My dear brothers and sisters in Christ:
A former CFL football player was recently found guilty of two counts of aggravated sexual assault for having unprotected sex with two women without telling them he has HIV.
Public health directives such as “Sex Can Kill: Use Condoms” apparently didn’t make much of an impression on him. He faces a long jail term and his wife and children will have to deal with the long term fallout from his infidelity and irresponsibility.
Did he know that although the correct, consistent use of condoms offers some degree of protection against sexually transmitted diseases (STDs) that are transmitted by fluids, condoms do not prevent the spread of the two most common STDs, human papillomavirus (HPV) and genital herpes?
Did he understand that even with barrier protection, having a new sexual partner that has had other partners is potentially “high risk” sexual behaviour?”
Did he care?
Given the serious long term health problems that STDs present to individuals over their life span and rising infection rates, it is critical that questions be raised and current strategies be reevaluated.
Since risky sexual activity places adolescents at significant risk, physicians, educators, and governing bodies have sought to impact escalating rates of disease by promoting various strategies aimed at reducing risk.
These strategies have, for the most part, focussed on preventing the spread of disease through the use of barrier protection in the form of the condom.
Two major reasons account for the limited success of this approach despite extensive “safe sex” and “safer sex” campaigns.
First of all, condoms provide only limited protection against “skin-to skin” contact and “skin to sore” sexually transmitted diseases and currently there is no cure for viral STDs, such as HPV, genital herpes, and HIV/AIDS.
Secondly, although condoms offer some protection against discharge-related infections such as HIV, chlamydia, and gonorrhea, protection may be compromised by compliance issues, incorrect use, or mechanical failures.
Given the lack of protection of the condom against the spectrum of STDs and the unsuccessful attempts to achieved sustained compliance, the approval of Merck & Co’s vaccine, Gardasil, was greeted with near “salvific” excitement.
Merck’s marketing strategy has been resourceful, timely and tapped into some deep fears.
Reported parental reaction in the media has been supportive, with comments such as “I’d be in favour of anything that prevents anyone from having to fight any kind of cancer” and “The kids all think they’re so immortal, especially the younger ones. They’re the ones who often think they can get away with unprotected sex.”
Predictably, some medical practitioners jumped on the bandwagon and quickly proposed that every 9 to 13 year old girl in the country should be vaccinated against the sexually transmitted virus that causes cervical cancer. Furthermore, the National Advisory Committee on Immunization says that girls and women aged 14 to 26 should also be vaccinated against human papillomavirus even if they are already sexually active because they may not have yet been infected.
Seemingly, the big question now is “who will pay?” Girls must receive the injection three times for it to be effective, totalling a cost of $405 per patient.
Rather than ask, “who should pay?”, we would be further ahead to address the primary behaviour that predisposes individuals to sexually acquired infections.
Parents, physicians, educators, and governing bodies should adopt a health oriented approach that addresses sexual attitudes and behaviours recommending delayed genital sexual activity and partner reduction.
One of the national health objectives for 2010 developed by the US Department of Health and Human services is “to increase ... the proportion of adolescents in grades 9-12 who have never had sexual intercourse.”
Parents must take responsibility for playing a role in the promotion of healthy lifestyles. Parents need to promote ongoing dialogue with their pre-teen and teenage offspring about relationships and sexuality. Through teaching, active monitoring of social and other activities, and giving overt guidance regarding appropriate and safe dating relationships, they need to protect their offspring from counterproductive influences and potential abuse.
Teens are relentlessly bombarded with sexual messages and imagery in media, entertainment, advertising, and in some types of music. Although it is difficult to objectively quantify the full impact of sexual imagery, we are all aware of the impact of popular culture on both behaviour and self-image. Consider, for example, the demands for cosmetic procedures such as breast enlargements, liposuction, collagen implants, and buttock enhancement.
We need to move beyond a societal preoccupation with appearance, image and measuring up to an artificially created supposed ideal; teach critical thinking skills; provide guidelines as needed; and teach right from wrong.
☩ Frederick Henry