“I know that STIs are dangerous,” says Maya. “I know there are serious risks. I know that I need to use a condom with someone new. I know this. But for some reason, I still occasionally have sex with one-night stands or – most recently – holiday flings without using a condom.”
Maya is 28. But pretty much every sexually active twenty-to-thirtysomething I know has admitted to doing this at least once in their lives – be it with someone on Tinder they’d been seeing for a few weeks or with a 42-year-old bead-wearing hippie they met for one night in Goa.
With younger generations, it’s even worse. Last year, Public Health England found that out of 2,000 people aged 16-24, almost half have had sex with someone new for the first time without a condom and – incredibly – one in 10 had never used one.
Now, a more recent study from The Mix suggests why: one in five people aged 18-24 doesn’t actually understand what an STI (a sexually transmitted infection) is. Out of more than 1,000 people surveyed, a third said they’d never had an STI test, and for 20% of those it was because they were too embarrassed to get tested.
This is particularly worrying considering 16 - 24 year olds are most at risk of being diagnosed with an STI in the UK of any age group. But it’s small fry compared to what’s going on across the pond in America. There, only a third of people use condoms, and it seems that many of them don’t really understand how.
Instead of recognising that condoms are disposable and should only be used once, they are washing them and reusing them. The Centres for Disease Control and Prevention (CDC) has had to issue a public warning to the public, stressing: “We say it because people do it: Don't wash or reuse condoms! Use a fresh one for each sex act.” (NB reusing condoms can weaken the latex, meaning they’re more likely to split, and rewashing doesn’t remove all bacteria meaning it could lead to infections.)
All of these studies together suggest that, right now, there’s a serious worldwide problem when it comes to understanding sex and STIs. While overall rates of STIs in England are relatively stable, with 420,000 new cases each year, the rate of syphilis has increased by 20% and gonorrhea has increased 22%. “I honestly had no idea that it was possible to get syphilis in 2018,” admits Maya, when I tell her. “I thought it was a Victorian thing.”
'I’ve not been too worried about condoms because I know that with things like chlamydia, you can treat them early with antibiotics,' admits a 25-year-old friend of mine
Her honesty sums up one of the biggest problems with STIs: the lack of education and understanding around them. A lot of that is down to public messaging. In previous generations, there were huge awareness-raising campaigns about STIs like HIV. But last year, the government launched its first sexual-health campaign in eight years. Is that gap to blame for recent rises?
“Right now, we’re on the tail end of previous campaigns,” explains Chris Martin, CEO of The Mix. “We know they work – there’s a clear correlation that if you give people the information, they will modify their behaviours positively. It’s something we can see now with a fall in pregnancy rates. We need to make sure young people have access to the information and services they need.”
The government recently updated sex and relationships education (SRE) guidelines, but they won’t be compulsory until 2020. Brook, the sexual-health charity, has been campaigning for this for years and believes it will make a big difference to the rates of STIs in the country. “This is a once-in-a-generation opportunity to get this right for young people and the results of these survey are proof that we need can’t hold off any longer,” stresses Isabel Inman, communications manager.
But she also goes on to explain that people could be becoming more casual about condom use because of “the misconception that because most STIs are easily treatable there is no risk of long term harm.” “I’ve not been too worried about condoms because I know that with things like chlamydia, you can treat them early with antibiotics,” admits a 25-year-old friend of mine. “To be honest, so long as I’m avoiding pregnancy, that’s my biggest concern. And sex feels better without them.”
PHE found that this was one of the biggest reasons people didn’t use condoms – both men and women prefer the feeling of sex sans latex. But there are also gendered reasons. When I speak to women, I find that their main priority is not getting pregnant, so, as long as they’re taking some form of contraception, be it the implant or the highly-debated Natural Cycles fertility app, they will occasionally go without condoms.
While, unfortunately, it still seems to be the case that, until women bring up protection, men are more likely to go without – the Mix found 50% would never ask a partner if they’ve had a recent STI test before having sex.
“It’s not fair for women to have a primary responsibility,” says Martin. “We need to empower both boys and girls to have a proper discussion about it. We found the vast majority said they’d be embarrassed to talk to partners about being tested or not. It’s still quite a taboo subject to discuss. But we’ve got to get people talking, including boys, because obviously they contract these diseases as well and they can often go unnoticed for even longer.”
The answer to fixing this is two-fold. It is partly a government issue. Education needs to be improved so that young people properly understand the STIs they’re being told to avoid, and so the stigma can be removed. Public-health campaigns and compulsory SRE in schools would be a good start.
But it’s also up to us, as individuals, to start discussing STIs with our partners. It’s time to move beyond the awkwardness for the sake of our health, because as uncomfortable as it might be to talk about gonorrhea with a one-night stand, it’s going to be a lot more uncomfortable to get a phone call from them two years later saying they’ve given you an STI.