With the level of sexually transmitted diseases at an all time high, it’s time to stop sweeping the issue of unprotected sex under the table
In most Asian families, sex is a dirty word, a taboo subject, inappropriate for family discussion. Cultural barriers seem to prevent many parents from being able to discuss important aspects of sexuality with their children, resulting in many young people remaining ignorant about serious issues that are very much a part of their lives.
Because so much emphasis is placed on the moral aspects of sex, important health risks are missed. There seems to be a feeling that talking about sex somehow makes people more promiscuous. Too much emphasis is placed on abstinence and even the thought that a young Asian person might engage in sexual activity is dismissed.
A recent poll showed that around 45 percent of British South Asians, who include Indians, Bengalis and Pakistanis, didn’t have a condom handy the first time they had sex – almost double the 23 percent of the British white population who were caught short the first time.
Unsurprisingly it also showed that over 80% of British Asians had never discussed sex with their parents. It’s time we were all open to the idea. It could be a matter of life or death…
What are the dangers?
Putting aside the issues relating to teenage and unwanted pregnancies, a real worry is the ferocious rise in rates of Sexually Transmitted Diseases (STD).
Researchers at the Federal Centre for Disease Control and Prevention in the USA found at least one in four teenage American girls has a sexually transmitted disease. The most common one (HPV) is a virus that can cause cervical cancer, and the second most common (Chlamydia) can cause infertility. In the UK, Chlamydia is the most common STD.
Chlamydia can cause an abnormal discharge and painful urination, but often has no symptoms. Therefore many people do not come forward to be tested as often they have no idea that they're infected. It can have serious side-effects, one of which is Pelvic Inflammatory Disease (PID) which can lead to infertility in women. Treatment for chlamydia is very effective, and may only require one dose of antibiotics for complete eradication.
HPV can cause genital warts but often has no symptoms. It is present in many adults at some stage but not everyone develops warts. The virus is the cause of cervical cancer in women, although the strains responsible for cervical cancer are different from those that cause warts.
Genital herpes can cause blisters but is also often symptomless. There are medications that can reduce the severity of an attack but there is currently no cure. The risk of infection with herpes is highest when blisters are present but it is still possible to catch it at other times.
What is the scale of the problem?
In Britain the rates of STDs have doubled in the last 10 years and Chlamydia rates have tripled. In women under 25, the rates of Chlamydia vary from 1 in 10 to 1 in 4.
Remember these statistic are only based on the women that have been diagnosed; there are countless people who are carrying STDs who are unaware, simply because they think no symptom means no ailment. But it is estimated that of the approximately 70,000 people in the UK who may be HIV positive, up to 20,000 may not know they have the condition.
What is contributing to the problems?
There is certainly a degree of ignorance about the dangers of STDs. Some feel sex is only sex when there is penetrative intercourse, ignoring the fact that oral sex can also spread STDs.
I often hear statements like “I think I’m ok, because he/she didn’t look like they had an STD”. Obviously this is extremely naïve thinking but many people will find themselves with a partner they know nothing about. It goes without saying that under the influence of alcohol or drugs, inhibitions and common sense can fly out of the window.
There were nearly 2 million attendances at genitourinary medicine (GUM) clinics in the UK in 2007 - more than double the number recorded in 2002. This increase in people using GUM services has inevitably put pressure on their ability to deal with infections.
If people are not being treated quickly then this has an effect on the spread of infection. No-one wants to be told that they have a serious, often disfiguring sexually transmitted infection and then be told to come back next week, or the week after. Some people also describe a sense of embarrassment in visiting a GUM clinic. One patient told me, “I was so nervous. What if I bumped into someone I knew? Sitting in the waiting room was awful as we all knew what we were there for.”
But where can people go?
Many young adults are scared to seek help. Often they cannot see their GP because the GP may be a parent, uncle, friend of the family etc… Confidentiality is also a real concern and there is a feeling that anonymity cannot be guaranteed.
It is vital to overcome the obstacles and get appropriate medical assistance. There are family planning clinics in most boroughs and also a number of private clinics that provide an immediate confidential service.
What can be done?
Healthcare professionals suggest safer sex, such as the use of condoms, as the most reliable way of decreasing the risk of contracting sexually transmitted diseases during sexual activity, but safer sex should by no means be considered an absolute safeguard.
Condoms are a very good way to reduce the risk of getting infections. If you use them all the time, and use them correctly, they work.
There are some basic guidelines that need to be followed:
• Not putting the condom on too tight at the end, and leaving room at the tip for ejaculation. Putting the condom on snug can and often does lead to failure.
• Avoiding condoms made of substances other than latex or polyurethane, as they don't protect against HIV.
• Avoiding the use of oil based lubricants (or anything with oil in it) with latex condoms, as oil can eat holes into them.
• Using flavoured condoms for oral sex only, as the sugar in the flavouring can lead to yeast infections if used to penetrate.
Not following the guidelines above perpetuates the common misconception that condoms aren't tested or designed properly.
In order to best protect oneself and the partner from STDs, the old condom and its contents should be assumed to be still infectious. Therefore the old condom must be properly disposed of. A new condom should be used for each act of intercourse, as multiple usage increases the chance of breakage, defeating the primary purpose as a barrier.
A 2008 survey by Ipsos MORI revealed that half of all under 25s don’t use condoms with new partners.
All sexual behaviour that involves contact with the bodily fluids of another person should be considered to contain some risk of STD. Most attention has focused on controlling HIV, which causes AIDS, but each STD presents a different situation.
Vaccines are available that protect against some viral STDs, such as Hepatitis B. There is also now a vaccine to protect women against the strains of HPV that are most likely to lead to cervical cancer. This is offered to all women aged under 25, but women above this age can still receive the vaccine from a private clinic. Vaccination before initiation of sexual contact is advised to assure maximum protection.