We’ve come a long way from the condom on a banana approach to teach young people how to have safe sex. The teens who make up a chunk of Generation Z, the population raised by the internet, have multiple avenues and resources (including pornography) to learn about foreplay and sex.
And while one 2005 report indicates the proportion of teens between the ages of 15 and 19 having sexual intercourse has decreased — some studies note Gen Z doesn’t have much interest in sex to begin with — there was no change in rates of teens having multiple partners or males not using condoms. Experts say this still puts this age group at risk of sexually transmitted infections (STIs).
Between 1998 and 2015 (the most recent national data available), chlamydia — the most commonly reported STI in Canada — has risen from 39,372 to 116,499 annual cases among all ages and genders, and gonorrhea infections increased from 5,076 to 19,845 in the same time period. Infectious syphilis rates rose dramatically from 501 to 4,551 cases.
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According to a 2014 report from Health Canada, teens aged 15 to 19 made up 1,081.9 cases of chlamydia per 100,000. The cases of gonorrhea in this age group was 101.79 cases per 100,000, while cases of infectious syphilis made up the lowest rate of four per 100,000.
However, the greatest relative rate increase, Health Canada notes, for syphilis was in males aged 15 to 19 — a 300 per cent increase.
The importance of sex ed
Dr. Dustin Costescu, family planning specialist in the department of obstetrics and gynecology at McMaster University in Hamilton, Ont., says the rise among STI rates in teens is multi-factorial. He says, however, the issue (for any age group) is still around condom use.
Messaging around condom use also needs to change, he says, since the majority of teenagers think of condoms as contraceptives.
“We do know some populations are at an elevated risk,” he says. “While teens are exploring their sexuality, they may be neglecting condom use. Teens struggle in negotiation around condom use.”
He says when you ask teenagers about things like HIV, they see it as a chronic disease, something that has been cured.
“There is a lack of understanding, but there’s also a risk of scaring them for being sexuality active. We want to find a balance [so they can] realize their risks and we don’t shame them from having sex — that’s a challenge for all sexual educators.”
He adds while adolescent pregnancy rates in Canada are decreasing, teenagers know they have to use protection, but the messaging around condom use for STIs is not so clear.
He says there is also confusion around screening guidelines, pap tests and STI tests. Many are unsure when to get tested and STIs also come with a stigma of otherness — there’s a “type” of person who gets an STI.
STIs in the curriculum
STIs are introduced in school curricula through sexual education and health classes. In Ontario, the Ministry of Education says students learn about safe and healthy relationships throughout the provincial curriculum.
“The curriculum is structured so that students learn about human development and sexual health as one component of their overall health,” a ministry spokesperson tells Global News. “The focus is not simply on learning facts, but on helping students use facts and knowledge to make healthy choices and connections to their everyday lives.”
Since Ontario’s sex ed curriculum change in 2015, students are now introduced to STIs in Grade 7 (how to prevent them), and in Grade 10, they expand their knowledge on infections themselves, as well as how to use condoms and find a health expert.
“There are also optional examples and prompts provided to teachers in the curriculum. They are there to help prepare teachers for the questions and discussion that may arise during the learning and to encourage students to think about different questions/situations that they could possibly face,” the ministry adds.
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Similarly in British Columbia, STIs are part of the physical and health education curriculum, and students explicitly start learning about the topic in Grade 6. However, the B.C. Ministry of Education adds classroom teachers may bring up the topic at any point in relation to their class. In Grade 9, students learn about protection from sexually transmitted infections in particular.
In Alberta, schools are required to offer human sexuality education in Grade 4 to Grade 9, and STIs are introduced starting in Grade 8, while Quebec’s new sex ed curriculum is set to launch in the fall.
And for the rest of the provinces, STIs and prevention usually start in Grade 5 or 6, and this includes topics around HIV/AIDS, condom use and abstinence.
Are Canadian teens aware?
Drew, an 18-year-old student from Pickering, Ont., says STIs were first covered in sex ed class in Grade 9.
In his friend circle, he adds, STIs don’t often come up in the conversation around sex. If anything, most people in his age group are worried they may get pregnant.
“I feel like STIs are a scary thing, but a lot of people in my generation just don’t seem to be that scared by them.”
For Jordana, 17, of Toronto, the thoughts are similar. STIs are mostly treated like a joke (if someone gets a pimple, for example, it’s mocked as herpes) and rarely is it seriously discussed.
“I definitely think that learning about STIs should be something that is covered in school every year, and information and support should be readily available to anyone,” she tells Global News.
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She adds STIs should be covered every year (in Ontario, it becomes optional after Grade 10), because some teens don’t often think about the repercussions of having unprotected sex with a stranger or multiple partners at ages 14 and 15.
“I know a lot of people think that STIs are something of fiction and will never happen to them,” she says. “Most of us are not mature enough to go to the doctor on a regular basis, as well as taking the time to get informed about the topic of sex, unprotected sex, birth control, and preventative measures against STIs.”
Matthew, a Grade 8 student in Toronto, says he was introduced to STIs in Grade 6 and the topic of safe sex was covered the following year. And although he believes he has enough knowledge about infections, he could learn more.
While Hadiqa, 16, of Hamilton, Ont., says STIs are still seen as “weird” and “gross” for the majority, and people in her age group just don’t talk about them.
And while she agrees with most teens that sexual health education should be mandatory until Grade 12, she says it will only become more and more useful as teens move into adulthood.
‘The talk’ is still valuable
Costescu says parents and educators need to start meeting teens where they’re at and talk openly about safe sex.
“We need to do a good job of listening to adolescents and what messages work with teens,” he says. “Ideas among adults will not go anywhere if it’s not a relevant message.” He stresses talking to them about sex does not increase sexual behaviour — a common reason parents don’t open up about it.
“At the end of the day we have to decide what is worse. The sexual activity? Or the consequences?”
Dr. Jillian Roberts, child psychologist at Family Sparks, says it’s also important to step in as parents because teens are more likely to look up sex and pornography online before talking to adults.
“It is no longer possible to avoid ‘the talk,'” she tells Global News. “Further, it is no longer appropriate to think of ‘the talk’ as a single event. Doing so places kids in harm’s way.”
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She adds adults themselves still see a stigma and shamefulness about sex, and this also needs to change to ensure STI rates drop for teens in the future.
“Kids need to have a strong relationship with their parents and know that they can talk to their parents about all the complex issues facing the modern generation. Parents need to shed any embarrassment and tackle this topic head-on.”
Read more from our series Below the Belt: Canada’s STI Problem
arti.patel@globalnews.ca