Access to sexual health services and associated risk behaviours of rural and regional young men in Australia

Submission note: A thesis submitted in total fulfilment the requirements for the degree of Doctor of Philosophy to the Australian Research Centre in Sex, Health and Society, Faculty of Health Sciences, La Trobe University, Bundoora.

This thesis investigates the access to sexual health services and associated risk behaviours of young men in rural and regional Australia. For the purpose of my research, rural and regional men are defined as those who, at the time of this study, were aged between 16 and 25 years and were living within Rural, Remote and Metropolitan Areas (RRMA) 3 to 5 according to the RRMA classification. The specific research objectives are a) to determine the proportion of rural and regional young men who have accessed sexual health services; b) to investigate the socio-demographic determinants of access to sexual health; c) to examine the relationships between masculinity, risk perceptions and behaviours, and access to sexual health; d) to discover health providers' opinions on major barriers, and e) to determine whether or not masculinity is acknowledged in the health policies and by the service providers. This research was undertaken in two stages. I used both quantitative and qualitative methodologies to collect data for my research. The quantitative method (Study One) addressed research objectives a), b) and c) and used an online survey. Three hundred and ninety-six participants were recruited from three regional Technical and Further Education Institutes. Qualitative methods (Study Two) were used to fulfil research objectives d) and e) through 11 key informant interviews. While most of the participants indicated that they were sexually active, had engaged in sex, and exhibited drug-and alcohol-related risk behaviours, their risk perceptions of becoming infected with sexually transmissible infections were low. The majority of the participants did not access sexual health services although general practitioners and community health nurses were considered the most trusted source of advice on sexual health matters. A quantitative measure of hegemonic masculinity was found to be associated with certain risk behaviours and was associated with the participants’ confidence in visiting a health service provider and access to health services for general health problems, but not with access to sexual health services. Key informants perceived that dominant masculine beliefs are associated with risk behaviours of young men and identified remoteness, opening hours, stigma and gender of the health provider as major barriers for the provision of sexual health services for rural young men in Australia.