The excellent news is that charges of teenage pregnancies are at file lows. In 2014 in England and Wales they had been on the lowest fee since 1946, with solely 15.6 pregnancies per 1,000 ladies youthful than 20.
Sadly, charges of sexually transmitted infections (STIs) are nonetheless very excessive. There have been 440,000 diagnoses within the UK in 2014, and the underneath 25s are one of the excessive danger teams. STIs have a excessive monetary price for testing and therapy: diagnoses of chlamydia alone price the NHS £620m in 2011.
Condoms present efficient safety towards STIs however many individuals select to not use them – round 15% of under-25s reported having unprotected intercourse with two or extra companions within the final yr. So why don’t younger individuals use condoms? Essentially the most generally given purpose is the influence on sexual pleasure and intimacy. Pleasure is after all an important a part of intercourse, so something that’s perceived to intrude with it’s certain to be considered negatively.
Some additionally argue that younger individuals don’t use condoms as a result of they aren’t terrified of contracting STIs anymore. At the moment, the vast majority of frequent STIs, together with chlamydia and gonorrhoea, will be cured shortly with antibiotics, whereas HIV will be managed and people who contract it might probably count on to reside 20 years longer than was the case in 2000.
Whereas this concept is smart, the proof supporting it’s blended. Analysis has proven individuals’s beliefs in regards to the seriousness of non-HIV STIs will not be associated to their behaviour, suggesting that it doesn’t make any distinction whether or not individuals suppose STIs are critical or not: they’re nonetheless prone to put themselves in danger. That is even supposing, if left untreated, they’ll trigger problems corresponding to infertility.
Concern of HIV, however, might properly affect behaviour. The issue is that many individuals might not really feel vulnerable to catching it, notably non-black-African heterosexual individuals, who’re statistically at decrease danger of HIV. One examine confirmed heterosexual individuals who had been at excessive danger of STIs and HIV underestimated that danger and lots of didn’t use condoms. This implies that younger individuals’s determination to make use of a condom or not might rely on whether or not they suppose they’re vulnerable to an STI relatively than how extreme they suppose the implications are.
We also needs to bear in mind that the choice to put on a condom isn’t all the time made by one particular person. Their companions might also be concerned, and expectations about their response (or a scarcity of debate altogether) might affect the selection. Getting caught within the “warmth of the second” is a generally cited barrier to condom use and experiments have proven that sexual arousal in males reduces their potential to make choices.
Intercourse-positive method wanted
So what can we do to vary this case? Earlier instructional programmes have usually centered on the “risks” of unprotected intercourse. However proof suggests that scaring individuals, particularly those that really feel unable to vary their behaviour, can simply trigger them to turn out to be defensive.
The truth that perceived lack of sexual pleasure seems to be the elemental purpose most individuals don’t use condoms highlights how vital it’s to deal with the constructive facets of intercourse, relatively than solely specializing in the unfavorable penalties. Discovering a approach to improve sexual pleasure with condoms, or not less than change beliefs about pleasure, is vital. This may very well be so simple as enhancing precise sensation with condoms, from recommending thinner designs to revolutionary new supplies corresponding to graphene. Alternatively, it might contain persuading those that secure intercourse will be good intercourse.
This sex-positive method makes an attempt to focus on an vital driver of behaviour: motivation. We’re primarily pushed by our needs and desires in any specific second. Due to this fact, we have to make individuals wish to use condoms, relatively than making them really feel that they need to. To do that, we must always give attention to outcomes which might be vital to individuals –- issues that we all know they need.
For instance, when concentrating on smoking, specializing in appearance-related penalties could also be more practical than specializing in health-related penalties, for individuals who worth being enticing. Interventions to extend condom use ought to due to this fact give attention to extra instant objectives that younger individuals care about, corresponding to having fun with good intercourse or gaining social approval.
We actually haven’t cracked the issue of getting individuals to make use of condoms but. Nonetheless, specializing in objectives which might be vital to younger individuals create an thrilling new space for future investigation.
Rosie Webster receives funding from UK Nationwide Institute for Well being Analysis, Well being Know-how Evaluation Program, 10/131/01.
Views are completely of the writer and don’t replicate the views of the funder or of UCL eHealth unit.