The Inbetweeners: 16 & 17 year olds attending SRH are vulnerable

Introduction:
Legally, 16 and 17 year olds can consent to sex but may still be vulnerable to sexual exploitation; opportunities to identify vulnerability may be lost when transitioning into adult services.

Methods:
In the financial year 2015-16 there were 1975 attendances of 998 individuals <18 at a sexual & reproductive health service. A risk assessment proforma was used in 98.8% (n=505/511) of those 16 or under and 72.9% (n=355/487) of those aged 17. These were analysed using an electronic report.

Results:
New safeguarding concerns were identified in 4.3% (n=8) of 16 year olds and 3.8% (n=8) of 17 year olds, representing 53% of all under 18s. 20% of 16 and 17 year olds (n=61 and n=70 respectively) were known to social care, compared with 34% (n=52) of under 16s. 4.2% (n=14) of 17 year olds and 3.2% (n=9) reported a history of >10 sexual partners. Presence of mental health difficulties ranged from 21% (n=63) of 16 year olds to 26% (n=93) of 17 year olds.

Consent to contact agencies if required was documented in 12% (n=103) consultations; 45% (n=46) did not give consent, of which 37% (n=17) were known to social care. Housing was documented in 98% (n=846). 13% (n=110) did not live at the family home.

Discussion:
Using a risk assessment proforma with 16 and 17 year olds enabled staff to recognise vulnerabilities related to child sexual exploitation, 53% of all concerns were among this age group. When transitioning to online and adult services care models should include assessment to identify vulnerabilities such as pre-existing involvement with social care, older partners & mental health difficulties. Staff should be competent in managing disclosures and have a working knowledge of social care, referral thresholds and pathways within local networks for those at risk of CSE.

The Inbetweeners: 16 & 17 year olds attending SRH are vulnerable

The Joint Annual Conference of the British Association for Sexual Health and HIV & the Society for the Study of Sexually Transmitted Diseases in Ireland