body language also means no.
• Consent must not be coerced by pressure, threats, intimidation, harassment or making someone feel guilty or ashamed.
• Consent is mutual. Both partners must agree and clearly understand what they agree to.
• Consent is a continuous process. Consent must be freely given for each sexual activity.
• It’s not consent unless both partners feel safe and comfortable.
• If someone consents once, it doesn’t mean they consent for any future activities.
• Consent can be withdrawn at any time.
• Consent is not implied by sexual text messages, photos, clothing, flirting. Consent must be explicit.
• You can’t give consent if you are drunk, high, unconscious or asleep. Consent requires both partners to be sober and alert.
• Physically resisting is not consent.

For more information about consent, young people can go here: https://kidshelpline.com.au/teens/issues/what-consent

For more information on how to talk to young people about consent, you can go here: https://raisingchildren.net.au/teens/communicating-relationships/tough-topics/getting-giving-sexual-consent-talking-with-teens

The age of consent for sex in Australia is between 16-17 years depending on the state or territory.

In most states and territories, even if you have reached the age of consent, it is illegal for an adult to have sex with someone aged under 18 if they are in a position of care or authority, such as a teacher, youth worker, foster carer etc.

You can read more about age of consent here: https://youthlegalserviceinc.com.au/fact-sheet-age-of-consent/

It is illegal to create, possess or distribute sexual images of anyone under the age of 18. In some cases, this can mean that people under 18 are committing a crime if they take, or share, sexual or nude images of themselves or another person aged under 18 (often called ‘sexting). However, the intention of the law is to protect young people from harm, not to prosecute them for consensual sexual practices. Some states and territories have introduced laws that aim to ensure young people are not harmed or exploited by sexting, while also ensuring they are not prosecuted unfairly. You can read more about this here: https://www.vic.gov.au/sexting

It is important that young people understand the possible risks associated with sending or sharing nude or sexual images and understand the responsibilities they have to keep other young people safe. It is never okay to share someone’s nude or sexual images without their consent.  More information about sexting can be accessed here: https://yla.org.au/nsw/topics/internet-phones-and-technology/sexting-laws/

Research shows that young people value opportunities to talk with adults about sex and relationships and that they want more conversations about these issues with trusted adults. However, these conversations can be hard for both adults and young people. Often people do not know when or how to initiate conversations about sex and relationships and often everyone is embarrassed. Our best advice is to give it a go and make sure the young people you work with know you are available if they have any questions or worries. Below are some helpful resources:

The Busy Youth Workers’ Guide to Talking Sexual Health

This website provides information for youth workers, advice on how to talk to young people about a range of issues (eg. pregnancy, STIs, pornography) and links to resources you can share with young people.

https://medicine.unimelb.edu.au/cersh/resources/the-busy-youth-workers-guide-to-talking-sexual-health

Play Safe Pro

Play Safe Pro is a website for youth workers and other people who work with young people. It include information, links to training, activities and resources to support youth workers to engage with young people to support sexual health. It also has a handy resources for talking to young people about sexual health, including identifying where opportunities to initiate conversations may arise:  https://pro.playsafe.health.nsw.gov.au/

Betterhealth Victoria:  talking to young people about sex

Betterhealth Victoria provides information about strategies for talking to young people about sexual health. This is designed for parents but also has some good strategies, and links to resources, that may be useful for young people of different ages:

https://www.betterhealth.vic.gov.au/health/healthyliving/talking-to-children-and-young-people-about-sex

Sexual Health Victoria: talking to young people about sex

This is for parents and carers primarily, but provides excellent guidance on the range of topics young people may want to talk about

https://shvic.org.au/for-you/for-parents-and-carers/sex-education-talking-to-young-people

Opening conversations with young people about sexual health

This is a resource from Ireland, but it was originally developed by NSW health. It is a comprehensive guide to initiating tricky conversations about sex with young people. The resource pays attention to issues for youth workers such as creating a safe and respectful environment for conversations. It also provides language and prompts to assist in keeping conversations going.

https://www.youthworkireland.ie/wp-content/uploads/2022/11/YWI-Talking-About-Sexual-Health-Resource.pdf