Why Its Important to Have Safe Sex - Term Paper Example

Why is it important to have safe sex? In evaluating the importance of safe sex, it is necessary to evaluate the directly correlated issues. As the topic intrinsically covers multifarious issues, in this paper I shall focus on the subject of underage sex, teen pregnancy, rise in sexually transmitted diseases (STDs) and correlation with declining fertility rates. It is estimated that approximately 75% of American high school students have sex before the age of 17, with 72% having had sex before the age of 15 and only 42% having had sex with one person (Gibbs, 2008:63). However, aside from the potentially socio-psychological ramifications, the alarming rise in underage teenage pregnancy, sexually transmitted disease and fertility decline highlights the importance of sexual health education and safe sex. For example, in the US, empirical data demonstrates that 13% of the pre-17 teenagers having sex never use birth control with 26% using it occasionally (Gibbs, 2008: 64). The statistical data highlights the reality of “safe sex” measures failing and the need to address this. Additionally, recent studies indicate that 25% of girls between the age of 14 to 21 who have unplanned pregnancies were intoxicated when they had sex and out of this percentage, more than 90% had not previously contemplated having sex (PHLS et al, 2008). Additionally, the percentage of teenage boys within this bracket was stated to be 30% (Gibbs: 2008). Indeed, the statistics on teen pregnancy indicate that there is a direct correlation between the use of drugs, alcohol and sexual relationships (Gibbs: 2008). Indeed, the changing social acceptance and shifts in societal attitudes demonstrate that “teens aren’t looking for sex they are looking for love, acceptance, and security” (Brain, 1998). Additionally, it has been posited that many teenagers suffering from low self esteem become increasingly dependent on sexual relationships to establish identity (Brain, 1998). Indeed, Galambos et al’s research into emerging adulthood highlights the importance of understanding the complexities of the “crossover effect” in establishing identity. For example, Rindfuss (1991) has defined the crossover effect as being “demographically dense” because it is defined by a larger number of transitions in and out of varying roles in a short period of time (Rindfuss, 1991). Moreover, it has been argued that these transitions are pivotal points during which individuals will experience most key turning point life events involving family and relationships, sex, education and work (Rindfuss, 1991). Moreover, there appear to be diverging views regarding the dominance socio-economic background factors in the crossover effect, which is indicated by the detailed discussion in the research study itself. Indeed, it is submitted at the outset that the transition will inherently be subjective and dependent on the transition of various roles. As such, it is submitted that the results of any sample is intrinsically limited by the operation of a multiplicity of background causal factors and therefore any results in this research paper should be evaluated in that context. For example, one line of argument posits that in general terms transition to adulthood and crossover is achieved when an individual completes school, moves out from their parent’s home, establishes employment, gets married and becomes a parent (Settersten, Furstenberg & Rumbaut, 2005). Conversely, it is submitted that the transition points themselves are shaped by multifarious factors beyond mere macroeconomic forces; including shifts in the roles of social institutions, social norms and social values, which further can constrain role opportunities (Schwartz, Cote & Arnett, 2005). This inherent complexity in the crossover effect and identity as a teenager directly correlates to the growth in sexual relationships as the dynamic of contemporary family relationships change, arguably being replaced by the comfort offered through sex (Schwartz, Cote & Arnett, 2005). However, whilst such comfort may be provides part of the explanation in relation to the sharp rise in underage sex, it further reiterates the importance of safe sex. This is further evidenced by the Time report investigation undertaking by Gibbs demonstrating a prime reason for failing to have safe sex is the idea that “it can’t happen to me syndrome” (Gibbs, 2008). Nevertheless, more worryingly is the fact that the Time investigation demonstrated that the biggest fear of a teenager in relation to sex was AIDS and pregnancy, however this did not result in any significant increase in ensuring safe sex in practice (Gibb, 2008). This further raises two central issues. Firstly, the risks posed by unprotected sex must be discussed further to highlight the importance of having safe sex. Secondly, it is necessary, to evaluate why current measures geared towards sex education and safe sex initiatives are failing in practice. For example, the last twenty years, two central triggers have shaped sexual health education and promotion initiatives, namely the emergency of the HIV epidemic and the change in social attitudes towards sexuality and sexual behaviour (Orr, 2008). These in turn have reflected a changing dynamic and shifting emphasis on primary intervention, yet unprotected sex remains a worrying phenomenon amongst the underage population (Orr, 2008). Moreover, whilst the Time investigation indicated that the central fear of teenagers in particular with regard to unprotected sex was contracting HIV and unplanned pregnancy, this arguably ignores the increase of other sexually transmitted diseases. Indeed, a UK Public Health Laboratory Service Report 2008 indicated that the main reason for attendance at genito-urinary medicine clinics in the UK was Chlamydia, herpes simplex and HIV (PHLS et al, 2008). Chlamydia affects both men and women and has become increasingly common, with the worrying problem of the condition not manifesting in obvious signs or symptoms, leading to the condition being referred to as the “invisible condition” (PHLS et al, 2008). Additionally, the Report demonstrated that there has been a dramatic rise in the number of teenagers affected by STDs. Chlamydia is estimated to impact 20 to 40% of sexually active groups with differing gender consequences (Gibb: 2008). Firstly, if we consider men, the disease can create infertile sperm and in women, the condition can damage female organs and cause permanent damage to fertility without a woman realising it (PHLS et al, 2008). Indeed, it is estimate that Chlamydia can create a 25% risk of infertility. If a woman suffers the infection a second time, the change of infertility increases to 50% (PHLS et al, 2008). As stated above, recent empirical data suggests that teenagers have become a significant risk factor group for STDs due to the rise in sexual activity, thereby rendering an entire generation at risk (PHLS et al, 2008). Additionally, it has been observed that female teenagers are particularly at risk (Gibb: 2008). Teenagers are argued to be more at risk of the HPV virus, with rates as high as 40% contrasted with the rate in the adult population, which is 15% (PHLS et al, 2008). The report also indicates that men are more likely than women to contract an STD and that the proportion of the population that have had an STD has risen dramatically since 2002 (PHLS et al, 2008). Interestingly, whilst men are more likely to have an STD the report indicates the increase since 2002 is significantly attributed to the rise of STDs amongst women (PHLS et al, 2008). From the UK perspective, the number of Britons having tests for HIV has risen significantly with the number of women being tested almost doubled (PHLS et al, 2008). Interestingly, notwithstanding the rise in STDs, there has been a significant reduction in the number of individuals concerned by STDs, which arguably highlights the importance of government further consideration of initiatives and additional funding for safe sex education and information (PHLS et al, 2008). Moreover, the report’s indication of a decreasing concern in relation to STDs highlights the rise of the complacent attitude. This is further compounded by the closing of the gender gap with figures for unprotected sex converging towards equality between men and women (PHLS et al, 2008). To this end, “safe sex” effectively means the prevention of bodily fluids from one partner to another and whilst safe sex will not guarantee contraction of an STD, it will significantly reduce the risk (PHLS et al, 2008). Furthermore, the Report indicated that on the past two decades the UK has seen the total fertility rates much lower than the necessary replacement value for generations, which has been directly correlated with the alarming increase of sexually transmitted diseases, highlighting the need for safe sex (Ruddock et al, 1998; Walden et al 2007). Additionally, the 2008 Report into STDs by Genito urinary medicine clinics demonstrates a steady increase in STDs and aimed to analyse the correlation between decreasing fertility rates and rise in STD. In utilising data from the annual abstract of statistics at the Department of Health and Social security, the total fertility rates were calculated between 1951 and 1998. The results indicated a significant correlation between the rise in TFI and STDs. Furthermore, it is evident that Europe has been experiencing the lowest fertility rates and longest period of fertility below replacement levels (Day 1995; Walden et al, 2007). Indeed, the 2008 report demonstrated that by mid 1998 the replacement fertility rate in England and Wales was less than 2.1 children per women for the best part of two decades, which is well below the necessary value for replacement of generations and the figure is rising (Walden et al, 2007; PHLS et al, 2008). However, fertility rates are decreasing, the case of STD’s received in genito urinary clinics, has been steadily increasing. For example, between 1991 and 2001 reported cases of STD’s at GUM clinics more than doubled in England and Wales (Public Health Report, 2008). Furthermore, new cases of STDs reported by clinics in England and Wales between 1949 and 1993 demonstrated an increase by approximately 650% . In 2008 the figure had increased by a further 400% (PHLS et al, 2008). In this period, there was a sharp rise in cases of gonorrhoea and chlamydia which in both cases is significant as if left untreated is associated with wider issues such as pelvic inflammatory disease and Tubal factor infertility (PHLS et al, 2008). It is submitted that increased sexual risk behaviour accounts for much of the rise in STD diagnosis however the delays for up to a week for urgent and as much as four weeks for non urgent appointments increases duration of infectiousness which in turn increases the STD incidence (Chandran, 1993; Hine, 2003) . It is also important to consider that cases of STD’s in the population is underestimated as diagnoses made in non GUM clinics go unreported in this type of data set and infections such as gonorrhoea and genital chlamydia infection are characteristically asymptomatic and therefore go undiagnosed (Ruddock et al, 1998; PHLS et al, 2008). Alternatively, studies and evaluations have posited that comprehensive sexuality education is an effective strategy to help young people delay their involvement in sexual intercourse, which has created polarised debate particularly in considering the teen pregnancy subject (Orr, 2008). Teen pregnancies is a rising problem in both the US and UK. For example “Each year 1 million teenagers become pregnant, 85% of those pregnancies are unplanned” (Orr, 2008). However, this creates wider ramifications such as sexually transmitted diseases as the number of STDs has risen dramatically and according to the National Institute of Health, out of 12 million new cases of STD, 3 million of them are teenagers and the unplanned pregnancy and sexually transmitted disease can cause problems in the unborn child (retrieved February 26, 2009, from National Institution of Health website: ww.nih.gov). The domino effect of this contemporary social phenomenon has far reaching psychological and economic ramifications as evidenced by the burden on the welfare system: “over three quarters of all unmarried teenage mothers begin receiving cash benefits from other AID to families with dependent children program within five years of both of their child” (Kaiser Family Foundation, 2005). Moreover in the US, the National Institute of Health estimates that 97 pregnancies occur per 1,000 women aged 15-19 (retrieved February 26, 2009, from National Institution of Health website: ww.nih.gov). Moreover, in the UK twice underage teenagers are more likely to get pregnant than in Europe, thereby perpetuating the controversy as to how to tackle the problem and how to address safe sex (Orr, 2008). For example Family Youth Concern argues that “the government’s current policy is to tell kids about contraception but that’s obviously failed…. Young people need to know the truth. From a health, personal and social welfare point of view, they should be put of sex” (retrieved 27 February, 2009, from Family Youth Concern website: www.famyouth.co.uk). Other groups such as the British Pregnancy Advisory Service which provides abortions and counselling to young girls feel this is unrealistic as empirical data clearly highlights the inefficacy of trying to prevent teenage sexual relations (Orr, 2008). Internationally, there has been no general consensus on how to address the problem, creating polarity. On the one side of the spectrum, the US has implemented virginity club initiatives, which reward young girls for abstinence. Conversely, Holland teaches sexual relationships, contraception and abortion to children as young as five (Orr, 2008). Additionally, the figures for sexual health in France, and the Netherlands indicates that STD rates are much lower in comparison to the UK and US as sex education is mandatory in school (Orr, 2008). Additionally, the International Planned Parenthood Foundation argues for an approach akin to the system in Scandinavia and Holland which have the lowest rate of pregnancies. This approach expressly acknowledges that teenagers are sexually active and uses an open approach to promote positive sexual health education (retrieved 4 March 2009, from International Planned Parenthood Federation website: www.ippf.org). However, whilst clearly polar opposites, they are clearly open in their approach in contrast to the UK approach where “We as a nation are used to thinking of sex as something naughty or not to be discussed….. that simultaneously makes it far more appealing to kids and harder for them to talk to them about” (retrieved 27 February, 2009, from Family Youth Concern website: www.famyouth.co.uk). Nevertheless, this fails to account for the change in attitudes to sex, which no longer considered as reserved for marriage and the Kaiser Foundation reported that a third of sexually active teen aged 15-17 stated that “being in a relationship where they felt that things were moving too fast sexually” and 24 per cent had “done something sexual they didn’t really want to do” (Kaiser Foundation, 2005). Moreover, the Kaiser Foundation report found that 21% of teens reported having oral sex to avoid sexual intercourse. Additionally, a big problem with the safe sex approach is the failure rate of condoms is never mentioned and according to the Office of Family Planning for the state of California, the average belief among people is that condoms are 98% effective, when only 88% effective depending on how the condom is used (retrieved 26 February from California Office of Family Planning website: www.cdph.ca.gov). In conclusion, the above analysis demonstrates that the alarming rate of STDs, unwanted teenage pregnancy and complex reasons for the increase in underage sex highlights the importance of safe sex in the contemporary social environment. This in turn begs the question as to how best address the issue and implement safe sex initiatives in practice. Firstly, Sutton et al posit that from a healthcare perspective, the andragogy approach is appropriate (Sutton, 1997). Moreover Sutton et al opine that this allows a client to learn through experience and accomplishment, and build on existing experience and knowledge, which encourages the thought process of the client and identifies key factors inherent to the problem of unsafe sexual practices (Sutton, 1997). The aim of changing a person’s behavioural approach is to encourage a client to take up healthier behaviour for example to discuss and demonstrate the correct use of a condom and make informed decisions regarding behavioural change (Sutton, 1997). Sutton and Payne (1997) suggest that education and learning in sexual health can be considered under the following basic principles: “adults learn from one another as well as the educator, they can learn from asking questions and getting answers. Within a group setting, they lean from other people’s questions and answers. Within a group setting, they learn from other people’s questions and answers especially shy or inhibited. This may not be practical within the client/professional relationship in the GUM clinic, but can be applied, where the aim is the promotion of sexual health”. In any event, the negative ramifications of unprotected sex are clearly permeating a societal shift, which in turn in highlights that safe sex is imperative. BIBLIOGRAPHY Books Brain, M. (1997). Teenager’s Guide to the Real World. BYG Publishing. Day, L.H. (1995). The future of low birth-rate populations. London: Routledge. Hine, A. (2003). England’s population: A history since the doomsday survey. London: Hodder Arnold. Sutton, A., & Payne, S. (1997). Genito Urinary Medicine for nurses. Whurr: London. Walden, M. L. & Thoms, P. (2007). Battleground Business. Greenwood Publishing. Journals & Reports Arnett, J. J. (1994). Are college students adults? Their conceptions of the transition to adulthood. Journal of Adult Development, 1 213-224 Arnett, J. J. (2000). Emerging Adulthood: A theory of development from the late teens through the twenties. American Psychologist. 55, 469-480. Chandran, 91993). STD and contraception. Malays Journal of Reproductive Health: June 11(1): 1-7. Galambos, N. L., Turner, P. K., & Tilton-Weaver, L. C. (2005). Subjective Age in Emerging Adulthood: The Crossover Effect. Journal of Adolescent Research. 20: 538. Gibb, N. (2008). The Pursuit of Teen Girl Purity. Time. July 2008. Orr, D. (2008). How Best to Stop Teen Pregnancies. The Independent, 2008. PHLS, DHSS& PS (2008). Sexually Transmitted Infections in the UK: New Episodes seen at Genitourinary Medicine Clinics, 1991-2008, London: Public Health Laboratory Service. Rindfuss, R. R. (1991). The Young adult years: Diversity, structural change and fertility. Demography, 28, 411-438. Ruddock, V., R . Wood, & M. Quinn (1998). Demography and Health. Population trends: 94: HMSO Schwartz, S. J., Cote, J.E., & Arnett, J. J. (2005). Identity and agency in emerging adulthood. Youth & Society, 37(2), 201-29. Settersten, R. A., (2007) Passages to adulthood: Linking demographic change and human development. European Journal of Population, 23, 251-272. Websites: California Office of Family Planning: www.cdph.ca.gov Family Youth Concern: www.famyouth.co.uk Kaiser Foundation: www.kff.org National Institute of Health: www.nih.gov International Planned Parenthood Federation website: www.ippf.org Read More