Monday, October 17, 2005

*ST Article: Spike in number of teens with sex infections....but is there and so what?*

Hmmm, the title is not as punchy as I somewhat hoped it might have been. Here's a partial fisk for your edification. Personal comments are prefaced by a >.

Para 1.
There has been a dramatic increase in the number of young people hit by sexually-transmitted infections

> Okay, catchy paragraph, let's see if it's properly substantiated with a longitudinal study preferably over a period of 5-10 years.

Para 2 - 3
Figures from the government-run DSC Clinic show that those aged 10 to 19 now form 6 per cent of all sexually transmitted infections (STIs) - double the 3 percent in 2002.

They accounted for only 206 cases in 2002, 490 in 2003 and about 600 cases last year.

> It's only 3 years but alright, that could still constitute a trend. I just wonder a number of things. 1. What's the repeat infection rate? 2. What sort of counselling if any does the clinic do? Is it only abstinence? In which case it's going to be less effective than the alternative of teaching safer sex.

If we're talking about a majority of people who repeatedly return for treatment, then the number of new patients admitted every year works out to be about 200 i.e. constant and given the birth rate of Singapore working out to be around 1.6-1.7, it means that the rate of new infections is actually dropping. Of course such a figure would mean that there were no infections in 2001, so a more reasonable figure would be what? 100-150? Anyway, the data wasn't on the DSC Clinic website, so anyone who has data would be greatly appreciated if you could send it over.

But fine, let's say there's this alarming trend in the number of teens having STI, then what's the cause behind it and we come to...

Paragraph 8 and 9
Counsellors at the clinic attribute this disturbing spike in sex diseases among the young to a cavalier attitude towards sex.

"Their more immediate concern is unplanned pregnancy and, ironically, they try to prevent this by the unrealiable withdrawal method," said Ms Theresa Soon, DSC's senior executive.

> URGH!!!! Nope they're not so much cavaliar as willfully and awfully misinformed. Sorry but when you have pro-abstinence groups peddling junk science like condoms don't work and can't prevent STIs and you should be all good boys and girls and not have sex before marriage (where you will suddenly and miraculously have all the knowledge you need to have sex and prevent unwanted STIs and pregnancy), what the hell do we expect?

1. Preaching and I use the word preaching, abstinence doesn't work. It's terribly alienating and people will tend to want to have sex regardless of what you say and not equiping them with the knowledge and skill to know what they're going is gross negligence. Even if you manage to convert all the people on the margins to believe in abstinence, there's still going to be a core who will have sex regardless of what you say and they are the ones you need to reach out to.

2. An abstinence only policy (as opposed to the Abstinence plus policy that I adovcate) is mutually exclusive to teaching about safer sex and this has severe repecussions on STIs. It's not simply, as Ms Theresa Soon knows and implies through her statement, about preventing unwanted pregnancies. It is also about preventing STIs. Hands up all those of you who know that STIs can be transmitted through unprotected oral sex. In fact any form of penetrative sex can lead to the transmission of STIs.

More than that though, condoms if properly used work, tremendously well. Not as well as ABSOLUTE abstinence perhaps (see oral sex comment above and an impossible pipe dream) but way better than what Focus on the Family claims. Click here for a meta-study on condom effectiveness by NZ MOH or hell, just use a google search on "effectiveness of condoms in preventing STIs". The organisations that promulgate the who ineffectiveness of condoms bit tend to be right wing christian fundamentalist groups.

3. The link in the above two. Given that condoms are made out to be about as effective as the withdrawal method or condoms, guess which one a young teenage male will prefer. Gee. We have a duty to our young female citizens as well, and perhaps it's time to get over some outmoded moral quesiness and perhaps think about allowing teenage girls to obtain oral contraceptives. IT'S THEIR BODY WE'RE TALKING ABOUT HERE. Why the hell we regulate some parts of it while not allow them to take control of their own bodies? But more importantly, expecting females to be able to control their sexual partners to such an extent that they can effectively make them wear condoms is a little too much to expect. Why haven't we started bringing in female condoms yet?

Which brings me very nicely to paragraph 10 and the incident from the 16 year old Normal Stream student who has had sex with 4 partners and was forced to have sex with her first boyfriend but began to enjoy it 6 months later when she dated a 28 yo man.

> Before I begin with the serious discussion bit, let me indulge in a little juvenile humour. I don't get the bit about the 28 yo man except that it probably proves the point that good sex requires experience and practice. So in the absence of actual practicals, theory might help. Perhaps we should provide 'fornication manuals' in schools then. If we believe that reading stuff makes them more knowledgable or better people (moral and civics education for example) then I don't see the real problem with erotica being made available at a younger age. Before you start lighting torches and picketing my place, please note the following: to purchase a Playboy in Australia requires you to be 15. In the Scandenavian countries, it's 14.

But the more serious issue is this. This paragraph is utterly irrelevant in the sense that having sex does not NECESSARILY equate to a higher risk of STIs. She was forced to have sex so I really don't see the bearing on any part of the earlier paragraphs. But more importantly it fails again to distinguish between the 'morality' of pre-martital sex and the necessity of equiping teens to know how to have safer sex.

Which allows me to end with the final quote Madam Halimah Yacob who says, "We need to strengthen the value system of our young, so that they understand the virtues of keeping chaste and shun pre-marital sex and promiscuity." Let's just hope that their husbands and wifes don't fool around then. And that after years of keeping them in ignorance, they will suddenly know everything.


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