STI rates rising, but sex-ed adrift

Facing changing landscape, university services attempt to progress sex-ed 

Fifty-five per cent of Queen’s survey respondents regularly use condoms during sex.
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*Names have been changed to protect the anonymity of students.

Most first-year students in residence know they can get condoms for free or cheap from their Dons or the Sexual Health Resource Centre (SHRC) on campus. 

Their knowledge of sexually transmitted infections (STIs), however, often ends there.

With a range of birth control options available today—including pills, patches, and IUDs—the risks posed by unprotected sex often go unnoticed. And when formal sexual education hasn’t been conducted since the beginning of high school, students often lag behind on sexual health education.

Teaching students about their sexual health remains a difficult task: while unplanned pregnancy rates are on the decline, the rate of STIs is on the rise.

Granted, the advancement of diagnostic tools, such as the Nucleic Acid Amplification Test (NAAT), also likely plays a role in higher national rates of STIs. 

Between 2005 and 2014, national reported rates of chlamydia rose by 49 per cent; gonorrhea by 61 per cent; and syphilis by 95 per cent, according to the Government of Canada’s 2013-2014 Report on STIs.

According to the same report, all three STIs are most prevalent in young adults, aged 20 to 29.

This age range is also when STIs pose their highest risk to long-term health. As young adults enter their mid-20s and their peak reproductive years, both chlamydia and gonorrhea have the potential to lead to infertility in both men and women, if they advance untreated. 

Chlamydia and gonorrhea are the most commonly diagnosed STIs on campus, according to Dr. Carolyn Borins, Medical Lead at Student Wellness Services (SWS).

Where is education hiding?

At Queen’s, it seems sexual education can be hidden in the corners of our campus—but students often forget to seek it out.

According to Queen’s National Collegiate Health Survey, last conducted in 2016, 55 per cent of students reported using a protective barrier during sexual activity most of the time; 18 per cent reported using one sometimes or rarely; and 14 per cent reported never using one.

These reports are consistent with the 2014 Canadian Community Health Survey, which found 58 per cent of people aged 20 to 29 use condoms.

While the male condom is certainly the most popular barrier used, it’s not necessarily foolproof, nor is it the only option.

“Not all barrier methods work the same and there are misconceptions about what kind of sex leads to the transmission of STIs,” J. Aksel Richard, Director of the SHRC, said. 

Using a barrier method during intercourse often doesn’t account for STI transmission from oral sex. For that purpose, dental dams—latex sheets used between a mouth and vagina—can be found at the SHRC. Gloves, non-latex condoms, and reality condoms (female condoms) can also be found at the SHRC as alternative methods.

Only 60 per cent of students reported ever receiving any information from Queen’s related to STI prevention—and 69 per cent of students indicated interest in receiving more, according to a Queen’s 2016 survey.

People often believe that having no symptoms indicates good sexual health. In fact, chlamydia—the most common STI reported both on campus and nationally—fails to show any symptoms in 70 per cent of women and 50 per cent of men.

The stigma that surrounds STIs, however, can cause people who are affected to refrain from telling past and future sexual partners. This can contribute to their spread, potentially causing reinfection. 

When a previous partner phoned Jack* and told him he may have gonorrhea, Jack visited SWS for an urgent check.

In the past, Jack had consistently gone for routine STI testing to KFL&A, since he heard his peers share negative experiences about SWS.

“I had heard about SWS being a subpar health service,” Jack said. “But looking back at the experience I’ve had, I’d go back there.”

Jack underwent testing and treatment for gonorrhea. After a quick injection of the antibiotic ceftriaxone and a prescription of pills, he was told he could resume sexual activity in approximately four weeks.

According to him, health care professionals can be inconsistent about when it is acceptable to resume sexual activity. Another partner of Jack’s who may have had gonorrhea was told he could have sex again one week later.

Nevertheless, Jack’s treatment was quick and painless—and it made SWS seem like a more approachable resource on campus.

People who want to avoid telling their past partners about their STIs have the option to give past partners’ contact information to a public health nurse, who will then call and encourage them to get checked.

According to Jack, being open about his STI is a step toward ending the stigma associated with them.

For Rebecca*, the waiting room at SWS was a little too public already.

Although her results came back negative, she felt that the nurses and doctors in the waiting room too openly discussed her symptoms in front of the other students. 

“It’s nice to be comfortable,” she said. “But things can be a bit too casual. I think it comes from disorganization.”

Where to find it

While students may have to seek it out, SWS is responding to the rise.

The peer-led sexual health team runs The Ask Me Anything About Sex campaign, an online forum on which students can pose anonymous questions related to sexual health. Answers are posted on Health Promotion’s Facebook page each week and read by an average of 1,000 students, according to Dr. Borins.

Peer Health Educators also collaborate with Residence Life to create presentations in residence. One example is a trivia game focusing on STIs that also functions as an educational workshop. 

Outside of residence, some faculty Orientation Weeks include a presentation by the Health Promotion, which gives a general overview of taking care of health while at Queen’s.

While specific STI-related information is all available upon request, education on campus can be more reactive than proactive.

Ashley*—a student who recently underwent STI testing at SWS—feels her sexual education was not consistent with that of her peers, since she came from a different province. While she expected university was going to improve her knowledge, it failed to catch her up.

Despite being somewhat in the dark about her sexual health, Ashley regularly visits SWS for STI checks.

A quick blood test there is the answer to her worries. She, too, hopes to lend SWS a better reputation than it’s received in the past. 

Whether discouraged by stigma or simply uneducated about the prevalence and symptoms, the fact remains: STIs are on the rise, and people are avoiding getting tested.

Perhaps they don’t know how or where to get tested—or they think that testing positive could derail their life.

In reality, the most common STIs are cured in a one-time dosage of pills or an injection of antibiotics.

The scariest part, perhaps, is telling others.

With mounting STI rates, education is available, but sometimes hidden. Students are forced to adapt, often without an adequate guide.

 

Student Wellness Services information can be found here. The Sexual Health Resource Centre information can be found here.

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