STIs rates in Canada are rising — decline in condom use may be to blame
With the recent news of STI outbreaks in Alberta, experts are wondering if a decline in condom use may be to blame.
Nathan Lachowsky, an assistant professor at the University of Victoria, told Global News we need more sexual health research in Canada in general to explain trends like this one.
“A lot is changing about the ways that Canadians are having sex, but we don’t know why as we don’t have nationally representative surveys like many other nations,” he said.
Lachowsky presented findings on condom use practices, focusing on gay men, at the STI & HIV World Congress in Vancouver this week.
Lachowsky said rates of some sexually transmitted infections continue to increase across the country, and this is partly due to people using condoms less.
The importance of sex ed
He added that much of this comes down to a lack of sex education.
“We can absolutely improve the quality and depth of sex education in schools, which requires both stronger curriculum and implementation,” he explained. “Youth should be learning about condoms and practise how to use them before they are in the moments of having sex with someone else for the first time.”
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He said that as a society, we also need to remove the stigma related to STIs.
“That is what shuts down conversations within schools, within families, and between partners,” he said. “How much more pleasurable would sex be if you weren’t concerned about getting an STI?”
Samantha Bitty, a Toronto-based sexual health and consent educator, added that sex education also has to be inclusive.
“If the types of sex you’re having isn’t represented in the sex education you receive, you’re less likely to feel empowered to suggest safer sex methods.”
But Lyba Spring, a retired sexual health educator based in Toronto, said education is only one factor.
“Even though there are guidelines for sexual health education, it is unevenly applied throughout the country,” she told Global News. “Young heterosexuals may indeed rely on methods of birth control other than condoms, but there are also other factors which may impede their condom use.
“Negotiating safer sex requires not only an ability to communicate but also a feeling of self-worth.”
Spring added that older Canadians who did not have the benefit of sex ed may not be aware of the risks of STIs in general.
“Canadian seniors for whom pregnancy was once an issue would not necessarily think about STI prevention because they may have been in a long-term relationship before losing their partner to death or divorce,” she added. “They may believe their new partner did not have more than one partner in the past.”
Men who have sex with men may also be at risk without proper sex education of STIs, Spring said.
“Men having sex with men who are at low risk for HIV transmission because they are HIV positive but using medication that keeps their levels undetectable, or men who are using [HIV prevention drug] PrEP may ignore the risk from other STIs aside from HIV.”
Embarrassment buying condoms
For some, there can be a feeling of anxiety or shame when it comes to buying condoms.
“Anyone who is buying condoms and lube should feel great about making sexually healthy choices,” Lachowsky said. “As public health, we should also be making condoms, lubricant and other prevention strategies readily available and easily accessible for everyone.”
Spring added that where you live may also be a factor.
“It is not clear how easy or difficult it is to obtain/buy condoms in rural or remote areas,” she explained. “Moreover, there can be an embarrassment factor, especially if one is in a smaller town.”
Communication is critical
When it comes down to it, all three experts agree communication between partners or partners is key.
“It’s hard to talk about the kinds of sex you want to have and how to prevent passing an STI, but we need to start practising,” Lachowsky said. “Practice makes perfect. Getting tested for STIs regularly is also a critical part of being a sexually responsible and healthy adult.”
The majority of STIs do not have any symptoms, he said, which is why we should not rely on our own self-assessment.
Bitty said these conversations also include talking about pleasure, power dynamics, stigmas around STIs and even shame when it comes to condom use.
Spring agreed and added that people shouldn’t be afraid to ask questions.
“[For example,] ‘After we both get tested for the usual suspects (HIV, chlamydia, gonorrhea, syphilis) what are you comfortable doing without barrier protection?’ or ‘If you have a history of cold sores, I need to know so we can talk about transmission through oral sex.'”
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