Sarah Flicker1; Amrita Ghai6; Robb Travers3; June Larkin2; Crystal Layne4; Susan Flynn4;

Adrian Guta2; Roxana Salehi6; Jason Pole2; Kristin McIlroy2 1.Faculty of Environmental Studies, York University, Toronto, ON; 2. University of Toronto, Toronto, ON; 3. Wilfrid Laurier University, Waterloo, ON; 4. Planned Parenthood, Toronto, ON; 5. POGO, Toronto, ON; 6. York University, Toronto, ON

Clinical Encounters: Toronto youth experiences with sexual health clinics

For more information contact: Flicker@yorku.ca

For more information contact: Flicker@yorku.ca

Access to accurate information regarding STIs, HIV, pregnancy, and sexual health services is crucial for healthy sexual development in youth. This is the period where young people begin to make decisions about themselves as sexual beings and where their first sexual experiences often occur 1. Accessing appropriate sexual health information and preventative care from service providers prior to becoming sexually active has been shown to prevent unwanted pregnancies and STIs.2

Background

Methods

The Toronto Teen Survey (TTS) used a community based research approach to survey 1,216 youth through 90 workshops conducted by our trained youth advisory board. Youth were asked:

if they were going to services for sexual health reasons, what kinds of services they accessed, to rate their experiences and what might promote or discourage access.

Percentage of youth who have visited clinics for sexual health

reasons

Variable OR (95% CI) P

Biological Sex

Male

Female* 1.70 (1.16-2.48) .006

Age

18

13* 0.12 (0.05-0.27) <.001

14* 0.21 (0.10-0.43) <.001

15* 0.27 (0.16-0.47) <.001

16* 0.30 (0.17-0.53) <.001

17 0.82 (0.48-1.40) .46

Years in Canada

Born in Canada

Not born in Canada, lived in Canada 0-3 years 1.81 (0.98-3.34) .06

Not born in Canada, lived in Canada 4 + years 1.03 (0.64-1.65) .90

“Have you had sex”

No

Yes* 8.93 (5.79-13.78) <.001

Not sure 2.38 (0.99-5.76) .054

Sexual Orientation

Straight

LGB2PQ 1.84 (0.77-4.40) .17

Questioning 2.21 (0.76-6.40) .15

Race

White

Aboriginal 0.58 (0.13-2.58) .47

Asian* 0.21 (0.10-0.42) <.001

Black* 0.47 (0.28-0.81) .006

Other 1.18 (0.52-2.68) .69

Multi-Racial 0.58 (0.31-1.08) .09

Religion

None

Catholic 1.23 (0.72-2.09) .45

Protestant 1.28 (0.75-2.18) .37

Muslim 0.49 (0.21-1.14) .10

Other 1.38 (0.66-2.90) .39

Parental Education

University

<High school 1.27 (0.58-2.81) .55

High school 0.80 (0.49-1.31) .38

College 0.98 (0.61-1.57) .92

Don’t know 0.62 (0.33-1.18) .15

Predictors of Clinic Visits (n=1047)

Youth who are sexually active are 9 times more likely to seek out sexual health services compared to those who have not yet had sex. Young women in the TTS are twice as likely to access sexual health services compared to young men. As youth age, they are more and more likely to access services. LGB2 and Questioning youth are twice as likely to access sexual health services compared to heterosexual youth. Asian, Black and Muslim youth were less likely to access services.  While we can’t speak with the same certainty because of the small numbers that we surveyed, Aboriginal youth were also less likely to access services compared to White youth.

Some youth are more likely to visit clinics than others

Despite the importance of sexcare, few teenagers use the services available to them. Gendered interventions are needed to improve teen ual health clinic access.

Conclusions

Attributes ranked as most important facilitators to clinical access by gender

Reasons for clinic visits by gender

Young women who have attended clinics are most likely to go for birth control, pap smears and pregnancy tests. Young men who have attended clinics are most likely to access free condoms, information about safer sex and HIV or STI testing. Generally, young women rated their experiences accessing sexual health services more favorably than young men or transgendered teens. Youth of all genders did not feel that clinics were particularly positive towards youth. The most important things that young women want to see in a sexual health clinic is that it is confidential/private, that it be a space where they are comfortable asking questions and that it is non-judgmental. For young men, the most important factors were that a clinic provides good information, that the location was close by or easy to get to and that they feel comfortable asking questions.

Gender Matters