Condom use among teens in ‘alarming decline,’ WHO says as STI rates rise

A rise in sexually transmitted infections (STIs) and unplanned pregnancies are top of mind for the World Health Organization after it released a new report showing condom use among adolescents has been on an “alarming decline” in the past decade.

The data, published Thursday, comes from a survey of more than 242,000 15-year-olds across 42 countries between 2014 and 2022.

Of those sexually active 15-year-olds surveyed, one in five boys and 15 per cent of girls reported having sex in 2022 — a number that the report notes has not grown since 2014.

But while that number has stayed stable, the report showed that the boys reported using condoms 61 per cent of the time, down from 70 per cent in 2014, while the girls reported using them 57 per cent of the time compared to 63 per cent.

The report noted 30 per cent of adolescents reported not using either a condom or a contraceptive pill in their last sexual encounter.

In Canada, just 63 per cent of girls and 61 per cent of boys reported using a condom in their last sexual intercourse.

“Are we providing them enough access so that they don’t have barriers in their way?” Shamin Mohamed Jr., founder and president of LetsStopAIDS, told Global News.

“I think there’s a wake-up call that’s needed not just by our political parties, but us as a community to come together and say we want our youth to be best informed, to make the best decisions with the tools they have.”

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The “alarming decline” found by the WHO in condom use follows another notable series of declines between 2014 and 2018, when use reported among boys dropped by nine per cent and use reported among girls dropped by six per cent.

“There is a need for sustained educational and health interventions to promote condom use, combined with other highly effective contraceptive methods,” the WHO urged.

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Condom use also varied by country, with Albanian girls seeing the lowest rate at 24 per cent while Serbia saw use at 81 per cent. Boys used condoms the least in Sweden with about 20 per cent wrapping up, while 77 per cent did so in Switzerland.

Canada’s ranking put it roughly midway through the listing of countries, while Canada was also one of the countries where there was a “significant decrease” reported among girls who reported using the contraceptive pill.

For girls, a significant decrease was observed in Belgium (French) and Canada, and a significant increase in Czechia, Ireland, Malta and Portugal. Among boys, reported contraceptive pill use decreased in Canada but increased in Malta, United Kingdom (Scotland) and United Kingdom (Wales).

The WHO notes unprotected sex can lead to unintended pregnancies, unsafe abortions and a higher risk of STIs. But there remain barriers to use, experts say.

“They don’t always work because people can’t use them, they don’t use them, they don’t want to use them,” Patrick O’Byrne, a nurse practitioner at Ottawa Public Health’s sexual health clinic, told Global News.

Data from the Public Health Agency of Canada shows as of 2022, STI rates were on the rise following a dip in numbers in 2020 — a decrease sexual health experts say may be due to fewer people getting tested than just less people having sex.

The data does not separate by age group.

Chlamydia rates sat at about 299.12 cases per 100,000 people as of 2022, an increase from the 278.88 seen in 2020. Gonorrhea was up from 81.13 in 2020, sitting at 92.34. Syphilis, however, only dropped slightly in 2020, but the bacteria has increased 107 per cent from its previous high in 2019 to 48.74 cases, and O’Byrne said he’s not surprised.

“Going back some 20 years of practice, we would have seen in Ottawa a single new case of infectious syphilis every month and now it’s probably every one to two days,” he said.

PHAC only has data up to 2022, but some provinces’ more recent numbers show the cases haven’t stopped rising.

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Syphilis cases in B.C. in 2023, for example, soared to 2,067 from 1,067 in 2019 and the number among 15 to 19-year-olds jumped 207 per cent in 2023 to 43 cases, up from 19 in 2019.

Ontario’s gonorrhea cases rose to 14,146 in 2023, a 20-per cent increase from 2022.

In Nova Scotia, meanwhile, 2,730 cases of chlamydia were reported last year, compared to 2,281 in 2022.

The WHO says the data underscores the need for comprehensive sexual education, yet warns some nations have claimed it “encourages sexual behaviour.”

Abbey Ferguson, Halifax Sexual Health Centre’s executive director, told Global News last week that backlash against such education is concerning, but stresses that knowledge can make you better informed.

“Sex education that you got as a young person directly impacts the type of sexual health precautions that you use as an adult in the ways that you understand the systems and how to get tested,” she said.

In its report, the WHO urged that in addition to better sexual education, policy makers, educators and health-care providers should work to enhance access to youth-friendly sexual health services and conduct further research to identify the “underlying reasons” for the decline in condom use.

“It’s (condoms) a simple tool, a tool that can fit in your pocket, that you can bring with you and it actually gives the opportunity for confidence, for young people to feel that if they are going to be in a situation that they could truly take ownership of themselves,” Mohamed Jr. said.

“Let’s be frank, I think they’ll still be going forward with that sexual activity, with or without that tool.”