A bit about sex…
The control of sexually transmitted infections has been an enduring concern. Swift societal changes and medical advances over the last 50 years has altered the way sex and sexuality is seen by society, and dealt with by the health sector – culminating in the contemporary medicalisation of sex.
The impact of sexually transmitted infections on public health remains an issue of concern. We now face the resurgence of syphilis across the globe, the preservation of the HIV infection at relatively high levels in select groups, a diminishing efficacy of gonorrhoea treatment, and astronomical levels of chlamydia infection among youth.
To help better understand the topic of sexual health, perhaps it is important to understand why we act the way we do. Often this stems back to youth and first sexual engagements. A range of social and cultural forces shape people’s sexual behaviour, and it is the formative years that are especially important to people’s attitudes to sex later on, and sexual health outcomes.
A great piece of research by Marston and King (2006) investigates youth sexual behaviour. Published in the Lancet, the extensive review provides a global perspective on young people’s sexual behaviour. The study reports seven key themes, with all themes present, in varying degrees, in all countries examined. The themes are as follows:
young people assess sexual partners as ‘clean’ or ‘unclean’;
sexual partners have an important influence on behaviour in general;
condoms are stigmatised and associated with a lack of trust;
gender stereotypes are crucial in determining social expectations and, in turn, behaviour;
there are penalties and rewards for sex in society;
reputations and social displays of sexual activity or inactivity are important; and
social expectations hamper communication about sex.
Condom use is influenced by all of these pressures.
References:
Marston, E. & King, E. (2006). Factors that shape young people’s sexual behaviour: a systematic review. The Lancet, 368:1581-1586.
Woodbridge, M. 2012. The Assessment of Men’s Risk of STI and HIV in the General Practice Setting. Department of Primary Health Care and General Practice, University of Otago, Wellington
Woodbridge, M., Dowell, A., Gray L. (2015). ‘He said he had been out doing the traffic’: general practitioner perceptions of sexually transmitted infection and HIV testing strategies for men.Journal of Primary Health Care. 2015 Mar 1;7(1):50-6.