Fiona O'Malley (Dún Laoghaire, Progressive Democrats)
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Sex and sexuality are core dimensions of the human experience and are important contributors to our general well-being. In Ireland sex is a topic much speculated on and eloquently written about by many of our literary giants. We have, however, been remarkably, if not surprisingly, short of evidence about matters sexual on which to design services in education, according to the two authors of the report on the Irish Study of Sexual Health and Relationships who opened an article in yesterday's The Irish Times. The report makes us very much aware that this is the first time such a comprehensive study into attitudes to sexual activity and relationships has been undertaken in Ireland. It certainly deserves a serious response in terms of policy direction from the Government.

Chief among the important findings of the report is the extent to which attitudes to sex generally and sexual relationships in particular have changed in the past 30 years. Irish people's attitudes are now far more in line with those of continental Europe and a more liberal and tolerant attitude to sex and sexuality prevails, which is healthy. Just 6% of the 7,500 people surveyed think that pre-marital sex is wrong. In 1973 that figure was 71%. Equally telling is the fact that 64% of the sample believe that abortion is acceptable in some circumstances and this is something of which we, as public policy makers, need to be cognisant.

Sex education in schools is now far more accepted than ever before and 92% of those surveyed supported sex education for young people on the subjects of sexual intercourse, sexual feelings, contraception, safer sex and homosexuality. The report also dwells on the high level of risky behaviour in which young people engage and to this I will address the rest of my contribution. It is nothing short of a scandal that the incidence of sexually transmitted diseases in Ireland increased by over 240% in the years between 1998 and 2003. This is, by any standard, a major public health problem.

The implications of the spiralling growth in sexually transmitted diseases for the future population are worrying indeed. Untreated, some sexually transmitted diseases can lead to infertility and this is something we need to address. Equally, in the first six months of 2005 over 140 new cases of HIV were recorded and, as far as we know, they might be only the tip of the iceberg. Nowadays young people are very well informed about the dangers of HIV and AIDS and the protections they need to take to avoid contracting such conditions. The report highlighted that the cost and availability of contraceptives was a problem, in particular for young people. Some 15% of the people surveyed indicated that cost was an issue in the use of condoms. I am sure the Minister will agree, and I have spoken with the senior Minister in the Department, that, given the147 new instances of HIV and AIDS, it is something with which we will have to deal in the budget.

As the Minister will know, condoms are VAT-rated at the 21% rate for luxury items. None of us can continue to consider a medical device which offers protection against infection a luxury item. At the very least I call on the Minister for Health and Children and the Minister of State at the Department of Health and Children to persuade the Minister for Finance, at a minimum, to reduce the VAT rate on condoms from 21%. It is a joke to consider them luxury items.

I hope public policy will reflect the modern attitudes to sex and sexuality in Ireland.

Seán Power (Kildare South, Fianna Fail)
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I thank Deputy Fiona O'Malley for raising this matter on the Adjournment this evening. I welcome this report, the Irish Study of Sexual Health and Relationships, which is the first national study of its kind in Ireland. The study is based on the responses of 7,441 people and provides a wide range of data which will be of benefit to policy-makers and service providers alike.

On foot of a recommendation of the national AIDS strategy committee, my Department and the crisis pregnancy agency commissioned the Irish Study of Sexual Health and Relationships, ISSHR, in 2003. The results of that survey form the basis of this report. The survey was conducted by the Economic and Social Research Institute, ESRI, and the Royal College of Surgeons in Ireland, RCSI, and is in line with research in other European countries. Its purpose is to provide useful information on attitudes and behaviours and to provide a benchmark for evaluating the impact of our policies and practices regarding HIV and other sexually transmitted infections, STIs, and our overall sexual health.

The main report was launched this week. Three sub-reports focusing on "first sex and sex education", "sexual health challenges and related service provision" and "contemporary sexual knowledge, attitudes and behaviour" will be published in the coming months.

The findings are significant and convincing and send a clear message to policy-makers, parents, teachers, health care providers and society in general. That message is simple — Ireland is changing and so too are sexual attitudes and behaviours. Our sexual health policies and services cannot be allowed to fall behind, but must keep pace with this change. For example, the findings show that since 1973, the proportion of the population who agree that sex before marriage is "always wrong" fell from 71% to 6%. The findings also show that over 50% of the population believe that "homosexual sex" is never wrong. This view is even more prominent among under 25-year-olds.

While the data gathered for this study was examined on the basis of the location of the respondents, there was little or no difference between the attitudes and behaviours of people across the country, regardless of whether they lived in urban or rural communities. The data shows a largely consistent pattern, however, in respect of socio-economic groups: the higher the standard of education of the respondent, the more likely it was that people had better knowledge, safer sex practices and better outcomes from their first and later sexual experiences.

This survey shows that Irish people want to maintain good sexual health and, importantly, they want their children to learn about this early in life. The findings show almost universal support for sex education for young people on sexual intercourse, sexual feelings, contraception, safe sex and homosexuality. There is wide scale support for sex education at home. The report also shows that while increasing numbers of young people are receiving sex education, just over half of respondents find the education received helpful. Poor levels of knowledge among some groups on sexual matters were reported.

On the issue of the age of first vaginal sex, the study shows that most respondents had a first sexual encounter at 17 and older. However, a growing minority are having first sexual intercourse before age 17. Sexual intercourse under the age of 17 is shown to be associated with lower education levels.

On the issue of contraceptives, over 90% of the group aged 18 to 34 report using a contraceptive at their last sexual encounter. Of those in the youngest age group who did not use contraception, the most common reasons include drinking alcohol, taking drugs, cost, no contraception available, unplanned, and not thinking of contraception.

This is a base line study and the findings will inform policy and service development in sexual health related areas into the future, building on current developments. There are several specific HIV and STI education and prevention programmes in place, such as a national public awareness advertising campaign to promote sexual health. The campaign is aimed at men and women in the 18 to 35 age group to increase awareness about safe sex and sexually transmitted infections. The overall goal is to increase safe sex practices, reducing the incidence of STI transmission and unwanted pregnancies among young people in Ireland.

Several areas within the HSE have significantly advanced strategies and programmes in the area of sexual health at regional level, with dedicated human and financial resources allocated. Partnerships between statutory and voluntary providers to improve sexual health and promote safe sexual practices are common at national and local level. Resources are available for population group specific work, for particular high risk groups such as young people, those working in prostitution, gay men, IV drug users and the homeless.

The development and promotion of sexual health and relationships within the framework of personal and social development is a cornerstone of sex education programmes as supported by my Department and the Department of Education and Science in the school and out of school settings. In response to the specific issues regarding unplanned pregnancy, the Crisis Pregnancy Agency, CPA, was established by statutory instrument in 2001, funded in its entirety by the Department of Health and Children. The CPA is a planning and co-ordinating body established to formulate and implement a strategy to address the issue of crisis pregnancy in Ireland.

While the results of the survey strongly indicate that much good work is being done, we must do more. We can empower people of all ages, but especially our young, with relevant, suitable and meaningful sex education. Recognising the importance of sex education in the home, we can assist and provide resources for parents to fulfil their role. We can further reduce risky behaviours by improving access to affordable contraception and protection. We can improve access to STI services and encourage people to use them and improve outcomes from crisis pregnancy.

The report strongly suggests the need for a sexual health strategy to be prepared by my Department and the HSE with the involvement of other key stakeholders. A comprehensive strategy and action plan will be developed swiftly once the three further reports are issued within the next three months.