SEX ED. | With STDs and sexual infections on the rise in Canada, what are we to do?

Did you learn much about safe sex in school? Yeah. Me neither.

And now, Canada’s lack of decent sexual education is starting to have an effect.

Though most of Generation Y grew up with some form of sex ed. in school, as well as AIDS awareness campaigns and safe sex messages from mainstream media, according to Heath Canada, Chlamydia, Gonorrhoea, HPV, Syphilis, and HIV/AIDS infection rates are all on the rise. Infection rates began climbing back in 1997, and though the problem has never received much mainstream attention, the trend has continued ever since.

Dose spoke to a number of recent high school grads and the negative sentiments about their school health classes were strikingly similar.

Many reported that they received little or no sexual health info at all.

“We never even had a real health class,” said Iris Graham, 20, who graduated from North Vancouver’s Argyle Secondary School in 2003. “We learned about general stuff in grade seven – I don’t even remember what. And then we learned a little more in high school CAP (Career and Personal Planning) and Biology in grade eleven or twelve. I remember being taught the names of the parts of the body, a little about different kinds of STDs, that you need to have protection … but honestly, that’s about it.”

And that’s one of the better reports.

Experts agree that Canadian high schools aren’t stepping up when it comes to giving their students adequate sexual health info.

I spoke (individually) to Shanti Gidwani, Director of Clinic Services at Options for Sexual Health (formerly Planned Parenthood) in Vancouver, and Dr. Gina Ogilvie, Associate Director of STD/AIDS Control at the BC Centre for Disease Control about this disturbing phenomenon.

Here’s just a little of what they had to say.

Photo by Michael Prewett on Unsplash

Jen Selk for Dose: Why are infection rates on the rise? What role does school education play in the problem?

Gidwani: “We’ve been doing a lot of work with high school health-education departments, and we’re finding that they’re very inconsistent. Sometimes we find good programs, sometimes not. It depends on the school board and the school. It’s hit or miss. And if you don’t get proper sex education in school there’s very little opportunity to do so in adult life. Family doctors are often too busy to discuss anything beyond just supplying birth control … [But] because every school and school board is different, there’s not a uniform answer to what is happening.”

Ogilvie: “There are a couple of things to consider. Having seen what happened with AIDS, there was a huge impact on the public in terms of their behaviours. They saw the consequences of their actions more clearly. And those consequences were very serious. Now, with the success with HIV treatment, people aren’t dying of HIV/AIDS the way they did in the 1980s. It’s true that there is not the fear there was in the past … People are also testing more. So they’re potentially more aware of the infections out there. That affects behaviour too.”

Selk: Is Gen Y complacent when it comes to protection and smart sex?

Ogilvie: “I wouldn’t use the word complacent because I think that’s kind of judgemental. But it is true that Generation Y did not see the direct devastation that losing people with HIV caused, and certainly that would have an effect on their behaviour … Fear is a big motivator, but it’s not the only motivator, and complacency doesn’t really describe the problem … Knowledge is a foundation … We need to find innovative and clever ways to speak to our target audience.”

Gidwani: “Generation Y might not be comfortable taking about HIV/AIDS and safe sex … And then there’s condom fatigue — people not using protection as much as they used to.”

Selk: Tell me about the shift from saying STD to STI. This is new to me, but I still hear STD most often. 

Ogilvie: “It’s an important distinction. Infection implies something very different from disease. Many people can be infected and not know about it, for example. You can be infected without symptoms.”

Gidwani: “If you look at medical definitions of disease and infection, you’ll see that infection implies that a part of the body is actually invaded, so the term infection more accurately describes the condition. In addition, many infections are curable … the term infection carries less of a social stigma than disease. That said, there are many places, in the USA, especially, that are changing back to STD because that term is more well-known. The bottom line is that they mean the same thing.”

Selk: Is the rise in infection rates a real trend or a statistical blip? How worried should people be?

Ogilvie:  “Those are Health Canada stats, not BC stats, but they’re going on 6 or 7 years now. I don’t think you can call that a blip. It’s not an exponential jump, but it is a continued trend rise, for sure … There are important implications for STIs. For young women, STIs can lead to infertility, ectopic pregnancies. In men and women, they can more easily acquire additional infections if they already have one. There are numerous things to consider.”

Selk: What needs to change? How can we impart to people that this is something they need to take seriously?

Ogilvie: “People change their behaviours for lots of reasons. Not just fear. The key thing is knowledge. We need to find innovative and clever ways that speak to the target audience. Futhermore, knowledge and information needs to come from different areas – not just the health department. And it needs to be consistent. Fear is a big motivator, but it’s not the only motivator. In addition, knowledge is but one part of changing behaviours. Knowledge is a foundation, but people need to feel like they’re at risk, they need to act on that. They need to put that into their decision making process.”

Gidwani: “The message won’t hit home if you’re just being didactic. We always need to consider the cultural appropriateness of discussing certain things to different groups of people. Age, race, and gender have to be considered.”

Photo by Almos Bechtold on Unsplash

Selk: Planned Parenthood (or rather, Options for Sexual Health) offers very inexpensive birth control. Is that a tactic to try to get people in the door to push further education?

Gidwani: “Once we get them in the door, we can start educating them appropriately. We’ve created that hook. … There are great organizations out there for generation Y that create awareness in age appropriate ways, but not enough.”

Selk: Getting back to Sex Ed. for a second, what do you think of the quality of the sexual health curriculum in this country? 

Ogilvie: “What we know about education is that there’s been a challenge with shifting fiscal priorities. Furthermore, every school and school board is different. School boards need to look at what they’re doing with health education, and sexual health education in particular. There’s not a uniform answer to what is happening. Each school needs to look at what is going on, and how that’s contributing or not contributing to the health of Canadian youth.”

 Selk: What do you think of the idea that Generation Y may feel like they already know everything there is to know about safe sex and sexual health?

Ogilvie: “I’ve been in medicine now for 10 years and I’m still learning. So I find it hard to believe that anyone has achieved knowledge saturation on any topic.”

Sidebar and Stats, Source: Public Health Agency of Canada

Chlamydia

According to Health Canada, Chlamydia is the most common bacterially transmitted STI in the country, but more than 50 percent of males and 70 percent of females with Chlamydia have no symptoms. They also report that “after being in decline for many years, rates of Chlamydia infection have risen steadily since 1997.” Unpleasant regardless of biological sex, symptoms include discharge, painful peeing, and sometimes bleeding, itching, and burning. Oh, and swollen testicles, if you’ve got ‘em.

Gonorrhoea

In the 1980s and early 1990s, the rate of gonorrhoea in Canada went down steadily, but after reaching an all-time low in 1997, rates began to climb. Health Canada reports that “from 1997 to 2001, there was a 45% increase” overall, and that among men aged 30-39, “the rate went up 68%.” Though treatable, often with a single dose of antibiotics, some strains of the bacteria have become resistant (think super bugs). Symptoms include vaginal and penile discharge, possible rectal pain and discharge, and everybody’s favourite – pain while urinating.

Human Papillomavirus (HPV)

Heath Canada estimates that 75% of Canadians will have at least one HPV infection in their lifetime. There is no known cure, however, the immune system does repress the infection eventually. The most serious risk of HPV is cancer, particularly cervical cancer in women. HPV can also lead to other types of cancer such as cancer of the penis, anus, or vulva. HPV can also come with warts. These warts may appear on the vulva, cervix, rectum, or thigh area, or on the penis, scrotum, rectum, or thigh area. Otherwise, HPV is often a silent infection, and many people show no obvious signs of having it, even under a microscope.

Syphilis

Commonly thought of as the disease that  killed many a Victorian prostitute, Syphilis is the STI that (unexpectedly) just keeps giving. Cases of syphilis in Canada used to be rare, but in 2002 there were four times as many cases as in 1997, and that number continued to rise through 2003. There have been outbreaks in Vancouver, Calgary, Toronto, Ottawa, Montreal, and the Yukon, among gay, straight, cis-het, trans, queer, and other folks alike. Syphilis doesn’t discriminate. Cases have run the gamut. Syphilis can start off with a painless ulcer or sore at the spot where the bacteria first entered the body, and can progress to patchy hair loss, rash, fever, swollen glands, muscle and joint pain. If left untreated, it can affect the brain, blood vessels, heart, and bones, and may eventually lead to death.

HIV/AIDS

It’s been more than 20 years since HIV/AIDS was first diagnosed in Canada, but thousands are infected each year. At the end of 2002, Health Canada estimated there were approximately 56,000 people in Canada living with HIV/AIDS and that approximately 17,000 or 30% of those were not aware of it. The number of cases of transmission amongst straight-identifying people is increasing in Canada and is the number one mode of HIV transmission in the world. While treatment options and outcomes are a lot better than they used to be, if HIV becomes AIDS, opportunistic infections like pneumonia and cancer can take advantage of a body’s weakened immune system and eventually lead to death. Rent Philadelphia if you need a refresher on that depressing possibility.

Please, folks. Pack a prophylactic.

2018: A heavily-edited version of this piece about sexual infections on the rise in Canada published under the heading “Lost in transmission?” in Dose,  August 3, 2005. See clip below.

I was initially proud of this piece about “sexual infections on the rise in Canada”, and worked on it periodically over the course of most of the summer of 2005. But Dose‘s style was glib, and my initial draft went through multiple edits with multiple editors, changing significantly each time. I wasn’t happy with the final version (which you can see below).

Still, I think there is important, perennially valuable stuff here, particularly in the interview content, which is why I’ve included that here.

Note, the young person I quoted up top, Iris Graham, is actually my cousin. I used to babysit for her. As with the wedding survival guide, this was another story where Dose wanted me to interview endless strangers on the street, and while I did so, as much as humanly possible, I don’t feel like those quotes were really appropriate here. Though of course, the geniuses known as my editors used many of them in the print-published version of the piece. Yay.

Pieces like this one were put in “The Spread” which is the centre section of the folded, tabloid-style newspaper.

A double-page spread, if you will. It was a coveted spot, and one my name appeared in often, for a time. How to break up with a friend, the wedding survival guide, cheap chic, and so many other pieces I wrote for Dose were featured in The Spread.

Sadly, because Dose seemed to think its readers were too stupid to actually read much, most of the space in any individual spread was filled with stupid illustration. Such was the case with this piece, which could have been so much more useful than it was.

Published in Dose, August 3, 2005.