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Trauma informed care in sexual health

Trauma informed care in sexual health: A guide for professionals working with young people If you work with young people in out of home care (OOHC), you’ll probably need to talk about their sexual and reproductive health at some point. These discussions can be especially challenging, as young people in OOHC may have experiences of trauma. It’s important to approach these discussions with extra care and consideration. By learning about trauma informed practices and creating safe, supportive environments, you can help reduce the risk of re-traumatisation and make a positive impact on the sexual health of young people in OOHC. What is trauma informed care? Young people who have experienced trauma need your support to access safe, informed, and compassionate sexual health education. Trauma informed care offers a framework that makes this possible. But, to understand and define trauma informed care, you need to first understand what trauma is. The Blue Knot Foundation defines trauma as a deeply upsetting experience that overwhelms a person’s ability to cope. It happens when someone feels threatened or helpless, causing long-lasting emotional, psychological, and sometimes physical effects. Young people in OOHC who’ve experienced trauma are more likely to face poorer sexual health outcomes due to complex factors such as poverty, neglect, abuse, and family breakdown. These challenges may make it harder for them to access the support and care they need. This is where trauma informed care comes in. Trauma informed care is a systems-level approach that helps organisations understand, recognise, and respond to trauma. It involves a strong awareness of how trauma affects a person’s needs and behavior, guiding professionals to create safe, non-judgmental environments for discussions about sexual health. As one research paper puts it: “Trauma informed care is a strengths-based framework that is grounded in an understanding of and responsiveness to the impact of trauma. It emphasises physical, psychological, and emotional safety for everyone and creates opportunities for trauma survivors to rebuild a sense of control and empowerment.” The four R’s of trauma informed care The Substance Abuse and Mental Health Services Administration (SAMHSA) outlines four key assumptions that form the basis of trauma informed care. These are often referred to as the ‘four Rs’ and apply to all areas of an organisation. Realise the impact trauma can have on families, carers, organisations, communities and individuals Recognise the signs of trauma, that relationships can be the basis for healing, and that the service delivery setting plays a role in facilitating the foundation for trauma informed care Respond appropriately and effectively by applying the principles of trauma informed care Seek to prevent Re-traumatisation of young people Trauma informed care principles Along with the 4 Rs, SAMHSA has key trauma informed care principles (also known as trauma informed values) that are essential for providing trauma informed care to young people. These are universally recognised and should be integrated into your service. 1. Safety Physical and emotional safety are crucial in a trauma informed approach to discussing sexual health. If you work with young people, it’s important to create safe, welcoming spaces. This means being aware of the physical environment, ensuring privacy, and recognising emotional triggers during conversations. 2. Trust and transparency Building trust with young people who’ve experienced trauma takes time. Be transparent in your interactions, avoid making promises you can’t keep, and provide clear information to help build and maintain trust. Building trust with young people also involves establishing trust and openness with their families and communities. When building trust with young people, it’s Important to provide support within the scope of your role and follow mandatory reporting requirements. Mandatory reporting in NSW requires professionals and individuals in roles working with children and young people to report harm or concerns about a young person’s safety, welfare, or wellbeing. 3. Peer support People who have experienced trauma often connect better with young people facing similar challenges. That’s why working with trained peers with lived experience can be a powerful way to build trust and create a sense of safety. Peer supports workers, who are already important in mental health and addiction services, can play a key role in sexual health education by providing relatable insights and support that resonate with young people. 4. Collaboration and mutuality Young people should be empowered to take charge of their health—including sexual health decisions. Working together in decision-making can help restore the sense of control that trauma often takes away, leading to a more balanced power dynamic. 5. Empowerment, voice, and choice As our detailed Trauma Informed Care Guide says: “Educating young people about sexual health leads to empowerment, and empowerment leads to awareness, higher self-value, and choice.” That’s why it’s important to recognise, nurture, and validate the strengths and autonomy of young people regarding their sexual health. 6. Cultural, gender, and identity sensitivity At the core of trauma informed care is a deep awareness of the historical and systemic factors, such as historical trauma, genocide, and institutional racism, that can shape a young person’s experiences. That’s why services need to explicitly acknowledge the diverse cultural, gender, and identity needs of young people. Strategies for professionals when working with young people with trauma This trauma informed care cheat sheet provides practical trauma informed care examples. Safety Make sure the environment is comfortable, private, and free from distractions Set up a calm, welcoming space with comfortable seating, soft lighting and no loud noises or music – make sure it’s quiet and private Ask the young person if you can do anything else to make it a safe environment Display posters or signs that signal inclusivity and safety (e.g., rainbow flags, culturally diverse imagery) Avoid sudden movements or interruptions during conversations Be prepared to recognise signs of trauma, such as dilated pupils, long pauses, or fidgeting, like twisting tissues. If you notice these signs, consider suggesting a break in the conversation or using Grounding Activities to help Trust and transparency Clearly explain what will happen during each interaction and why Follow through on commitments and promises made during discussions Be upfront about mandatory reporting and other important information from the start Use clear, simple language to avoid confusion and build trust Check-in regularly with the young person to make sure they feel comfortable and understood Make sure your body language is open and welcoming Peer support Introduce young people to peer support workers with similar experiences Share stories or examples from peers who have overcome similar challenges Reach out to Blue Knot Foundation if you require assistance finding peers who can assist Collaboration and mutuality Involve young people in their care plans by asking for their input and preferences Use “What do you think?” or “How would you like to proceed?” during discussions to give them control. Listen and act on their responses Validate opinions and acknowledge their expertise and input Empowerment, voice and choice Ask open-ended questions to give young people a chance to express themselves fully Encourage them to ask questions and advocate for their own needs Offer choices wherever possible, even in small decisions (e.g., where to sit or when and where to meet) Avoid making assumptions about preferences or experiences As Blue Knot Foundation says: Do something ‘with’ a person rather than do something ‘for’ or ‘to’ the person Cultural, gender, and identity sensitivity Use inclusive language and ask for pronouns and names Never assume someone’s gender, sexual preferences, religion or culture Display culturally relevant and gender-diverse materials in your service Provide translated materials or access to interpreters for CALD young people Collaborate with cultural or community leaders to deliver culturally sensitive care. For example, when working with Aboriginal and Torres Strait Islander communities, engage Elders in supporting young people, especially during health-related conversations, and connect with relevant organisations for additional support Additional trauma informed care resources Play Safe Pro Trauma Informed Care Guide: This tool offers detailed guidance on how to approach conversations with young people who may have experienced trauma. It includes strategies for tailoring discussions to diverse groups, such as Aboriginal and Torres Strait Islander youth, young people with disabilities, and culturally diverse youth Because You Care Training: This free online training on trauma informed care is designed for foster carers and OOHC workers. It offers trauma informed approaches to discussing sexual health, helping professionals navigate these sensitive conversations Blue Knot Foundation Fact Sheet for Applying Trauma Informed Principles: The entire Blue Knot Foundation website is a valuable resource, but this factsheet offers practical, easy-to-implement advice for guiding conversations. By using trauma-sensitive approaches, you can create safer, more supportive environments that empower young people to make informed choices about their sexual health. FAQs about trauma informed practice What is trauma informed care? Trauma informed care is a service approach that acknowledges the impact of trauma on people’s lives. It aims to create safe environments, prevent re-traumatisation, and promote healing by understanding and addressing the effects of trauma. What does trauma informed mean? The definition of trauma informed care includes understanding how trauma impacts a person’s behavior and health. It incorporates this awareness into the care process to ensure safety, support, and empowerment while preventing re-traumatisation. What are the 5 principles of trauma informed care? The principles of trauma informed practice include Safety, Trustworthiness, Peer Support, Collaboration, and Empowerment, all of which help ensure that care is supportive and promotes healing. What are some trauma informed practice examples? Examples of trauma informed care include creating safe, non-judgmental environments, using empowering language, and providing care choices to help avoid triggering trauma.

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First-time sex: what young people need to know

First-time sex can bring a mix of excitement, nerves, curiosity, and questions. And it is often influenced by emotions, expectations, and social pressures. This is where professionals like you can make a real difference. By providing young people with accurate, empathetic, and non-judgemental information, you can help them feel empowered and supported as they navigate how to have sex for the first time. What is first-time sex? It’s essential to recognise that first-time sexual experiences are diverse and deeply personal. For some young people, first-time sex may be vaginal intercourse, anal, or oral sex. For others, it could mean choosing not to engage in any sexual activity at all, and needing advice on how to say no. There’s no universal script, and everyone moves at their own pace, guided by their own values, comfort levels, and readiness. Creating a safe, inclusive, and non-judgemental environment is crucial to encourage safe and healthy conversations. Young people need to feel supported to ask questions, express their concerns, and explore their feelings. Helping young people set personal boundaries The first step in helping young people decide if they’re ready for first-time sex is guiding them to set boundaries. Step 1: Encourage reflection on boundaries Start by guiding young people to think about what they’re comfortable with and what they’re not. Boundaries might include: deciding when they’re ready to be physically intimate, understanding what types of sexual activities feel right for them, knowing what conditions (like being in a committed relationship) are important. Step 2: Navigating societal and partner pressure It’s not unusual for young people to feel influenced by peer pressure, what they ‘think’ everyone else is doing, peer opinions, or a partner’s expectations. As a professional, you can explore strategies for dealing with pressure and help them figure out how they can respond. Role-playing conversations or scenarios can help build their confidence. Step 3: Equipping young people with language to say ‘no’ The power of saying ‘no’ confidently cannot be overstated. Provide young people with phrases they can use, such as, “I’m not ready for this right now,” or “This doesn’t feel right for me.” Assure them that they don’t owe anyone an explanation, and their boundaries should always be respected. Check out our article on consent for great activities and examples. Step 4: Let them know it’s okay to wait There’s no universal timeline for when someone should be ready to have sex. Help young people see that readiness is personal, shaped by emotional maturity, trust, and values. It’s okay to wait, or to choose not to have sex at all. Step 5: Teach them about consent and communication   Consent is at the heart of every healthy relationship. But understanding consent means going beyond a simple ‘yes’ or ‘no.’ Help the young people you’re working with understand that if it’s not a clear and enthusiastic ‘yes,’ it’s a ‘no.’ Again, our consent article will help provide more details. Consent, as defined by the NSW Department of Communities and Justice, is a continuous and voluntary agreement between people (aged 16 and above) involved in any form of sexual activity – not just vaginal, oral and anal sex but also other sexual activities like: engaging in masturbation alone or with partners kissing body rubbing using sex toys phone sex or ‘sexting’ reading or watching pornographic material Also encourage them to have clear, open communication with their partner, it’s the key to making first-time sex a positive experience. Young people should feel comfortable talking about their expectations, feelings, and boundaries. You can guide them in developing these communication skills by offering scripts or practical advice. Accessing and understanding contraception and condoms If young people feel ready for first-time sex, it’s important to talk about condoms, contraception, and regular STI testing. The role of condoms Condoms are one of the most effective tools for protecting against sexually transmissible infections (STIs) and unplanned pregnancies. When chatting to young people, you can help them understand the importance of using condoms consistently and correctly. Condoms can be used for oral sex dams too. You can share this guide from Play Safe on how to use condoms correctly or maybe even try this Play Safe Pro Condom Demonstration Game. And remember, you can get 144 free condoms every single month for your service. Having these on hand will mean you’re able to provide young people with condoms when they need them. Contraceptive options From oral contraceptives to long-acting reversible methods, there are many options available to young people who want to prevent unplanned pregnancies. There is no one contraception that is the right choice for every person though, and it is always best to direct young people to a GP to discuss what is best for them. When speaking about contraception though, remind people that the best way to stay safe is to still use condoms, as they’re the only method that protects against STIs, not just unplanned pregnancies. STI testing Regular STI testing is an essential part of sexual health. Normalise conversations around testing and explain that it’s a simple, routine process. If they’re ready to have sex, then they should also be ready to get tested regularly every three to twelve months, and when they experience symptoms, have condomless sex, or change sexual partners. A holistic approach to first-time sex Sex is about more than the physical side of things—it’s also about emotional readiness, relationship dynamics, and individual values. By addressing all these elements, professionals can support young people in making informed, confident choices. FAQs about first-time sex Young people often have questions before or after first-time intercourse or other sexual activity. The below provides some guidance on common questions from young people about having intercourse for the first time. But remember, it’s important to encourage them to consult a doctor for any medical concerns or tailored advice. Does sex hurt the first time? For some, first-time sex can be uncomfortable. It’s important that young people have consent and keep communicating about what they do and don’t like. What are some tips for first-time sex? Focus on communication, consent, and comfort. Let young people know to take their time, always use protection like condoms and dams, and make sure they’re emotionally and physically ready. Also advise young people to talk openly with their partner about sexual boundaries and expectations. Can first-time sex cause pregnancy? Yes, first-time sex can cause pregnancy if contraception isn’t used. Safe sex and using condoms are the best ways to prevent pregnancy and protect against STIs.

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HIV stigma and discrimination

HIV and AIDS continues to be surrounded by myths and misconceptions that affect the lives of those living with or at risk of the virus. To help us tackle these misunderstandings and learn how professionals can create safe spaces to discuss sexual health, we sat down with the team at ACON, NSW’s leading HIV and LGBTQ+ health organisation. In this article about HIV stigma and discrimination, the ACON team share their valuable insights on common HIV myths, their impact, and how we as professionals and wider society can work to combat these myths during our work with young people. Busting myths about HIV Q: What are the most common misconceptions about HIV in NSW, and why do they persist? ACON: Let’s be real – HIV comes with a lot of baggage. The most common myth? That HIV equals death. Even today, some people still think that if you get HIV, your life is over. That couldn’t be further from the truth! Thanks to modern treatments, HIV is now a manageable condition, like diabetes. People with HIV who are on medication can live long, healthy lives, and if their viral load is undetectable (meaning super low), they can’t pass it on to others. This is what’s known as U=U: Undetectable = Untransmittable. Find out more about U=U Another big misconception is that only certain people (like gay men) can get HIV. This idea is outdated and harmful. HIV doesn’t care about your sexuality, gender, or background, it’s about behaviour, not identity. So why do these myths stick around? A lot of it has to do with how HIV was portrayed in the past, especially during the AIDS epidemic of the 80s and 90s. Movies, TV shows, and even public health campaigns back then focused on fear and tragedy. For example, in Australia, the Grim Reaper campaign was a terrifying ad that linked HIV to death, and that legacy still lingers. Add to that a lack of current education and open conversations about sexual health, and it’s no wonder these myths persist. Q: What impact can these misconceptions have on people living with or at risk of HIV? ACON: The effects of these myths are huge and deeply personal. For people living with HIV, the stigma can feel isolating. Imagine being scared to tell someone about your health because you’re worried they’ll judge you or reject you. That’s the reality for many people, even though HIV is manageable and not something to fear. This kind of judgement can mess with someone’s mental health and make them feel “less than”. For people at risk of HIV, these myths can prevent them from getting tested or seeking prevention methods like PrEP (a daily pill that protects against HIV). They might think, “HIV is something that happens to other people,” or they might fear being judged for even bringing it up. This is especially true for young people or those from migrant communities, where the fear of discrimination, or even deportation, can stop them from accessing healthcare. These misconceptions also delay diagnoses. If someone doesn’t think they’re at risk, they might not get tested, which can lead to worse health outcomes and a higher chance of spreading HIV to others. It’s a vicious cycle, and breaking it starts with better education and more empathy. Q: What’s the best way to address fears or misconceptions young people might have about HIV testing and treatment? ACON: It’s all about creating a space where no question is off-limits. Young people are curious, but they also don’t want to feel judged. Professionals working with them need to be approachable and open, ready to bust myths without making it awkward or overly clinical. Start by normalising these conversations. Sexual health should be as easy to talk about as mental health or physical fitness. Use simple, relatable language. Don’t throw around terms like “undetectable viral load” without explaining them. If someone doesn’t understand what you’re saying, they’ll tune out. Also, meet young people where they are. If they ask a bold or even funny question, roll with it. For example, if someone asks, “Can I get pregnant from oral sex?” instead of laughing it off, use that moment to talk about what’s possible and what’s not. When young people feel like their curiosity is taken seriously, they’re more likely to open up and learn. Creating welcoming spaces Q: What practical steps can professionals take to create welcoming spaces to discuss sexual health? ACON: First impressions matter, and the environment sets the tone. Imagine walking into a clinic that feels cold and sterile – it’s not exactly inviting. Now imagine a space with soft lighting, comfy chairs, and maybe some fun art or posters on the wall. Which one feels more welcoming? Exactly. It’s not just about the decor, though. Language is key too. Use words young people understand, and if they’re talking about “hooking up” or “using condoms,” mirror that language. Avoid overly medical terms that might feel alienating, like saying “rectum” instead of “butt”. Most importantly, be approachable. If someone wants to talk about sex, don’t make them feel embarrassed. Acknowledge that sex is a normal part of life, and make it clear that you’re there to help, not judge. And if you don’t know the answer to something? Be honest but point them to resources, like  , where they can get the info, they need. Trust and empathy go a long way. Q: What role does advocacy play in reducing stigma, and how can professionals get involved? ACON: Advocacy is like shining a flashlight into a dark room – it helps people see the truth about HIV and clears up the confusion. By spreading awareness about things like U=U and PrEP, advocacy challenges outdated ideas and shows that people living with HIV are just like everyone else. Professionals can play a big role in this. Start by challenging stigma in your own workplace. If you hear a colleague, make an offhand comment about HIV or someone’s lifestyle, gently correct them. Compassion goes further than confrontation. Learn how to leave stigma at the door You can also get involved in broader advocacy efforts. Join or support organisations like Positive Life NSW or ACON, which work tirelessly to educate communities and provide resources. And don’t underestimate the power of your voice – whether it’s sharing accurate info on social media, running workshops, or just having honest conversations, every little bit helps. Reducing stigma isn’t about being perfect or knowing everything. It’s about being kind, open, and willing to learn. When you approach things with empathy, you create a ripple effect that makes the world a little safer and more understanding for everyone. Supporting people living with HIV Q: What are the key challenges faced by young people living with HIV in Australia, and how can professionals help address them? ACON: Young people living with HIV often face a unique set of challenges. These include navigating their diagnosis alongside normal life transitions, such as starting a career or building relationships. Stigma can amplify these struggles, making it hard to connect with others or access support. Professionals can help by offering tailored resources and creating non-judgemental spaces for young people to share their experiences. Peer support programs can also make a big difference, helping young people feel less alone while learning from others who have walked a similar path. Additionally, integrating mental health services with sexual health programs can provide holistic care that addresses both physical and emotional needs. Turn awareness into action A huge thanks to the team at ACON for sharing such valuable insights and practical tips. By addressing misconceptions and fostering open, empathetic conversations, we can all play a part in reducing stigma and supporting the health and well-being of people living with or at risk of HIV.

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Talking to parents, guardians and carers about sexual health factsheet

Parents, carers, and guardians are a young person’s first and continuing educators Parents shape young people’s views on relationships and sexuality. Open, honest conversations help empower them with the knowledge and support needed for safe, healthy relationships. As a professional working with young people, you can support parents, carers, and guardians in building the confidence to discuss relationships, safety, and sexual health with their kids. Download Factsheet: Talking to parents, guardians and carers about sexual health    

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Key sexual health messages factsheet

Provide valuable support and information on sexual health to young people As a professional working with young people, it’s important to feel confident answering common questions about sexual health, and to know when and where to send young people to get more information and support. This factsheet covers key messages to help guide conversations about STIs, contraception, consent and healthy relationships. Download Factsheet: Key sexual health messages    

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Supporting young people to talk to their doctor about sexual health factsheet

Talking to a health professional about sexual health is an essential part of maintaining overall well-being for young people Young people might feel unsure, embarrassed, or even anxious about talking to a health professional like a doctor or nurse about sexual health. As someone who works closely with young people, you can help break down these barriers and support them to have positive conversations with health professionals. Download Factsheet: Supporting young people to talk to their doctor about sexual health  

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Staying safe during oral sex: Key messages for professionals working with young people

Oral sex is sex – and that means it’s important to practice safe sex, like it is with other types of sex. As a professional, you can help bust the myth that oral sex is ‘risk-free’ by making it a regular part of STI prevention talks. We spoke with Sexual Health Specialist, Dr Nathan Ryder, to put together a 101 on staying safe during oral sex.   What are the risks of oral sex? “There’s a common misconception that you can’t get an STI from oral sex, but that’s not true,” explains Dr Nathan. “Oral sex can carry a risk of several STIs. These include herpes, chlamydia, gonorrhoea, and more. While unplanned pregnancy isn’t a concern we have for oral sex, young people need to understand these risks and practice safe sex like they would for any time of sex.”   What STIs can be transmitted through oral sex? The following STIs can be transmitted via oral sex.  Genital/Oral herpes: The most common STI passed on via oral sex in Australia It’s caused by Herpes Simplex Virus and can spread from mouth to genitals Many people don’t show symptoms, but if they do, they might experience tingling or blisters around lips, genitals, or bottom People with herpes should avoid any sexual contact (including oral) during flare-ups to prevent transmission Chlamydia: A curable infection that often has no symptoms. Can lead to serious complications like infertility or Pelvic Inflammatory Disease (PID) if left untreated It’s treatable with antibiotics, making regular testing important Gonorrhoea (aka ‘Gono’): A curable infection that often has no symptoms If left untreated, it can cause infertility, pain and swelling of the testicles and PID It’s treatable with antibiotics, making regular testing important Syphilis: A curable infection that may have subtle symptoms. Symptoms may include mouth ulcers around the mouth, penis, vagina or anus and a red rash on the body (especially the palm of the hands and soles of the feet) If left untreated, can lead to serious health issues including damage to the heart, brain, spinal cord, eyes and bones. Syphilis can also cause birth defects and miscarriage in people who are pregnant Is treatable with antibiotics, making regular testing important Hepatitis A: A virus passed on through oral sex involving the anus (rimming) A vaccine is available to prevent hepatitis A   How to stay safe during oral sex “Practising safe sex by using barriers methods of protection, like condoms and dental dams, is one of the simplest ways for young people to protect themselves from STIs during oral sex,” says Dr Nathan. “It’s a small step with big impact. It’s also important to remind young people about regular STI testing if they’re having oral sex. This can include a self-collected swab (including a throat swab), urine sample and a blood test.” Order posters to promote regular STI testing. Teach them about barrier methods Using barrier methods is one of the simplest ways for young people to practice safe oral sex. If the young person you’re chatting with is engaging in oral sex with a penis, you can share this ‘How to use condoms’ guide from the Play Safe website. Order free condoms for your service. If they’re looking for advice on staying safe during oral sex on a vagina or anus, dental dams are a must. Although less common than condoms, dental dams provide great protection against STIs during oral-vaginal or oral-anal contact. They’re thin, flexible latex sheets that create a barrier—and if young people can’t find one, they can make their own by cutting a condom into a square. Encourage regular testing When chatting with young people, remind them that STI testing regularly is an essential part of looking after their sexual health. Encouraging regular testing not only helps young people look after their health and reduces the risk of unknowingly passing on infections to other people. Help them have conversations  Since many people don’t realise oral sex can pass on STIs, some might not be keen on using condoms or dental dams. You can help young people approach these conversations openly to encourage respect and understanding. Try providing young people with conversation starters to make these discussions easier. For instance, they might say, “I know it’s not as common, but I feel more comfortable using protection during oral sex,” or “Let’s get tested together so we can make sure we’re healthy.” Navigating stigma and normalising conversations Addressing oral sex safety (or any type of sex, for that matter!) can sometimes feel awkward for young people, especially since it’s often seen as a ‘taboo’ topic. You can play a role in breaking down this stigma, making it easier for young people to ask questions without embarrassment. By framing oral sex safety as just another part of healthy sexual practices, you can help them feel it’s normal and responsible to talk about it openly. It’s also helpful to reassure young people that asking questions and taking steps to protect themselves doesn’t mean they distrust their partners—it’s simply good self-care. Approaching these topics without judgement will help make discussions feel safer and easier for everyone.   Additional tools and resources for professionals We’ve got a whole range of interactive resources that can help guide your discussions with young people, including the Condom Card Game and Condom Demonstrations that will help make learning fun and engaging.   Final thoughts from Dr Nathan  “By providing clear, non-judgemental information and normalising discussions around sex, including oral sex, we can help young people feel more comfortable asking questions. This openness makes it easier for them to make safer choices without fear or stigma” says Dr Nathan. So there you go. By incorporating oral sex into sexual health discussions, you can help reinforce that safe sex practices aren’t limited to any one kind of sex—everyone deserves to feel confident and protected.   FAQs about staying safe during oral sex Can you get an STD from oral sex? Yes, STDs is an outdated term for STIs, so STDs can be passed on through oral sex. Infections such as herpes, gonorrhoea, syphilis, chlamydia, and others can spread through contact with the mouth, genitals and or anus. Practicing safe oral sex with barrier methods like condoms or dental dams reduces the risk. Can you get chlamydia from oral sex? Yes, chlamydia can be transmitted through oral sex. Although it’s less common than transmission through vaginal or anal sex, chlamydia can infect the throat if exposed to an infected partner. Regular STI testing, including throat swabs, is important if engaging in oral sex. Can chlamydia be transmitted orally? Yes, chlamydia can be transmitted orally. This bacterial infection can spread from the genitals to the throat through oral sex, and it often does not show symptoms. Routine testing helps detect and treat oral chlamydia, preventing further transmission.

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Check your bias: A guide to leaving judgement at the door

When discussing sexual health with young people, it’s essential to recognise and address personal biases. You might not think you have any, but often, our biases are unconscious, formed by our beliefs and experiences throughout our lives. Sometimes, our biases are invisible to us until we really start to look for them. In this article, we discover how, by understanding and mitigating biases, professionals working with young people can foster more open, trusting, and effective conversations about sexual health. Understanding bias and why it matters Bias refers to preconceived notions or attitudes that unknowingly influence our perceptions, attitudes, and behaviours. When it comes to discussing sensitive topics like sexual health, these biases can negatively impact interactions with young people in several ways. 1. Reinforcing stereotypes or marginalising certain groups Unchecked biases can perpetuate harmful stereotypes and further marginalise vulnerable groups. These assumptions and biases could include things such as thinking someone’s attitudes to sex are based on their religion or culture or suggesting that the person with the penis is responsible for carrying condoms. 2. Hindering trust and undermining credibility Even if it’s not intended, bias can make young people feel judged, making it harder for them to open up and share their experiences. It’s important for a person to feel supported and taken seriously, with zero judgement, especially when young people are already feeling vulnerable. 3. Adding to shame or stigma and creating barriers to healthcare access Judgemental attitudes can contribute to feelings of shame or stigma surrounding sexual health, which can put people off seeking help. It’s a vicious cycle we need to work hard at to break. Take condomless sex, or sex in general as an example. It’s a common topic that might come up in conversation, and if a young person senses disapproval when opening up about this, they could be less inclined to seek help – such as getting an STI test or to have conversations about their health again. They’ll also walk away without the information they need to make informed choices about their sexual health in the future. Recognising personal biases “As youth workers, we understand that we are people too, with our own histories, beliefs, ideologies and experiences. We understand that these things can impact on our practice. Realising this, youth workers take into account the diversity of values and interests that young people present with. We recognise that our own values may be different to theirs, and we respond to these differences in non-judgemental ways…Building self-awareness is something we must invest time and energy into. This comes through things like self-examination and critical reflection, regular supervision, and taking part in training and development opportunities that challenge and extend us,” Code of Ethics for Youth Workers in WA as shared in our Exploring Values Fact Sheet. When planning sexual health programs (or information/education) for young people, we need to make sure that we have considered and reconciled differing values. it is important that young people never: feel judged based on their sexuality or gender identity feel judged for the sexual behaviours they choose to engage in feel uncomfortable or embarrassed to engage in discussions about their values related to sex, sexuality and sexual health get excluded from the conversation because of their sexual experiences and behaviours. As the quote from the WA Youth Workers Code of Ethics above states, recognising these personal biases requires self-examination and critical reflection. Here’s what you can do: reflect on your own experiences and beliefs about sex and sexuality. How have they shaped your views? consider the cultural and societal norms that influence your attitudes towards sexual health. How do these impact your thought patterns? ask yourself if you hold any stereotypes about young people and their sexual behaviour think about how comfortable you are discussing different aspects of sexual health. Are there certain topics that you avoid or feel uncomfortable with? complete the Play Safe Pro Exploring Values Fact Sheet activity, which asks you to think critically about various values statements. Recognising these biases is the first step towards reconciling them and creating a more inclusive and supportive environment for discussing sexual health with young people. Strategies for mitigating bias Mitigating bias requires ongoing effort and conscious practice. Here are some strategies and techniques for professionals working with young people 1. Practice empathy Actively listen and empathise with the different perspectives and experiences of the young people you work with. This will foster understanding and connection. 2. Challenge assumptions Always question your assumptions and preconceived notions about sex and sexuality and consider alternative viewpoints and realities. Activities like the ones we outlined in the previous section of this article will help. Take the time to go through them regularly so that your own biases are always at the forefront of your mind. 3. Seek diverse perspectives Engage with diverse voices, including those from different cultural backgrounds, genders, and sexual orientations. This broadens understanding and promotes inclusivity. Why not run some of the activities above as a team? That way, you can share your own viewpoints and thought processes as well as helping people reflect and understand biases, they may not realise they hold. 4. Engage in continuous learning Like everything, committing to ongoing education and self-reflection is the best way to improve. Stay informed about current best practices in sexual health promotion and deepen your understanding of bias and its impact. Play Safe Pro and our partners run a whole range of sexual health training, including Sticky Stuff and Nitty Gritty, both of which provide information and free education about sexual and reproductive health; and ACON’s Pride training, which helps increase people’s knowledge of LGBTI communities, their experiences living in Australia, and gives guidance on inclusive practices. Values aren’t wrong; they’re just different As we wrap up, remember that values aren’t about right or wrong; they’re simply different perspectives and opinions. Our values can evolve, influenced by our life experiences, the people we meet, and the knowledge we gain. It’s also important to recognise that personal values might not always match organisational or professional values – and that’s perfectly okay. Recognising and addressing personal biases is a continuous journey for professionals working with young people. By promoting empathy, challenging assumptions, seeking diverse perspectives, and engaging in constant learning, we can all practice inclusive sexual health promotion.

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Healthy relationships: Helping young people recognise red flags

Navigating romantic and sexual relationships as a young person is a bit like setting off on a road trip with Google Maps refusing to load. From the thrill and nervousness of first time sex, to the complexities of defining boundaries, it’s likely young people will feel overwhelmed as they try and figure it out. As professionals working with young people, you have an opportunity to help them navigate these challenges and arm them with the tools to distinguish between healthy and unhealthy behaviours – AKA red flags. Because, while many relationships bring joy and fulfillment, it’s vital to acknowledge that unhealthy relationships also exist, with coercive, controlling or unhealthy behaviour that quickly takes a toll on mental, physical, and emotional well-being. Understanding the nuances of healthy relationships is complicated and can include complex topics like consent, boundaries, domestic violence, and abuse – areas where professionals specialised in these fields can offer support. In this article, we’re focusing mainly on the intersection of healthy and unhealthy relationships in the context of sexual health. We don’t expect you to have all the answers, but young people will trust you in your role and open up to you about relationship difficulties. Having more information and knowing where you can go for help is important. Warning: If someone is in imminent physical or other danger, always contact emergency services on 000 immediately. It is also important to keep in mind your Mandatory Reporting responsibility for disclosures that may arise from discussions around consent.   Understanding healthy relationships (green flags) Before talking to young people about the importance of healthy relationships, it’s important to first understand what a healthy relationship looks like, so that you can confidently explain it to a young person. Examples and anecdotes are a good way to do this, which is why we’ve created this easy-to-refer-to table. Open and honest communication Both partners feel comfortable expressing their thoughts, feelings, and concerns openly and respectfully. Example: Mohammed and Taylor are in a relationship and want to start having sex. They openly share their concerns, past experiences, likes and dislikes before, fostering a deeper connection and ensuring that no-one is pressured into doing anything they don’t want to. Trust and respect Mutual trust and respect are the foundation of the relationship, with both partners valuing each other’s opinions, boundaries, and autonomy. Example: Priya respects Mark’s choice to prioritise their sexual health by agreeing to get an STI test before having sex. Healthy boundaries Each partner respects the other’s boundaries, including physical, emotional, and personal boundaries, and communicates openly about their needs and limitations. Example: Rachel isn’t ready for sex. Instead of pressuring her, Mark tells Rachel he understands and they chat about what Rachel is ready for. They both acknowledge that these boundaries can change at any time, and agree to discuss the topic regularly. Conflict resolution Conflicts are addressed constructively and respectfully, with both partners listening to each other’s perspectives, seeking compromise, and working towards solutions together. Example: Seung wants to see more of their partner Mia, who is studying and working so has limited free time and struggles with last minute plans. Instead of getting angry, they discuss the issue openly and work together to find creative solutions, such as scheduling regular date nights that work around Mia’s schedule and agreeing to message to say hello each day and help Seung feel connected. Mutual consent and respect for boundaries Both partners prioritise mutual consent and respect each other’s boundaries, including in sexual interactions, and prioritise each other’s comfort and well-being. Example: Jiah wants to keep using condoms even though they and their partner Charlie have been tested for STIs and Jiah takes PrEP. Charlie would like to stop using condoms but understands it is Jiah’s choice. Charlie respects and supports Jiah’s choice, and proactively says this.   Understanding unhealthy relationships (red flags) Relationship red flags are warning signs that signal potentially unhealthy or manipulative behaviour in a relationship. Identifying red flags can be challenging as they aren’t always obvious – which makes them even more dangerous. Below are some common relationship red flags that professionals can familiarise themselves with and use to guide discussions with young people about healthy relationships. Lack of trust Constant suspicion, jealousy, or monitoring of partner’s activities. Example: Alex constantly checks Anna’s phone and social media accounts, accusing her of cheating without any proof. This leads to constant arguments and Anna feeling unsafe and unsupported. Controlling behavior One partner is controlling and makes decisions about what their partner can or can’t do. Example: Sam is always commenting on Taylor’s appearance and clothing choices, even telling Taylor not to wear particular outfits. Sam has also stopped Taylor from speaking to certain friends. Isolation Encouraging or enforcing isolation from friends, family, or support networks, limiting social interactions. Example: Dan’s partner keeps saying that they’re the only person he should need, actively encouraging him to not spend time with anyone else, including friends and family. Coercion and pressure Pressuring or manipulating a partner into doing things they are uncomfortable with, including sexual activities or risky behaviors such as condomless sex. Example: Jamie doesn’t want to have sex yet, but their partner is continually asking and pressuring saying things like ‘you would if you really loved me’. Disrespect Disregard for the other person’s feelings, opinions, or boundaries, including belittling or demeaning language. Example: Alex is constantly calling their partner cruel and unkind names during arguments. In public, Alex makes jokes and criticises their partner, making them feel small and embarrassed. Physical or emotional abuse Any form of physical violence, threats, intimidation, or emotional manipulation aimed at controlling or harming the partner. Example: Many of the examples in this table are emotional abuse. Emotional abuse can make you feel ‘crazy’ or trapped, out of control. Physical abuse involves the deliberate use of physical force to cause fear or harm. Even if it doesn’t result in visible injury or pain, it is still physical abuse. This can include pushing, shoving, hitting, throwing or hitting objects, and restraining. Anyone, including young people in physical danger should call 000 immediately. Disregard for consent Ignoring or disregarding the other person’s boundaries or consent, including pressuring or coercing them into sexual activities against their will. Example: Consent is an important and complex topic. Please see our previous article ‘Beyond Yes and No: How to navigate conversations about consent with young people’.   How to discuss healthy relationships with young people Create a supportive environment Discussing healthy relationships with young people starts with creating a safe and non-judgmental space where they feel comfortable expressing themselves. Like with all sexual health topics, use jargon-free, stigma-free language. Specifically, always reinforce the idea that experiencing unhealthy relationship dynamics is never their fault. By emphasising that everyone deserves to be treated with respect and dignity, you can help empower young people to recognise and address relationship red flags. Use interactive tools to help with learning Interactive tools are the perfect way to engage young people in topics about sexual health and healthy relationships as they take away some of the pressure of 1-2-1 conversations. Play Safe Pro’s Scenarios and Alphabet Soup are a great start, presenting hypothetical situations that foster learning and discussion. The Department of Communities and Justice (DCJ) have also shared examples of other organisations across NSW and how they implement healthy relationship discussions into their programs and services. Some of our these are: In the Council for Boys and Young Men, participants learn about healthy relationships by writing questions about relationships anonymously, and then discussing questions in a group-setting In Media Aware (Sexual Health Program for Young Adults), students explore media representations of romantic relationships and consider portrayals of unhealthy and abusive relationship behaviours, compared with realities of unhealthy and abusive romantic relationships In Guy Talk, one of eight interactive lessons focuses on managing relationships. These lessons are delivered via small and large group discussion, small group practice and individual and paired activities You can find out more about these.   Always refer to a professional Defining what is healthy and unhealthy is an important part of young people’s journey towards fulfilling, safe, and consensual romantic and sexual relationships. We hope that the above helps guide your discussions. However, it’s always important to recognise the limitations of your role, and immediately direct young people to other sources if they have concerns, questions, or are in immediate danger. This topic may also bring up things for you, so we encourage you to reach out for support if you need it. 1800 Respect– a confidential information, counselling and support service for people experiencing domestic or sexual violence Relationships Australia– provider of relationship support services for individuals and families Lifeline– 24 hour crisis support and suicide prevention Fullstop Australia– provides counselling, training and advocacy to support people impacted by sexual, domestic and family violence NSW Sexual Assault Services– every NSW local health district has a Sexual Assault Service that operates 24 hours a day, seven days a week NSW Sexual Health Infolink– for general sexual health and STI enquiries 000 if they are in immediate danger  

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Integrating sexual health promotion within your organisation

Did you know that young people in Australia face higher risks of sexually transmissible infections (STIs) yet are less likely to undergo screening compared to the general population? This is just one reason that shows the need for professionals working with young people across NSW to embed sexual health promotion within their organisations. As professionals dedicated to supporting young people, you hold an important role in promoting healthy sexual practices, such as condom use and regular STI testing. But what does this health promotion look like in real life? Alongside the right policies and procedures, sexual health promotion is about enabling people to make the most informed decisions for their health and take control (over the things they can) to achieve good health outcomes. This includes fostering a culture where discussions about sexual health are welcomed, where resources and accurate information are readily accessible, and where staff are empowered and equipped to address sexual health topics and support young people to achieve the best health outcomes possible. 1. Provide access to staff training One of the most important elements of successfully embedding sexual health promotion into an organisation, is staff education and upskilling. There are various free training programs available from trusted organisations across NSW. If you’re short on time during the busy workday, you can include some of the online trainings mentioned below as part of new staff onboarding. They are a great way to introduce staff to sexual health promotion with young people and will greatly benefit both your organisation and the young people you work with. Sticky Stuff Online Developed by Yfoundations, Sticky Stuff Online offers engaging tools and activities for organisations and workers involved in youth care to promote sexual health. New to the topic? This is for you. Need a refresher? This can help. This free self-paced online training is free, takes about an hour, and grants a certificate upon completion. Access it through Play Safe Pro.    Nitty Gritty Online Developed by Family Planning NSW, Nitty Gritty Online is a free self-paced course with five modules, designed to build on from the knowledge gained in Sticky Stuff. The core module covers communication strategies, health literacy, consent, STIs, and contraception. The other four modules, each around 45 minutes long, focus on effective strategies for working with priority groups like LGBTIQA+ young people, Aboriginal and Torres Strait Islander young people, culturally and linguistically diverse communities, and young people with disabilities. This self-paced training also grants a certificate upon completion. Access it through Play Safe Pro. Play Safe Pro Play Safe Pro also has various easy-to-read factsheets, which provide additional information for working with diverse audiences: Sexual health promotion with young people of diverse gender and sexuality Sexual health promotion with culturally & linguistically diverse young people Sexual health promotion with Aboriginal young people Sexual health promotion with young people with a disability Trauma Informed Care Booklet (especially helpful if you work with young people in out of home care) While not formal training, these resources can be used to upskill in down time and learn more about working with diverse groups of young people. ACON Pride Training ACON’s range of paid LGBTQ+ inclusion and awareness eLearning will help your organisation improve safety and inclusion for people of diverse sexualities and genders (the LGBTQ+ community). They can also work with your workplace to arrange bespoke training packages, and in-person training. 2. Assess your values and create a supportive environment As well as training staff on the facts around sexual health, think about the culture of your organisation. What can be done to create a safe space, where young people feel comfortable talking openly? Setting your organisation up Is your organisation set up to create a supportive environment around sexual health promotion? Play Safe Pro has developed an organisational checklist to help you assess where you are at and plan sexual health activities as part of your work. It is based on the five areas of action for health promotion in the integrated health promotion kit by Vic Health. Organisational policy As part of creating a supportive environment, having an organisational policy that ensure all young people have access to the information and support they need to achieve optimal sexual health and wellbeing, is important. Not sure where to start? We have drafted a model policy you can use to adapt to your organisation’s needs. It outlines the rationale for developing a safe, non-judgemental and sex positive environment that provides the best possible sexual health outcomes for young people. As part of creating a safe space and before speaking with young people about sexual health or sexuality, it is important to be familiar with your own beliefs and values. Play Safe Pro has a factsheet that can help with exactly that. Other proactive steps you can take to create a supportive environment when chatting with young people about sexual health, are: Always use age-appropriate language Actively listen to and validate concerns, and address them honestly Keep explanations clear and free from medical jargon. When needed, call in the experts like Nurse Nettie who can help you answer questions you’re not quite sure about Emphasise that sexual health is not a shameful topic – explain that it’s important to look after sexual health in the same way you’d look after your physical and mental wellbeing Never make an assumption about a person’s sexual identity or their sexual behaviour. 3. Example sexual health topics to discuss with young people Sexual health is complex and there are many different topics that may come up in conversations. However, some of the most important messages to covey to young people are: Regular STI testing Encourage young people to prioritise regular STI testing. Discuss the importance of testing, where to get tested, and how often it should be done. These resources can help: Navigating STI testing: Separating fact from fiction for young people Sexual health Check Fact Sheet And example statements you might use in conversations, are: “Regular sexual health checks are simple and usually only require a urine sample and sometimes a blood test.” “Most STIs can be easily treated with a short dose of medication.” “If you’re sexually active, have a sexual health check once a year or every time you change partners.” “STIs often have no symptoms so people may not know if they have one. If left untreated, STIs can lead to health problems.” Safer sex practices Discuss the importance of safer sex practices, such as using condoms and other forms of contraception, to prevent STIs and unintended pregnancies. It’s particularly important to be well-versed in condoms, as they are 99% effective when used correctly so are a great one to be able to talk about confidently. These resources can help: Condom Ordering Tool (did you know we provide free condoms to services working with young people) Condom Protocol – guide to providing condoms at your service Condom Card Game Contraception conversations: Supporting young people And example statements you might use in conversations, are: “Contraception is the best protection against unintended pregnancy.” “There are many different types of contraception available. Talk with your GP about which would suit you best.” “Condoms are the best protection against STIs.” “Take condoms with you when you go on a date, whether or not you think you might need them.” Consent Educate young people about the significance of consent during everyday life and sex. Explain what consent means, how to ask for it, and how to respect someone’s decision if they say no. These resources can help: Beyond yes and no: How to navigate conversations about consent with young people Consent Age and the Law Fact Sheet  And example statements you might use in conversations, are: “Just because you agree to going out with someone, doesn’t mean you have to have sex. It can take time before you, or your partner, feel ready.” “You may consent to sexual activities, but you can still change your mind at any time, for whatever reason, and your partner must respect your decision.” 4. Incorporate sexual health discussions into the day-to-day If you’ve completed training, delved into your values and familiarised yourself with the latest information on sexual health, condoms, consent and STIs, it’s time to make sure that everything you’ve learned is put into practice. Continual staff training and development: Implement or ensure you take part in training sessions to ensure you feel confident and equipped to initiate conversations about sexual health with young people. This ongoing development ensures that staff remain up-to-date and comfortable with addressing the topic of sexual health. Sign up to the PS Pro newsletter for new tools and resources. Utilise sexual health promotion resources: Introduce resources like posters into your service environment to foster spaces that encourage conversations and normalise STI testing and condom use, and don’t forget to order your free condoms. These materials can act as conversation starters, sparking interest and encouraging dialogue about sexual health among young people Normalise discussions: When you’re speaking with young people, integrate discussions about sexual health into broader conversations about overall wellbeing. By weaving these topics into everyday conversations, you help normalise discussions around sexual health, reducing stigma and promoting a culture of openness. Our Talking About Sexual Health Tool offers a practical way to do this: STEP 1 – Seek permission: Begin by asking for permission to discuss relationships and sexual health. This demonstrates respect and helps young people feel safe. STEP 2 – Open the conversation: Find out what the young person already knows and let them guide the discussion. Use open ended questions like ‘What do you already know about…?’ (e.g. sexual health/condoms/STIs/going on a date). STEP 3 – Provide information: Provide relevant information to address concerns and expand on existing knowledge, such as the importance of condom use and regular sexual health checks. STEP 4 – Check-in: Acknowledge their thoughts and understanding of what you’ve spoken about – this gives you a chance to address any misconceptions. STEP 5 – Resources: Offer access to additional information and resources, such as websites or videos. STEP 6 – Referral: You’re not expected to be a sexual health expert, so always introduce them to appropriate support services, such as GPs or sexual health clinics for more information and support. Making sexual health promotion a natural part of your organisation’s culture is crucial. When conversations about sexual health are easy, resources are available, and staff feel confident discussing sexual health topics, we can help to improve the sexual health of young people across NSW.

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Beyond yes and no: How to navigate conversations about consent with young people

People ask for and give consent every single day. Not just in the bedroom, but in everyday life too. Can I have this chair? Could I borrow your pen? I haven’t seen you in ages, can I give you a hug? No matter where you are, or what you’re doing, consent is important. And when it comes to sex, consent is critical. As someone who works with young people, consent is a topic that is very likely to come up in conversations. Understanding what consent is and being able to help young people set boundaries and navigate conversations around consent with confidence, is important. We have put together six strategies to help you guide those conversations. 1. Know the age of consent In New South Wales (NSW), the legal age of consent for sexual activity is 16. However, many young people may begin to explore relationships and behaviours at an earlier age as a natural part of their healthy sexual development. While the age of consent for sexual activity in NSW is 16, it also important to know that the age of consent in Australia differs across each state. 2. Be clear on what consent is Consent, as defined by the NSW Department of Communities and Justice, is a continuous and voluntary agreement between people involved in any form of sexual activity – not just vaginal, oral and anal sex but also other sexual activities like: engaging in masturbation alone or with partners kissing body rubbing using sex toys phone sex or ‘sexting’ reading or watching pornographic material As Youth Law Australia says, consent requires ongoing and mutual communication and is freely and voluntarily given. If one of the young people you’re chatting with has questions about what consent is, give them real life examples of how we use consent every single day. For example, they might ask if they can borrow a friend or sibling’s personal belongings like a bike or clothes – that’s asking for consent. Another example might be taking someone’s photo or petting someone’s dog. Asking before doing it is important and always needed. What’s also important is how someone responds. Is their ‘yes’ enthusiastic? Or, are they hesitant and unsure? Remind young people you’re working with that enthusiastic ‘yeses’ are what’s needed for consent. Then, steer the conversation back to sexual activity, and explain that consent works in exactly the same way. Do they want to kiss someone? Ask! Do they want to try something new in bed? Ask! If they’re still wondering, ‘what is informed consent?’, share this ‘Consent is like a cup of tea’ video. It’s an oldie but a goodie; and really helps simplify the concept of consent. Finally, it’s also important to talk about when consent can’t be given – for example, if someone is underage, under the influence of drugs or alcohol, because they are under coercion (more on that below), or because they’re feeling scared or unsafe. Affirmative consent is also law in NSW.  Laws make it clear that if a person wants to engage in sexual activity with someone, then they need to do or say something to show consent, and a person needs to do or say something to seek consent. Under the new affirmative consent laws: You can’t assume someone is consenting because they don’t say no. Silence is not consent. Consent is an ongoing process. A person can change their mind and withdraw their consent at any time. A person can’t consent if they’re so intoxicated that they can’t choose or refuse to participate. Consent can only be given freely and voluntarily. If you force or coerce your partner into sex, it’s not consensual. Consent must be present for every sexual act. If someone consents to one sexual act, it doesn’t mean they’ve consented to others. A person can’t consent if they’re asleep or unconscious. 3. Understand the role of boundaries When chatting with young people about consent, introduce them to the concept of boundaries and how they can develop their own, and respect others’. One way of explaining this is: Boundaries are like the invisible lines that define the limits of what we’re comfortable with and what we’re not. When we respect others’ boundaries, it means understanding and accepting when someone says ‘no’ or expresses discomfort. It’s also important to express your own boundaries and communicate what you are and aren’t comfortable with. Boundaries aren’t fixed; they can change over time and vary from person to person. That’s why open communication is key. But it’s worth the effort – because, by understanding and respecting boundaries – we create a space where everyone feels safe, heard, and respected. 4. Give practical examples By providing clear examples to young people, you can help equip them to handle any real-life situations that might arise. Below are a few examples you could use to guide conversations. Reinforce the need to check in regularly and make sure that the other person is still comfortable, especially if they start to look unsure, are not responding or look a little distant. However, while body language can offer cues about comfort, verbal communication is essential, and it’s always necessary to directly ask for consent. Situation Before sexual activity What to ask Can I kiss you? I was thinking about trying oral sex, how do you feel about that? I’d like to have sex, would you? It’s OK, no matter what your answer is Do you want to do what we were doing yesterday? I would really like to___would you be into that? Saying Yes or No Yes, I’d love to! I know I did that yesterday, but I’m not comfortable today – can we just do___instead? I’m not ready yet, but I’m happy to___ I don’t want to try that Situation During sexual activity What to ask Do you want to keep going? Does it feel good for you Do you feel comfortable doing this Is this okay? Saying Yes or No That feels good, I’d like to carry on Okay, I’m not as into this as I thought before, I want to stop here Situation Revoking consent Saying Yes or No Consent can be revoked at any time with no reason given. Some things young people could say are: I’ve changed my mind and I want to stop I’m not feeling this anymore. I want to stop It is also important to help young people spot coercion and peer pressure and offer advice on how they can handle the situation. Being pressured might look like: If you loved me, you would ____ Come on, everyone else is doing it. What’s wrong with you? Please I really, really want to. You’re being unfair A firm no or action that shows discomfort is all that is needed, and if someone continues to pressure them to do something they don’t want to, this is coercion. Support and guidance is available for anyone who has or is experiencing coercion or assault (see our referral pathways below). It is also important to keep in mind your Mandatory Reporting responsibility for disclosures that may arise from discussions around consent. Get interactive We have a detailed Consent & the Law Fact Sheet that supports this article. Other tools that can help guide discussions are our Scenarios and Alphabet Soup tools which offer an interactive, informal way to guide conversations around consent, STIs, and sexual health in general. Consent is a complex yet highly important subject for young people, and we hope that this article has helped prepare you for these conversations. Remember – it’s always important to recognise the limitations of your role, and immediately direct young people to other sources if they have concerns, questions, or are in immediate danger. 1800 Respect – a confidential information, counselling and support service for people experiencing domestic or sexual violence Relationships Australia – provider of relationship support services for individuals and families Lifeline – 24 hour crisis support and suicide prevention Fullstop Australia – provides counselling, training and advocacy to support people impacted by sexual, domestic and family violence NSW Sexual Assault Services – every NSW local health district has a Sexual Assault Service that operates 24 hours a day, seven days a week NSW Sexual Health Infolink – for general sexual health and STI enquiries 000 if they are in immediate danger

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Navigating STI testing: Separating fact from fiction for young people

Getting regular sexually transmissible infection (STI) testing is an important way that young people can look out for their health and is a normal part of a healthy sex life. Navigating where to go, what’s involved in getting an STI test and what it might cost can be tricky – especially if it is the first time a young person is getting tested. In this article we delve into all things STI testing so you can be ready to answer any questions young people you’re working with might have. What you need to know about STI testing 1. What is an STI test like? It’s normal for a young person to feel nervous about getting an STI test (also known as a sexual health check), but the good news is that it’s a straightforward process, and often free at bulk billing GPs. It’s also confidential (more on that below) which should help make them feel more comfortable about getting tested. As for the actual process, STI tests are quick and easy, usually requiring a blood test and either a self-collected swab, or a urine sample. The important thing is to let them know not to worry – their doctor will talk them through the process. 2. How often should someone get tested? This depends on a person’s specific needs and levels of risk. Generally, STI testing for young people is recommended every 6-12 months. However, testing more often might be needed depending on the kind of sex a young person has, their sexual health history, what medication they take (for example PrEP) and a range of other things. Testing may also be needed more regularly if a young person has had condomless sex, if they are experiencing any symptoms (not all STIs have symptoms though), if they have a new sexual partner, or if they are man who has sex with men. 3. Where to get an STI test? STI testing is widely accessible across NSW through various services. Young people can find their local STI testing location by visiting the Play Safe website as well as the healthdirect website. These services include: GPs: GPs can diagnose, treat, and provide information about STIs (as well as general health concerns), however some young people might be nervous about heading to a GP as they might be worried their family may find out, or may not even have a regular GP. Rest assured, GPs must keep health information confidential, unless a concern about duty of care or risk of harm comes into play. Sexual health clinics: These are confidential and free clinics run by NSW Health, mainly for people at higher risk of STIs and HIV. To find out about your local sexual health clinic, you can contact the NSW Sexual Health Infolink on 1800 451 624 (Monday – Friday). The Sexual Health Infolink can also find the most suitable service for your young person. Alternatively, Play Safe and healthdirect also outline a range of services available for young people. Youth centres: Some youth centres offer free STI testing for people under 25. Check out the headspace website for locations. Peer based models: Specialised services like aTEST and Check OUT clinic offer STI testing that is peer led. These services are run for the LGBTIQA+ community, by members of the community and are primarily run in the Sydney metropolitan region. Aboriginal Medical Services (AMSs): These locations provide culturally safe healthcare, including sexual health services for Aboriginal and Torres Strait Islander people. AMSs’ are bulk billed meaning there is no cost to see a health professional at these services. Family planning services: Family Planning NSW offers reproductive and sexual health services, including STI testing for young people. Some of their clinics like Penrith and Newcastle offer youth drop-in services on particular days of the week meaning no appointment is needed. To find out more, head to the Family Planning NSW website. Telehealth and online services: Telehealth services usually involve having an online video conversation with a doctor instead of visiting a doctor in person. Telehealth and online services can be great first steps and a great option for sexual health check ups, however, may not be suitable if a young person is experiencing any symptoms. If the doctor thinks that you should be tested for STIs, they will email or text you a pathology referral. You can then visit the relevant pathology provider/service to get the tests you need. If you have a Medicare card, the tests may be free but you may still need to pay the doctor for the appointment. There are many telehealth/online options so it’s a good idea to compare prices and choose a service with Australian registered doctors. Want to know more? You can read and share Play Safe’s most recent article on how to choose the right STI testing service. 4. How much does an STI test cost? If a young person has a Medicare card, they can get an STI test at a bulk-billing GP practice at no cost. If a young person gets an STI test at a non-bulk billing or part-bulk billing GP practice, the pathology (urine, swab and blood tests) will be free, but there may be a cost to see the doctor to get the test. There are a number of other testing locations that young people can go to. It is best to call each service to find out what their costs are. 5. Are STI tests confidential? STI tests and a person’s results are always confidential, so there’s no need for young people to worry about anyone finding out. If they’re over 14 years old, their entire Medicare records are kept confidential – even from their parents. You can share Play Safe’s information on confidentiality with young people to help put their mind at ease. 6. How long do STI test results take in Australia? STI test results are often very quick (within one week) and can even arrive via text message. When a young person gets their STI test, their doctor should let them know how and when they will get their results. If you’re supporting a young person to book their appointment, or to get there, remind them to ask their doctor when and how they’ll get their results. Dispelling common myths about STI testing There are so many myths around testing, and as someone who works with young people, it’s important to be prepared to debunk them. Myth 1: Only people who have multiple sexual partners or engage in risky behaviors need STI testing Anyone who is sexually active could be at risk of an STI and should have a regular STI test. STIs can be passed on through any type of sexual activity, including oral and anal sex. Myth 2: A person will always have noticeable symptoms if they have an STI This is a common one! Many STIs can be asymptomatic, meaning a person may not have any noticeable symptoms or know that they have an STI. Regular STI testing is important because it not only helps detect infections early, but also allows for prompt treatment and prevention of ongoing complications. Myth 3: STI testing painful and invasive STI testing is typically quick, easy, and straightforward. Depending on the type of test, it may involve providing a urine sample or a swab of the genital area (usually self-collected) as well as a blood test. Healthcare professionals will always make sure that the testing process is as comfortable and discreet as possible. They’ll ask for consent before starting any type of test and talk their patient through the process. Myth 4: STI testing is only necessary before having sex with a new partner Regular STI testing is important for maintaining sexual health, regardless of relationship status or sexual activity. It’s recommended for young people to get tested regularly (typically every 6-12 months), and more often if they have multiple sexual partners, engage in regular condomless sex, are experiencing any symptoms (not all STIs have symptoms though), or are a man who has sex with men. Myth 5: Condoms provide complete protection against STIs Condoms are highly effective in reducing the risk of getting an STI, but they don’t provide complete protection. Some STIs, such as genital herpes, can be passed on through skin-to-skin contact and a condom doesn’t cover all parts of skin around the genitals. While condoms offer great protection, getting regular sexual health checks is important. Help them get their regular STI test booked in So, there you have it – everything you need to know to help put young people’s minds at ease when it comes to STI testing. The main thing to remember is to let them know that getting tested is normal, confidential, straightforward and often free. You can support them to use the STI clinic locator or call NSW Sexual Health Infolink for more information or to get their regular STI test booked in. Our Youth Worker factsheet summarises this article in an easy to read resource. Check it out! If young people themselves want to know more about how they can prepare for their first sexual health check, you can point them in the direction of our Getting ready for your first sexual health check factsheet.

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Syphilis 101: A resource for professionals working with young people

Did you see the latest from Sydney’s Kirby Institute? Australia is seeing its highest number of syphilis cases in a decade. If you’re working with young people and they have questions or concerns about this, a little bit of knowledge can really make a difference in reassuring them. Now, you don’t have to be an expert, but it’s always good to be prepared. This article will help you get ready for any questions that might come your way. We’ll cover the basics of syphilis, including how it’s transmitted, its symptoms, and the available treatments. Plus, we’ll discuss how to create a safe and supportive environment for the young people you’re working with. Six strategies for talking to young people about syphilis 1. Understand what syphilis is What is syphilis? Syphilis is an STI caused by the bacteria Treponema Pallidum. The good news is, it’s treatable with antibiotics and injections. However, if left untreated, it can lead to some serious and sometimes life threatening health issues. Some of the common symptoms of Syphilis include: Painless ulcers around the mouth, genitals, or anus A red rash on the body, especially on the palms and soles Syphilis transmission happens through skin-to-skin contact during oral, vaginal, or anal sex, particularly when there are symptoms like ulcers or rashes. Even though syphilis symptoms may go away on their own, the infection will stay in the body until a person has treatment. Treatment is the key to saying goodbye to syphilis for good. 2. Let them know syphilis is 100% curable One question you’re likely to be asked by a young person is ‘can syphilis be cured?’ or ‘is syphilis treatable?’. As we’ve mentioned already, the good news is that syphilis is 100% curable through a course of antibiotics and injections. Of course, before treatment, it has to be diagnosed. Diagnosis happens via a blood test or the swab of an ulcer, usually by a doctor or sexual health nurse. After treatment, follow-up testing is completed to make sure the infection has cleared. When chatting with young people it’s important not to alarm them about syphilis or any STI. Instead,  encourage young people to have a regular STI test with their GP or healthcare provider. It’s an important step you can take to normalise sexual health and foster healthy decision making among the people you work with. For information on where a young person can get a sexual health check at or for other questions about STIs and syphilis, call the NSW Sexual Health Infolink (SHIL) to speak to a sexual health nurse. 3. Create a safe space Talking about sexual health can be daunting for both professionals and young people. As professionals, it’s important to do everything possible to make them feel comfortable to open up and talk about what’s on their mind. Let them know they’re in a safe space where there’s no judgement and no silly questions. Keep your answers simple and clear, avoiding unnecessary jargon. And remember, validation of feelings and concerns can go a long way in building trust. If you’re asked questions you don’t know the answer to, that’s not a problem! You can explore the Play Safe website to find your answer, or call the the NSW Sexual Health Infolink (SHIL) to speak to a sexual health nurse. 4. Use it as a chance to speak about sexual health in general The best way to protect against syphilis is to use condoms and to get regular STI tests.  When chatting with young people, speak about sexual health in general and how condoms and regular testing are the cornerstones to staying safe and enjoying sex with all of the fun and none of the worry. A good resource for them would be the 30-second ‘Could I have an STI?’ quiz on the Play Safe website, which will let them know in no time if they need an STI test or not. Don’t forget to give free condoms to anyone who needs them too. You can order a bag of 144 Play Safe branded condoms and lubricant to your service for free every month using Play Safe Pro’s condom ordering tool. 5. Use interactive tools to encourage conversations in a group setting Interactive games can be a fantastic way to break the ice and open up conversations around sexual health with less pressure than a straightforward conversation. Why not try the Handshake Game? This easy-to-follow game visually demonstrates the transmission of infections such as syphilis and the benefits of safe sex. It only takes around 10 minutes and is suitable for up to 30 people. Everyone who takes part will be introduced to sexual health concepts relating to safer sex, STIs, and sexual health testing and treatment — without an awkward moment in sight. 6. Always refer to a healthcare professional While it’s important to be able to open up conversations with young people about syphilis and sexual health, it’s always important to know the scope and limitations of your role and to direct them to a GP or their healthcare provider for personalised information, testing, and treatment. If they’re unsure where to go, they can give NSW Sexual Health Infolink a call, or they can use the online ‘Where can I get tested?’ tool on the homepage of the Play Safe website. Helpful external resources If you want to learn more about syphilis to guide your discussions with young people, or someone in your service wants to know more, check out the links below. Play Safe website NSW Health Fact Sheet Health Direct website

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