Dr. Stephanie O'Keeffe:

I will make a few general points touching on a number of the issues raised. With regard to campaigns, over the past ten years significant resources have been directed towards developing targeted, integrated campaigns directed towards at-risk groups. In response to Deputy Kelleher's comment that he hoped campaigns had changed, there is considerable science and literature behind how they are conducted nowadays, with resources put into evaluating them right across sexual health campaigns such as Think Contraception and the Man to Man campaign. We are going back to the target groups to make sure the message is being communicated, is effective and is not wearing down with people becoming tired of it. It is also ensured that campaigns are linked with a broader integrated strategy in order that where a person is listening to the message, he or she is also hearing the same message at school, at home, in the workplace or wherever, and we are also looking at new means of communication. Some of the more recent campaigns, including the gonorrhoea campaign that will be launched next week, are based on social media initiatives. There has been huge improvement and experience within the country, in government, among health services and among partners in how to do this work. Sexual health is one of the areas in which one can say good work is happening. The literature is clear about what works and what does not in terms of using fear tactics. Sometimes they work - with road safety or smoking, for example - but not necessarily with sexual health. The messaging around those campaigns is about empowering and informing, destigmatising and normalising certain behaviours.

Our teenage birth rate has decreased from 20 per 1,000 to 12 per 1,000. We have seen significant successes in terms of consistent condom use among at-risk groups. My colleagues, who have more experience than I, will discuss testing behaviours, working with GPs and so on. Over that period, we have seen more campaigns, partnerships, research and services. When one thinks about where we have come from in this country in the area of sexual health, we would all acknowledge that we are in a different space now compared to ten years ago, not to mind 20 years ago.

The Deputy asked about partnerships. I have worked in the sexual health area for a number of years and partnership is the significant element of how we do this work. Partnerships can be difficult. They involve a level of trust. One must work hard at them but one can see that in the sexual health area, it is a critical piece of the broad integrated approach to addressing these issues and ensuring the messages are consistent. We are trying to bang the same drum with one message collectively. There has been much better practice in this area over the past ten years compared to the previous period.

Investment in research in sexual health has been impressive. We have much better data and information and we are able to answer the questions posed about, for example, sex education in schools. It is provided in 86% of schools, according to young people who report, and 90% of them say they have had it in schools. We have a much better environment to have robust and informative dialogue with the Department of Education and Skills and the out-of-school sector in ensuring the curricula we have developed are implemented in a more sustained way. I do not suggest that this is without challenges, because there always are challenges. There is always a new generation of young people coming through at different stages of their lives and it is important for us to have a sustained, strategic approach regarding how we address that.

Dr. Lyons will take the questions on testing and so on.