Access to sexual health care is a critical component of overall health and well-being for young people, particularly those aged 15–29. In Australia, primary care serves as the cornerstone for delivering sexual health services, yet young people face numerous barriers that hinder their ability to seek and receive appropriate care. Strengthening the primary care system is essential to ensure that health care practitioners have the time, resources, and support to provide non-judgmental, sensitive, and clinically appropriate sexual health care. This article explores the key issues surrounding young people's sexual health, the role of general practice, the barriers they encounter, and innovative measures to improve access. By delving into recent research, hidden challenges, and emerging solutions, we aim to provide a comprehensive roadmap for enhancing sexual health care for young Australians.

Understanding the Sexual Health Needs of Young Australians

Sexual Activity and Associated Risks

Most Australians become sexually active around the age of 15, marking the beginning of a period characterized by exploration and, often, risk-taking behaviors. While many young people navigate this phase with positive experiences, behaviors such as condomless sex and having multiple sexual partners increase the risk of adverse outcomes, including sexually transmitted infections (STIs) and unintended pregnancies. According to the Kirby Institute’s 2023 Annual Surveillance Report, young people aged 15–29 accounted for 69% of the 93,777 chlamydia notifications in Australia in 2022. This disproportionate burden underscores the urgent need for targeted sexual health interventions.

Untreated STIs can lead to severe health consequences, particularly for women of reproductive age, including pelvic inflammatory disease, ectopic pregnancy, and infertility. Opportunistic testing is critical, as many infections, such as chlamydia, are asymptomatic. General practitioners (GPs) are encouraged to discuss sexual health proactively, including intentions for pregnancy, to provide tailored pre-conception and contraceptive care. However, the lack of national abortion data in Australia obscures the true prevalence of unintended pregnancies, though studies suggest they are common among women under 30.

Beyond Reproductive Health: Diverse Sexual Health Concerns

Young people's sexual health needs extend beyond STIs and contraception. A 2024 study by Bittleston et al., involving a survey of 1,887 young people, revealed that many wish to discuss issues such as sexual dysfunction, difficulties with sexual experiences, and cervical screening with their GPs. Notably, young women expressed interest in cervical screening even when not yet eligible, indicating a strong inclination toward preventive health measures. These findings challenge assumptions that young people prioritize only immediate reproductive health concerns and highlight the need for GPs to address a broader spectrum of issues.

“Young people’s interest in discussing sexual dysfunction and preventive health measures like cervical screening suggests a shift toward proactive health-seeking behaviors, which primary care must support.” — Bittleston et al., 2024

Other concerns managed in primary care include period pain, endometriosis, pelvic pain, infertility, miscarriage, and issues related to sexual assault and violence. These diverse needs require a comprehensive approach to sexual health care that goes beyond traditional reproductive health frameworks.

The Pivotal Role of General Practice in Sexual Health Care

Primary Care as the First Line of Access

General practice is the primary avenue through which young Australians access sexual health services, including STI testing, contraceptive care, and management of other sexual health issues. The Royal Australian College of General Practitioners (RACGP) emphasizes that GPs should proactively raise sexual health topics with all patients, regardless of their identity or background. This proactive approach is critical for identifying asymptomatic conditions and providing preventive care. However, the affordability and accessibility of these services remain significant concerns, particularly as data on bulk-billing and low-cost services for young people are scarce.

Specialist sexual health clinics and community health services play a vital role in serving hard-to-reach or priority populations, such as Aboriginal and Torres Strait Islander youth or those from culturally and linguistically diverse (CALD) backgrounds. However, to ensure these specialized services can focus on complex cases, general practice must be adequately resourced to handle routine sexual health care for the broader population.

Building Trust Through Continuity of Care

Continuity of care is a cornerstone of effective sexual health care. Research by Jackson and Ball (2018) highlights that ongoing relationships between GPs and patients foster trust, improve communication, and enhance health outcomes. For young people, who may feel embarrassed or hesitant to discuss sensitive topics, rapport with a trusted GP is essential. This continuity allows GPs to create a safe, non-judgmental environment where young people feel comfortable disclosing their concerns.

However, the current primary care system faces significant challenges that limit GPs’ ability to provide such comprehensive care. Years of underfunding, coupled with the pressures of the COVID-19 pandemic and an aging population with increasing chronic disease burdens, have strained the system. As a result, GPs often lack the time to engage in opportunistic discussions about sexual health, particularly with young patients who may be reluctant to initiate these conversations.

Barriers to Accessing Sexual Health Care

Structural Barriers

Young people face numerous structural barriers when seeking sexual health care. High costs, long waiting times, and lack of transportation are significant obstacles, particularly for those in rural and remote areas. A 2019 study by Robards et al. found that navigating the health care system is often challenging for young people, many of whom are unaware of where to access sexual health services or perceive them as difficult to obtain. These barriers are compounded for marginalized groups, including Aboriginal and Torres Strait Islander youth, those from lower socioeconomic backgrounds, and CALD individuals.

Rural and remote youth face additional challenges, such as limited access to discreet or anonymous care. A 2020 study by Bell et al. highlighted that young Aboriginal people in the Northern Territory often struggle to access STI testing due to geographic isolation and concerns about privacy. Similarly, CALD youth may face heightened societal stigmatization, which discourages them from seeking care.

Societal Stigma and Confidentiality Concerns

Societal stigmatization of sex and sexual health remains a pervasive barrier. Young people often feel embarrassed to raise sexual health concerns with their GP, fearing judgment or discrimination. Confidentiality is a significant concern, particularly for those in small communities where anonymity is difficult to maintain. Lesbian, gay, bisexual, transgender, queer, and intersex (LGBTQI+) youth are particularly vulnerable to stigma and discrimination, both within and outside health care settings, which can deter them from accessing care or disclosing their sexual orientation.

“Stigma and discrimination in health care settings can profoundly impact LGBTQI+ young people’s willingness to seek care, highlighting the need for culturally safe practices.” — Brooks et al., 2018

Challenges for General Practitioners

GPs also face significant barriers in providing sexual health care. The primary care system is under immense pressure, with many practitioners struggling to balance the demands of managing chronic diseases, mental health issues, and an aging population. Sensitive topics like sexual health require time and sensitivity, which are often in short supply in busy clinical settings. A 2015 narrative review by Yeung et al. found that time constraints and the complexity of addressing sensitive issues are major barriers to chlamydia testing in general practice, a challenge that likely extends to other sexual health services.

Strategies to Improve Access to Sexual Health Care

Policy and Funding Reforms

Addressing the barriers to sexual health care requires a multifaceted approach, starting with policy and funding reforms. The Strengthening Medicare Taskforce has proposed several recommendations to bolster primary care, including increased funding to support low-income Australians and expanded after-hours services. These measures could alleviate some of the structural barriers young people face, such as high costs and limited access to care outside regular hours.

Investment in youth-friendly primary care spaces is also critical. Research by Cummings and Kang (2012) suggests that young people are more likely to engage with health services that are welcoming and tailored to their needs. This includes creating environments where young people feel safe discussing sensitive issues and ensuring that staff are trained in youth-friendly consultation techniques.

Leveraging Digital Health Solutions

Digital health care is transforming how young people interact with the health system. Many use online tools, such as menstrual trackers and social media platforms, to seek information about sexual health. However, a 2019 study by Robards et al. noted that some practitioners dismiss young people’s online-acquired knowledge, which can undermine trust. Integrating digital health solutions, such as telehealth consultations and online sexual health clinics, can improve access, particularly for those in remote areas or those seeking anonymity.

Online sexual health clinics, such as those studied by Estcourt et al. (2017), have proven safe and feasible for managing STIs like chlamydia. Expanding these services could provide a scalable solution for reaching young people who face barriers to in-person care. Additionally, health promotion campaigns should leverage digital platforms to disseminate reliable information about sexual health services, including details about costs, bulk-billing, and Medicare eligibility.

Targeted Programs for Priority Populations

Programs targeting priority populations are essential for ensuring equitable access to sexual health care. Initiatives like point-of-care STI testing in remote communities and “Doctors in Schools” programs have shown promise in reaching marginalized youth. Nurse-led models of care, as explored by Moulton et al. (2025), can improve access to contraception and medical abortion in rural settings, offering a blueprint for expanding sexual health services.

Health promotion campaigns should incorporate evidence-based features, such as repeated interventions, parental involvement, and skills-building activities, to maximize their impact. Organizations like the Kirby Institute and state health departments have developed valuable online resources, but these must be actively promoted to ensure they reach their intended audiences.

Addressing Stigma and Building Trust

Reducing societal stigma around sexual health is critical to encouraging young people to seek care. Training programs for GPs should emphasize culturally safe practices and sensitivity to the needs of diverse populations, including LGBTQI+ youth and those from CALD backgrounds. Creating safe spaces where young people feel confident discussing their concerns without fear of judgment is essential for improving access and outcomes.

Conclusion: A Path Forward for Sexual Health Care

Improving young people’s access to sexual health care through primary care requires a concerted effort to address structural, societal, and systemic barriers. By strengthening the primary care system, investing in youth-friendly and digital health solutions, and supporting targeted programs for priority populations, Australia can ensure that young people receive the care they need. Continued research, policy reform, and community engagement are essential to uncovering hidden barriers and implementing innovative solutions. Ultimately, empowering young people to take charge of their sexual health will contribute to better health outcomes and a more equitable health care system.