All Posts tagged sexual health
OK, so as promised in our previous blog from the #WorldSTICongress2015, we had our in-house gamers review the new STI game developed by WA Health Infection Protection.
Introducing Gamer 1: At 14 years old, this gamer has had 12 years gaming experience. Starting out at 2 playing Freddie Fish, he moved into Star Wars Lego games at 6, loved Mario Kart, built hundreds of architecturally designed cities in Minecraft (still a gold favourite) peppering these games with bouts of Team Fortress 2 and FIFA, until he discovered Assassins Creed and shoot-em-up games like Call of Duty.
The game has a really good concept. I like how they’ve integrated Minecraft a popular and well known video game into something that educates children about STIs and health. It’s pretty funny at first, because everyone is having sex and that’s a bit weird. I’ve never seen Minecraft people having sex before. This made me laugh but it could make some people feel uncomfortable. After a while you get used to it and then you realise that it’s actually quite serious that the more sex they have the more diseases they can get.
You feel you’re responsible for these people having sex and spreading diseases as quickly as they do. So you have to stop the spread of disease by giving them safe sex packs and treating them.
Sending them to the clinic to get tested is really good because you learn about the symptoms and the treatments that are available.
The only thing is that you can’t really tell if the person has symptoms - but they should still go to the clinic to get tested just in case they just caught something from the last person they had sex with.
The way the game could be improved would be to give the characters more personality. Perhaps a picture of them (avatar) and a description eg; Brown hair, blue eyes, likes girls, likes boys, likes both, only has sex with one person, has lots of sex, has symptoms, has no symptoms. Make it more personal. You have to take care of them so you might as well know who they are.
Introducing Gamer 2: At 12, this gamer likes to play SIMS, Minecraft, Super Mario Bros, Nintendogs, Wii Sports, Kitty Powers Match Maker. She is an app queen with an iPhone and an attitude.
It’s weird for a 12 year old to see Minecraft characters doing that with each other. We still haven’t had “The Talk” at school but my Mum has told me about all that stuff. I know it’s normal, but it’s still weird. I like the way it looks like Minecraft. The graphics were pretty good. I played for a while and treated some people at the Clinic but I got bored after a while. I didn’t really want to learn about sex and diseases so I stopped playing. I don’t think I’d play again unless the characters were more interesting. Maybe if they had pets or did other stuff.
Play Infection Protection by going to www.getthefacts.health.wa.gov.au
Download Infection Protection from www.getthefacts.health.wa.gov.au
Turning the corner, I braced myself for another unfathomably academic abstract with a title that reads something like Engineering Human Rhinovirus Serotype A-1 as an HIV Vaccine Vector. My poor overloaded brain just wasn’t able to cope with another poster of stats, graphs and nanotype. So imagine the relief when I turned the corner to find the complete opposite. Here, at the World STI Congress 2015, was a research group who had finally got their game on.
Infection Protection, an initiative from the WA Health Department, are using online gaming to get their Sexual Health messages out to the young (and the young at heart). You can check out Infection Protection by downloading it from www.getthefacts.health.wa.gov.au
Interactive Games Missing their Mark
Interactive games are playing an increasingly important role in education around health and social issues. Check out this list compiled by MedlinePlus to see how much of an influence health games are playing. While the intentions are good, the majority of health games miss their mark. Kids are so much more tech savvy than we realise and in the time it takes to develop and build a game, it’s easy to lose them if the game is lame. Yes, the intentions are good - but are they really reaching their target audience?
Cashing in on the Minecraft Model
Infection Protection appears to have hit their target by channelling the one game that has completely captured kid’s imaginations, Minecraft. Millions of young people from 2-22 are playing Minecraft - the global gaming phenomena that uses blockhead characters to build cities, worlds and galaxies. You can play online with other Minecrafters from across the globe, or offline if you have the demo game.
Infection Protection is a simple game but, from our perspective, the branding is spot on. And, just to be sure, we’re going to ask our 12-14 year old audience to review the game.
Stay tuned for an honest appraisal next week!
PS: We tried to download from the App Store but had a few issues, so we went to Get The Facts and found a whole bunch of other really great sexual health messages for young people.
Download Infection Protection from www.getthefacts.health.wa.gov.au
Download from www.getthefacts.health.wa.gov.au
Australians love to travel. Whether the destination is an island paradise, a cultural trip or backpacker adventure, sex in other cities is part of the experience for many travellers.
Travel-associated sexual adventurism has been implicated in the transmission of sexually transmitted infections (STIs) including HIV and syphilis. Travellers who acquire new sexual partners while travelling tend to engage in higher risk sexual practices.
In many cases, overseas travellers rquire travel vaccinations, providing an opportunity for the GP to develop a pre-travel risk assessment and to discuss safe sexual practices and STI testing options with travellers.
ASHM - The Australasian Society for HIV Medicine is running a training session for GPs and Practice Nurses in Sydney on February 25th. If you are a health professional, you might want to check it out here www.ashm.org.au/training
Thanks to the WA Aids Council for allowing ASHM permission to use their name. Check out their excellent website aimed at schoolies and young adults who are planning to travel
Sex in other Cities website
References and further reading:
Zablotska IB, et al. AIDS Behav. 2014;18:1436-42.
Mercer CH, et al. Sex Transm Infect 2007;83:517-522.
The past decade has seen a steady rise in sexually transmitted infections (STIs) in Australia.1 In 2010, young people aged 15-24 accounted for 42% of new HIV infections in people aged 15 and older.2
The adolescent population presents a unique set of challenges when it comes to sexual health education and behaviour change. Adolescence is a time for exploring sexuality, experimenting with risk-taking behaviour and finding new ways to connect that sets them apart from the adult world.
How do we reach young people to prevent STIs?
Moving health messaging into the digital gaming space, says Lynn Fiellin and colleagues at Yale University who presented their results at the Young People Epidemiology and Prevention Strategies oral abstract session at AIDS 2014 today.
Digital health technologies are growing at an unprecedented rate, particularly in the smart phone and tablet space. Mobile phone networks are now reaching up to 85% of the global population and the World Health Organisation estimates close to 5 billion mobile subscriptions worldwide.2
A recent infographic reported the State of the Mobile 2013:
• 91% of all people on earth have a mobile phone
• 56% of people own a smart phone
• 80% of time on mobile devices is spent inside games or apps
• Majority of teens play video games as long as they have access to them.3
And the largest audience of apps and video games? Adolescents - the digital natives or our techno world.
Serious Gaming delivers serious health messages
‘Serious Gaming’ is an emerging platform for imparting health messages and delivering health education. Serious gaming holds the promise of delivering STI prevention messages to teenagers through game-based learning.
Anyone who has talked to a teenager lately knows that gaming experiences can be engaging, immersive and educational. Many Australian schools now set homework where students are using video gaming platforms and apps to entice and encourage literacy and numeracy and to connect and collaborate with remote schools.
Applying health messages to video games has the potential to improve health literacy around STIs and may go some way towards prevention.
Studies into serious gaming cite neuroplasticity improvements, faster processing, increased cognitive flexibility and a deeper creative learning experience as just some of the results reported by young people who took part in serious gaming compare to those who played non-educational games.4
Today, Fiellin and colleagues showed that when teens were randomly assigned to 10 hours of gaming sessions that included: Sexual health and HIV knowledge, self efficacy, risk perception scenarios, short vs. long term priorities and an epilogue illustrating the consequences of their choices, their HIV risk knowledge had improved at 6 weeks, with knowledge levels maintained at 3 and 6 months.
Participants enjoyed the gaming experience, found it challenging, and reported that they felt responsible for the decisions made during game.
During question time, criticism of the study was aimed at the game’s apparent representation of heteronormative and gender-based stereotypes. Ms Fiellin agreed that the video game was limited in its choice of characters and diverse sexual orientation but that the research group now have proof of concept to develop the game further including the potential for a multiplayer platform.
Read our blog Chlamydia in Teens: What’s working…What isn’t?
- Australian Bureau of Statistics ABS June 2012
- UNAIDS Fact sheet Adolescents, young people and HIV www.unaids.org/
- World Health Organisation (WHO) Website. Tobacco Free Initiative. www.who.int/tobacco/mhealth/
- www.digitalbuzzblog.com/State of the Mobile
- Glass BD et al (2013) Real-Time Strategy Game Training PLoS ONE 8(8): e70350. doi:10.1371/
Chlamydia in Teens
Health experts warn that an epidemic of chlamydia may cause a wave of infertility in young Australians.1
The past decade has seen a steady rise in sexually transmitted infections (STIs) in Australia.2 Professor David Wilson, from the Kirby Institute estimates that rates of chlamydia have tripled over a ten-year period.3 Chlamydia is the most frequently notified infection in Australia with almost 83,000 cases diagnosed in 2012. The rise in chlamydia diagnosis is partly due to increased testing however, the Kirby Institute estimate that one in twenty young Australians have chlamydia and many don’t even know they have it.
The Burnet Institute recently reported that the group who have the highest percentage of positive test results are girls aged 12-15 years (13%) compared with females 16-19 years (12 %) and 20-24 years (8%).4 In males, the highest percentage of positive chlamydia tests were in those aged 16-19 years (15%) followed by 20-24 year olds (13%) and 12 to 15 year olds (9%).4 These figures may come as a surprise, but according to Carol El-Hayek, 12 to 15 year olds are definitely sexually active - and many of this age group are practising unsafe sex. Add to this the confounding factor that around 70% of females and 50% of males with chlamydia have no symptoms, so may pass on infection without knowing.5
For information about chlamydia symptoms, testing and treatment see What is Chlamydia?
Getting more Teens to Screen
Clearly, Australian teenagers as young as 12 years old are vulnerable to STIs, and the younger they are, the less likely they are to be tested. This age group are more likely to seek a test only after symptoms appear, or if they are identified as being at risk of unprotected sex by their GP, parent/carer or school counsellor.3
Chlamydia & Cyberspace
What’s also clear, is that young people are getting much of their health information from cyberspace. The internet plays a vital role in educating young people about STIs in a way that is familiar, non-judgemental and easily accessible. So how effective is cyberspace in reducing the rates of chlamydia in young people?
A recent study by Melissa Kang and colleagues from the University of Sydney GP Medical School, used the internet to engage sexually active young Australians aged 16-25 years in confidential, email interactions with a sexual health nurse or doctor. The goal was to educate and facilitate access to chlamydia testing services for young people. Subjects were invited to visit a specifically designed website to discuss chlamydia and the importance of testing.6
Young people were more likely to report having a chlamydia test after 6 months of email interaction with a clinician than those who were not offered such contact. The authors concluded that the internet and eTechnology may be useful in promoting chlamydia testing and healthcare seeking behaviour in young people.6
It goes without saying that cyberspace is a good place to start when designing public health messages about STIs for young people. There remain gaping research holes, sure to be filled over the next few years with studies on the extent and efficacy of internet-based education programs for young people. At this stage, and with little evidence to back up social media and internet-based programs, the most effective way to change behaviour are the still traditional methods of school-based programs, community health centres
In July 2013, The Australian Research Centre in Sex, Health & Society issued a report outlining the most effective (and ineffective) methods of delivering STI education programs.7
- Comprehensive one-on-one counselling with sexually active young people has shown to be effective in changing behaviour and reducing risky sexual practices;
- Generally, interactive internet-based programs are comparable to face-to-face counselling for increasing sexual health knowledge and improving attitudes towards practising safe sex
- Targeted outreach screening in community health settings and non-GP health services show high acceptance and participation in STI screening;
- Sexual health education via the internet and social media may improve young people’s sexual health knowledge and attitudes;
- Programs for Aboriginal and Torres Strait Islander youth that follow good cultural practices such as community consultation and ownership, collaborative development and engagement using multidisciplinary and interagency approaches are effective;
- Peer-led programs and youth development with at-risk young people and minority youth are effective in increasing knowledge and improving attitudes and motivations.
And what isn’t…
Programs focusing on abstinence were ineffective in reducing risk or delaying sexual behaviour. There is also indicative evidence that abstinence based programs may increase STI risk.7
There has been minimal success in increasing STI screening rates in general practice contexts, in particular for chlamydia. However, young people will respond positively to an offer from a clinician or GP for an STI test and many would prefer this to having to initiate the request.7
Take-home message for health practitioners:
- Offer confidential STI screening to young people.
- Make sure a list of sexual health clinics and youth health centres is available for young people from the age of 12 years.
- Avoid talk of abstinence. Young people are sexually active and need support not judgement.
- Keep up to speed on culturally appropriate, locally relevant, interactive sexual health education sites, apps and community programs.
In the meantime, there are plenty of informative, locally relevant websites, campaigns and Twitter feeds:
Red Aware YEAH is a youth driven health promotion organisation aimed at empowering youth to become involved in improving sexual health awareness in their local communities.
Get The Facts is a youth focused website about sexual health (Department of Health, WA).
Could I Have It? is a comprehensive site all about Chlamydia with information for young people and travellers. It even features online Chlamydia self-assessment and testing (WA based).
Better to Know is a website for Aboriginal and Torres Strait Islander people with information on STIs, how and where to test for STIs and how to tell a partner that you have an STI.
1. Brewster, K. Chlamydia epidemic may cause a rise in infertility among young Australians - experts warn. ABC News 24 October, 2013
2. Australian Bureau of Statistics ABS June 2012
3. Hagan, K. Chlamydia rates rise for younger girls. The Age, 24 October 2013
4. Somerville, C. Burnet Institute News, 24 October 2013
5. Better Health Channel: Chlamydia
6. Kang M, Rochford, A, Skinner R. et al. Facilitating chlamydia testing among young people: a randomised controlled trial in cyberspace. Sex Trans Infect. 2012;88:568-573.
7. Brown G, Croy S, Johnston K, Pitts, M., & Lewis, V. (2013). Rapid Review: Reducing sexually transmissible infections in young people. Melbourne: Australian Institute for Primary Care & Ageing (AIPCA) and Australian Research Centre in Sex, Health & Society (ARCSHS), La Trobe University.