A European health surveillance service has drawn together some alarming data showing that the increase in chalmydia infection among English men is running alongside widespread ignorance among young people in England of the disease, of other STIs and of condom use in general.
However, the Men's Health Forum, England and Wales, have suggested that the increase in male diagnoses may actually be a sign that things are moving in the right direction. (You can link directly to their response here or from the foot of the article if you want to read the Eurosurveillance material first.)
A survey for Brook Advisory Service of 1373 young people aged 16-21 at 21 schools and colleges at four sites in England found that although knowledge about sexual health and contraception was 'generally good', significant knowledge gaps were identified:
52% thought that chlamydia only affects women.
31% thought that sexually transmitted infections (STIs) could be caught from a toilet seat.
25% did not know that STIs can be transmitted by oral sex.
The majority of young people surveyed had used condoms on at least one occasion but only one third reported consistent use. Young people were more likely to use condoms if they had discussed and agreed it with their partners, if they had used a condom with their partners before and if sexually active friends were thought to use condoms. The study found that some young people put a condom on after initial penetration and others continued penetration after the condom had been removed.
Perception of STI risk
Although a large proportion of young people were worried about STIs and HIV in general (89% and 83% respectively), lower proportions considered themselves to be personally at risk of STIs or HIV (61% and 50%). Knowing someone who had been diagnosed with an STI encourages peerd to get tested, but did not necessarily mean that condom use was then more frequent. Condoms were seen primarily as a device for avoiding pregnancy, not STIs, and use became more inconsistent if other contraceptive methods were being used. Oral sex was common but young people rarely took steps to prevent STI transmission via this route – use of condoms for fellatio was rare, and using dental dams for cunnilingus was even rarer.
Sources of information for young people
School was considered the most important source of information about sexually transmitted infections – two thirds of young people cited this as their main information source followed by magazines and parents. State-funded primary and secondary schools in England and Wales are legally required to provide sex and relationship education for all pupils which specifically includes information on HIV/AIDS and other STIs.
STI trends in young people in England
There has been a notable increase in new diagnoses in several STIs over the past few years. The under-18 conception rate for England in 2003 was 4210 per 100 000, the highest rate in western Europe.
The material was drawn together by Eurosurveillance, a multiformat journal that publishes authoritative, peer-reviewed information on communicable diseases from a Europe-wide perspective, and is evolving in response to the challenges of collaboration across many more borders. Link directly to the Eurosurveillance report here
and follow up all the references.
But the increase in male chlamydia diagnoses may not be a bad thing, say the Men's Health Forum, England and Wales. Click here for more