Reckless romance is a risky business
SUMMER lovin’ happens so fast. As soon as the sun shines, people’s thoughts turn to beach holidays, music festivals and holiday romances. All these perfect opportunities for sex – hot, abandoned and risk-free sex.
But do we take precautions to make sure this sex is as safe as possible? Or do some of us gamble with our sexual health? Official figures reveal some cause for concern.
According to the Irish Contraception and Crisis Pregnancy (ICCP) Study 2010, 44% of all pregnancies reported by 18 to 25 year olds and 19% reported by 26 to 35 year olds are crisis pregnancies. This implies that it’s not just teenagers who are forgetful when it comes to contraception. The same study found that 9% of 18 to 25 year olds had used the morning-after pill as had 3% of 26 to 35 year olds.
HSE reports show an overall increasing trend in the rate of sexually transmitted infections (STIs). There were 12,719 reported cases in 2012, up from 3,361 in 1995. Those aged 39 and younger made up 90% of these cases, with 11.3% aged under 20, 59% in the 20 to 29 age group and a further 19.4% between 30 and 39.
“This increasing trend may be due to a number of factors,” says Dr Caitriona Henchion, medical director of the Irish Family Planning Association. “There are improvements in testing methods, improved access to testing and screening, more comprehensive surveillance as well as ongoing unsafe sexual behaviour.”
Why are so many of us still opting for unsafe sex? Why, when there are sex education classes in most schools and constant public health campaigns, are some people having sex without using contraception or only using a form that protects against pregnancy and not STIs? Is it youthful naivety born of the belief that nothing can possibly go wrong? Do people drink too much and throw caution to the wind at the end of the night? Or do insecure young women cave to pressure from men? A clue may be found in the Irish Health Behaviour in School-Aged Children Study 2010. This found that 93% of sexually active 15 to 17- year-olds surveyed used condoms as their form of contraception.
This high rate of usage is backed up by the ICCP study which found that 79% of 18 to 25 year olds always used contraception when they had sex.
“Overall, younger adults are more likely to use contraception consistently than older adults,” says Michelle Merrigan from the HSE Press Office. “The figures have decreased in older age groups.
From 2003 to 2010, it fell from 81% to 79% among 26 to 35 year olds and from 84% to 75% among 36 to 45 year olds.”
Is it that the safe sex message is so strongly communicated in schools that young people start out by taking it seriously and then once they become accustomed to sex, they become more blasé about contraception? Or is it that older people aren’t as well educated in sexual matters? “Adults aged 20 and over are more likely to have had less comprehensive sex education compared to their younger peers and may be more likely to engage in unsafe sex,” says Dr Henchion. “In the ICCP Study, 86% of those aged 18 to 25 reported receiving sex education, compared with just 57% aged 36 to 45.”
There may also be an element of ambivalence about unplanned pregnancy among older adults. One in seven aged 26 to 35 and one in five aged 36 to 45 told the ICCP study they did not consistently use contraception because ‘they did not care if pregnancy happened’. The taboo once associated with unplanned parenthood no longer exists.
The HSE is addressing this reluctance to use contraception with its Think Contraception campaign. “In 2012, in response to the increasing levels of notifiable STIs being diagnosed in young adults, the campaign was revised to include messages about STI risk as well as unplanned pregnancy,” says Michelle Merrigan. “We promote different forms of contraception on www.thinkcontraception.ie but focus on condoms as they are the only form that prevents both pregnancy and STI transmission.”
The campaign’s memorable ‘Do you want condoms with that?’ adverts were aimed at young singletons, like 24-year-old Agnes who lives in Cork City but grew up in a country town. “It took me a long time to get sense about sex,” she admits. “I started having sex when I was 17 and my first boyfriend was a bad boy. Our relationship was on-again, off-again and he definitely slept around. I didn’t see the point of taking the pill because we weren’t in a proper relationship and anyway, I’d never have remembered to take it.”
Her lack of caution continued after that relationship fizzled out. “I’d sleep with guys at the end of a night out,” she remembers. “If I were drunk, he was hot and we both wanted it, neither of us cared if he used a condom or not.”
She now realises how risky this was but never suffered repercussions. “I didn’t get pregnant or catch anything,” she says.
“I suppose I was lucky.”
Agnes is now in her first serious relationship and is taking the pill. “We’ve been together for a year now and because neither of us sleeps with anyone else, there’s no need for condoms,” she says. “I take the pill because I don’t want to get pregnant. I only started taking it after I got together with him. From talking to friends, most girls don’t take the pill until they are in long-term relationships.”
Sarah, 36 and from Kerry, wasn’t quite as lucky as Agnes. “I used to be clueless,” she says. “I was so insecure I always gave in to whatever my partner of the time wanted. Men rarely want to use condoms so I hardly ever did.”
She remembers a dalliance with an Australian who was fastidious about always using condoms. “I was 21 and he was older,” she recalls. “He took his sexual health very seriously and it was the first time I had ever encountered that.”
His example didn’t change her behaviour. That didn’t change until she contracted genital warts. “They were so painful and getting rid of them took so long that I changed after that,” she says. “I had to look after myself and my body. Nobody was going to do it for me.”
Susan, 29 and from Dublin, had different reasons for her lax approach to contraception. “I was on the pill from the age of 17 until three years ago when I started to get dark patches on my skin, especially my face,” she says. “I went to the doctor and he said it was because my liver wasn’t breaking down chemicals from the pill.
They looked really bad so I stopped taking it.”
She and her boyfriend used condoms for a while. “But he hates them and so do I,” says Susan. “Before long, we weren’t using anything. We’ve been together long enough to know neither of us have any diseases.”
She is now pregnant. “I’m due in September,” she laughs. “We wouldn’t have chosen to have a baby at this time but it’s not the end of the world. We both wanted kids in the long term.”
Lisa, 25, lives in Cork and is currently single wants to children in the future and is concerned about taking hormonal contraception. “I would have used condoms when I first started having sex and then changed to the pill as I got older – when I started freaking out (over the possibility of pregnancy).
“I haven’t been on the pill in about a year and a half — in my line of work I see so many people who can’t have kids; it just freaks me out so I prefer not to put things in my body that I don’t need.
“More recently, I’ve been relying more on timing (in my cycle) which might be dodgy but I feel like I know a good bit about it – I just look at what day in my cycle I’m on.
“I’d rather get accidently get pregnant now than never be able to. If you couldn’t get pregnant you’d always wonder if it was because of the pill and I think you’d blame yourself” Phil, 30 and from Wicklow, speaks from the perspective of a man with an active sex life. “I’ve had sex with more than 70 women,” he says. “I frequently use protection but not every single time.”
He thinks contraception is the woman’s responsibility. “If she doesn’t bring it up, I don’t use it,” he says. “Some girls bring it up initially but if you don’t have anything, they usually go ahead with sex anyway.”
He doesn’t worry too much about STIs. “If I were with an African or South American girl, I’d be more careful but with Irish or Eastern European girls, the most you are likely to get is Chlamydia and you can easily deal with that.”
He speaks from experience, having contracted Chlamydia while at university. He now gets tested every six months. “I want to make sure I’m ok and so far, so good,” he says.
The sunshine and skimpy clothing of summer may lead to thoughts of sexual adventures. But while TV and movie characters are free to cavort in the sand without fear of negative consequences, this is not true for those of us in the real world. With rates of gonorrhoea infections in Ireland increasing by 32.9% between 2011 and 2012 and herpes by 5%, there is a clear need for precaution.
Additional reporting Ciara Flaherty
It does not interrupt sex and can reduce bleeding, period pain, and PMT.
It does not protect against STIs; can have side effects; and vomiting, diarrhoea, antibiotics, and other drugs can interfere with its effectiveness.
They do not interrupt sex and are good for those who forget to take daily pills.
Can cause irregular bleeding, do not protect against STIs, and it can take time for fertility to return to normal once you stop taking them.
Does not interrupt sex, can stay in for up to 10 years, and works as soon as inserted.
May cause irregular bleeding, does not protect against STIs, and there is a risk of pelvic infection.
Does not interrupt sex, can stay in for five years, and works as soon as inserted.
Some medication interferes with its effectiveness, it may cause irregular bleeding, and it does not protect against STIs.
Do not interrupt sex, work for up to three, years and may reduce painful periods.
Do not protect against STIs, and may cause irregular bleeding, no bleeding at all, acne or weight gain.
Does not interrupt sex and easy to reverse.
May be seen on the skin, certain medication can interfere with its effectiveness, and it does not protect against STIs
Can be put in any time before sex, can be reused, useful if seeking to avoid hormones.
Does not protect against STIs and cystitis can be a problem for some users.
it does not involve chemicals and is free from side effects.
it requires keeping a daily record, involves avoiding sex at some times during the month and does not protect against STIs.
Widely available, protect against both pregnancy and STIs, and cause no medical side effects.
Putting them on requires practice and they can be damaged if handled roughly or used with an oil-based lubricant.
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