Public health policy has been one of the most controversial political topics and a major issue at every Australian Commonwealth election since the 1940s. The central reason for conflicting values and ideas that make the issue a cause for continual concern and controversy is the major stakeholders that bring forward varying positions and interests. Health care providers want high profits and incomes, those affected want to be able to access quality services at a affordable price while the state wants to keep a tight control over the money expended. These objectives cannot be
achieved at the same time, a reality that generates intense conflict. Hence, developments in youth sexual health policy and practice in the past decade have been rooted in an ideological context that incorporates neo-liberal approaches of responsibility and risk management and neo-conservative ideologies that entail an authoritarian realization of policy. However, social and cultural elements cannot be undermined when considering factors that motivate the formation of youth sexual health policy and policy in general.
In particular, the changing social, cultural and political environment of the 1970-80s laid the foundation for national awareness into sexually transmitted diseases and a need for pragmatic policy implementation within Australia. This was due to the emergence of the AIDS crisis in the mid to late 1980s. In response, the Grim Reaper educational awareness campaign was launched, with television images of ‘death’ knocking down people in a bowling alley. In effort by the National Advisory Committee on AIDS the campaign sought to educate Australians about the incurable disease and encouraged the widespread use of condoms. The campaign was fundamental in reinforcing the need to provide open and candid discussion on sexual relations within a conservative Hawkes government. The initial impetus for action on HIV/AIDS in the 1980s hence came from a cultural recognition by community groups and individuals first affected and concerned by HIV/AIDS e.g. the National Advisory Committee on AIDS, gay men, hemophiliacs and researchers. Australia’s response was therefore one of ‘grass roots’ activism pressuring governments first to acknowledge and then to fund the necessary steps to bring HIV infection under control, provide adequate care and treatment for those affected by HIV/AIDS. Effectively, this displaced traditional political party structures with an emergence of
new political groups and movements determined to advance ‘hot button issues’ and new social agenda in particular those regarding sexual health issues through a public choice approach.