| Abstract | Adolescencija ili mladenaštvo završna je faza odrastanja, u kojoj mladići i djevojke sazrijevaju tjelesno, psihosocijalno, emocionalno i kognitivno, a te promjene svaki pojedinac doživljava jedinstveno. Unatoč tome, pojedina ponašanja specifična su za ovu razvojnu dob te se proučavanjem može uvidjeti ponašaju li se mladi u različitim sredinama više ili manje slično. U adolecenciji se razvija osjećaj autonomije i seksualnog identiteta te se može pratiti kako se mladi u pojedinim zemljama odnose prema svom spolnom zdravlju i zdravlju partnera/ica. Spolno zdravlje definirano je kao stanje potpunog tjelesnog, emocionalnog, mentalnog i socijalnog blagostanja vezanog uz spolnost, a ne samo odsutnost bolesti, disfunkcije ili iznemoglosti. Da bi spolno zdravlje bilo očuvano, od najranije dobi potrebno je obrazovati mlade o temama vezanima uz spolnost, što je to odgovorno, a što rizično ponašanje te kako zaštiti sebe i druge. U ovom preglednom radu navedeni su osnovni podatci vezani uz spolno zdravlje i seksualno ponašanje mladih u tri zemlje Europe. Prikazane su sličnosti i razlike seksualne edukacije i zdravstvene skrbi, stupanja mladih u seksualne odnose, korištenje kontracepcije te osnovne informacije o programima cijepljenja i probira protiv najčešćih spolno prenosivih infekcija u Republici Hrvatskoj, Republici Sloveniji i Ujedinjenom Kraljevstvu. Iako susjedne zemlje, Republika Hrvatska i Republika Slovenija nemaju jednake rezultate u području preventivnih aktivnosti i spolnog zdravlja mladih. Među trima zemljama, Republika Slovenija se pokazala kao primjer dobre prakse u primarnoj i u sekundarnoj prevenciji spolno prenosivih bolesti i neželjene trudnoće, s visokim obuhvatom probira (70 %) i liječenja raka vrata maternice (90 %), velikim postotkom mladih koji koriste kontracepciju (73 % seksualno aktivnih 15-godišnjaka 2018. godine, za razliku od hrvatskih vršnjaka iste godine – 50 % djevojaka i 60,5 % mladića), višoj dobi stupanja maloljetnika u seksualne odnose te relativno dobrim rezultatima programa cijepljenja protiv humanog papiloma virusa (59,3 % djevojčica šestih razreda u školskoj godini 2018./2019.). S druge strane, u Ujedinjenom Kraljevstvu najveći je broj mladih koji koriste hormonalne oblike kontracepcije (31 % 2014. godine, u usporedbi s procjenjenih 10 % seksualno aktivnih adolescentica u Hrvatskoj 2014.), kao i procijepljenost protiv HPV-a (83,8 % procijepljenih djevojaka devetih razreda u školskoj godini 2017./2018., u usporedbi s procijenjenih 17,3 % djevojaka osmih razreda u Hrvatskoj iste godine). U Republici Hrvatskoj mnogo je manje 15-godišnjakinja koje su stupile u seksualne odnose (6,1 % 2018., u usporebi s 14,9 % slovenskih i 23 % engleskih djevojaka iste dobi), a od tri pručavane zemlje, u Hrvatskoj je najranije započet program besplatnog cijepljenja mladića protiv HPV-a (2017. godine, u usporedbi s Engleskom 2019. i Slovenijom 2021. godine). U Republici Hrvatskoj potrebne su sustavne promjene u edukaciji mladih o seksualnosti i spolnom zdravlju, s obzirom na poražavajuće znanje o seksualnosti u djece i roditelja, rijetku upotrebu kontracepcije u seksualno aktivnih maloljetnika (posebice djevojaka) te nisku procjepljenost protiv humanog papiloma virusa (HPV). Osim edukacije, potrebno je poboljšati rezultate, ali i praćenje preventivnih javnozdravstvenih programa, primjerice screening-a na rak vrata maternice i testiranje na spolno prenosive infekcije, veću dostupnost kontracepcije, cijepljenje protiv HPV-a, uz nužnu informatizaciju sustava praćenja svih usluga. |
| Abstract (english) | Adolescence is the final stage of growing up, in which young men and women mature physically, psychosocially, emotionally and cognitively, and each individual experiences these numerous changes uniquely. Despite this, certain behaviors are specific to this developmental age, and by studying such patterns, it can be seen that young people in different settings actually behave quite similarly. Adolescence also develops a sense of autonomy and sexual identity, and it is possible to monitor how young people in certain countries treat their sexual health and the health of their sexual partners. Sexual health is defined as a state of complete physical, emotional, mental and social well-being related to sexuality, and not only absence of diseases or dysfunctions. In order to preserve sexual health, it is necessary to educate young people from an early age about topics related to sexuality, both responsible and risky behavior and finally the protection of oneself and others. This paper presents an overview of basic data related to the sexual health and sexual behavior of young people in three European countries. For instance, it presents similarities and differences in of sexual education system and health care for adolescents and young people's age of first sexual intercourse in the Republic of Croatia, the Republic of Slovenia and the United Kingdom. Furthermore, it summarizes data on the number of young people using contraception, the most frequently used methods and vaccination against and screening programs for the most common sexually transmitted infection in the world. Although neighboring countries, the Republic of Croatia and the Republic of Slovenia do not have equal results in the field of preventive activities and sexual health of young people. Among the three countries, the Republic of Slovenia seems to be an example of good practice in both primary and secondary prevention of diseases and unwanted pregnancy, with a high coverage of cervical cancer screening (70%) and treatment (90%), a high percentage of young people using contraception (73% of sexually active 15-year-olds in 2018, unlike Croatian peers of the same year – 50% of girls and 60.5% of boys), the higher age at which minors enter sexual relations and the relatively good results of the vaccination program against the human papilloma virus (59.3% of sixth grade girls in the 2018/2019 school year). On the other hand, United Kingdom has the highest number of young people vaccinated against HPV (83.8% of vaccinated ninth-grade girls in the 2017/2018 school year, compared to an estimated 17.3% of eighth-grade girls in Croatia in the same year), as well as those who use hormonal contraception (31% in 2014, compared to an estimated 10% of sexually active adolescent girls in Croatia in 2014). Lastly, in the Republic of Croatia, there are much fewer 15-year-old girls who have entered into sexual relations (6.1% in 2018, compared to 14.9% of Slovenian and 23% of English girls of the same age) and Croatia was the first of the analyzed countries to introduce free HPV vaccination program for boys (in 2017, compared to England in 2019 and Slovenia in 2021). Systematic changes are needed in the education of young people about sexuality and sexual health in the Republic of Croatia, considering the devastating knowledge about sexuality in children and parents, the rare use of contraception in sexually active minors (especially girls) and the low level of vaccination against the human papilloma virus (HPV). In addition to education, it is necessary to improve the results, but also the monitoring of preventive public health programs, for example cervical cancer screening and testing for sexually transmitted infections, vaccination against HPV by computerizing the monitoring system. |
