Explosion of sexually transmitted infections: ‘Going out and having sex without a condom with strangers has become the norm’ | Society

Sexually transmitted infections (STIs) have risen sharply in Spain. The past three decades have seen the highest surge in incidence of gonorrhea, syphilis and chlamydia. This is stated in the Epidemiological Surveillance Report on Sexually Transmitted Infections 2022, published at the end of January 2024 and prepared by the Ministry of Health and the Carlos III Institute of Health. Experts are increasingly accepting of not using condoms, and half a dozen pieces of evidence support this. “It happened to me so many times that they didn’t want to put a condom on that I rethought my faith in people. Even in some cases they were taken away without consent,” says the 22-year-old, who, like the majority of the collected votes, prefers not to give her name.

The report shows that men are more susceptible to all sexually transmitted infections than women, although the increase is common for both sexes. The age group of 25 to 34 years old has the highest number of cases of the three mentioned sexually transmitted infections.

Gonorrhea is recording a big boom, with 23,333 cases reported in 2022, double the 2020 figure. The number of reported chlamydia cases also increases to 26,518, representing a 266% increase from 2016. And the number of 734 cases of syphilis reported in 2002 has increased. over these two decades to 8,141. The figures, which push back the Ministry of Health’s goal of eliminating HIV and sexually transmitted infections as public health problems by 2030, are included in the Strategic Plan for the Prevention and Control of HIV and STIs in Spain.

“When I was 23 years old, I was diagnosed with a sexually transmitted infection. “I broke up with my ex-partner, who was on the pill, and I had seven or eight consensual relationships without a condom,” says the 25-year-old from Valencia. In his case, the relationship usually involved “alcohol and drugs.” The infection marked a “turning point” in his life as doctors spent more than a year treating warts caused by the infection. Although he has recovered, he undergoes medical check-ups every six months.

Risky practices, such as not using condoms, are common among the younger population. More than half of people aged 15 to 29 have engaged in risky behavior at some point in the past six months, and 19% have done so very often, according to the Foundation’s Youth, Health and Wellbeing 2023 barometer. Youth. Moreover, 27.7% say they benefit from having such intimate relationships.

Gender inequality

Cristina Epalza, a pediatric infectious disease specialist at the 12 October Hospital in Madrid, found in her consultation that some teenagers have difficulty setting up barriers when maintaining relationships with people around them. “If they run into a stranger in an alley and are sexually assaulted, they know there is no consent. When they get to know the other person, things start to get complicated in their heads, but they have to push their limits,” he says.

The 22-year-old girl begins her report by saying that most of the girls she knows felt pressured in sexual relationships “to the point where they had to give in” or, if the man refused to put on a condom, stop. . Sarah, a 25-year-old Valencian who prefers not to give her last name, agrees. “You meet someone one evening and if they say the condom is tight or that they don’t have one, you agree not to use it because you think nothing will happen this time,” he explains.

Not knowing how to negotiate sexual relationships is a possible consequence of gender inequality, according to Planned Parenthood Federation deputy director Cedra Raquel Hurtado, who works with young people in group workshops and individual attention spaces. Men still have power over women. Sometimes they don’t know how to set limits because they “don’t want to disappoint, are afraid of a fight, or feel guilty.” You’ve often heard the phrase that reflects this inequality: “I must have done something to get us there.”

Low risk perception

In the age group with the highest incidence of gonorrhea, syphilis and chlamydia – from 25 to 34 years – there is a feeling of immunity. Epalsa insists that this is characteristic of a stage in life in which a person is not aware of the risks. It’s a vision with which Hurtado agrees, who believes that “in general there is no concern because they think infections are under control and HIV is no longer on the covers and the main campaigns.”

Spanish Red Cross sexual health spokeswoman Cristina Ferrero Camacho believes the chronic nature of some infections, such as HIV, reduces vigilance among the younger population. On a bench in the University City of Madrid, two 19-year-old girls talk about how their generation is relaxed about using condoms:

— The topic of sex has lost a little respect, it seems that it’s normal to do it without a condom.

— The biggest fear is pregnancy, but since the morning comes after the pill, you think that nothing can happen to you. It has become the norm to go to parties, have sex with someone you don’t know, and do it without caution.

“Maybe the moment will come when you don’t have a condom, and you’ll do it anyway.”

Newly diagnosed or untreated sexually transmitted infections can cause infertility even in asymptomatic cases. For example, cancer or warts, and in women who contract syphilis and become pregnant, this can be passed on to the fetus. In case of HIV infection leading to AIDS, the consequences can be fatal if not dealt with promptly.

Some young men associate the request to use a condom with a symptom of mistrust, an argument that Hurtado refutes: “You can trust me, but when you sleep with me, you are also sleeping with my entire erotic history.” In addition, he warns about myths about romantic love that are still very common in sexual relationships. Fad Juventud Research Director Anna Sanmartin explains that in many cases, in stable relationships, “the logic of trust comes into play, allowing the use of protective measures to be abandoned.”

The influence of pornography

Among the various factors that explain the rise in sexually transmitted infections, sexologist José Luis García identifies the “hypersexualization of society” and the influence of pornography, where “the condom is invisible.” “Porn is a sexual education guide for most minors, and the message conveyed is that bareback relationships are the best,” he says. Hurtado advocates for the eroticization of condom use and the connection of prevention with well-being and pleasure.

Sexuality education in schools, which is sometimes limited to teaching what a condom is and how to put one on, is not enough. So says Sanmartin, who needs to be “given other comprehensive tools.” Dr. Epalza reiterates that “it’s about respecting yourself and those in front of you, mental and physical health, and harmony.”

The Sexual and Reproductive Health Law, whose reform was approved in February 2023, focuses on improving sexuality education in educational centers and explicitly mentions the prevention of sexually transmitted diseases and infections. “This issue needs to be addressed from childhood, just like healthy eating,” says Epalza.

Going to the hospital for a test can be a barrier due to existing stigma around sexually transmitted infections. That is why the Ministry of Health intends to introduce self-contained samples so that people who have doubts about possible infection can speed up the process, meaning that instead of going to the center twice – once to report their suspicions and again to collect samples – they can go directly with the sample from home. Epalza also recalls that the law includes the concept of the age of majority of a minor, according to which From the age of 12, the health care professional must assess the patient’s maturity in order to be able to deal with the specific situation independently, without parental approval, always taking into account the greatest benefit for the adolescent.

The cost of condoms is another barrier cited by some young people interviewed. Fernando, a 20-year-old from Madrid, explains that he has friends who, “because they want to save money,” do not use them. The doctor is offering more free dispensaries. In France, this initiative is being promoted among people aged 18 to 25.

The idea that condoms interfere with or distract from pleasure is widespread. Alberto, 33 years old, admits that he has had unprotected sex for pleasure for a long time, a position with which most respondents agree. This removes a major barrier to preventing the transmission of sexually transmitted infections. The doctor warns: “No one wears a seat belt in a car because they think it’s more convenient, but they do so because they know they are risking their lives.”