SEX STUPID?

Peter Ebeigbe recently published results of his study into the ‘knowledge and use of contraception by rural in-school adolescents in Delta State’. The article appeared in the recent edition of the Nigerian Journal of General Practice (March 2012). It makes disturbing reading and I believe every adult especially teachers and general practitioners should read it. He wanted to find out the knowledge and use of contraception by adolescents in randomly selected rural secondary schools. He distributed questionnaires to 233 children, and found that only about half had had any information about how to prevent pregnancies. The information was from doctors and nurses in 17.2%, school teachers in 16.7% and a family member (relatives/elder sister) in 11.2%.  My first question is: what is the input from fathers and mothers? Are we shirking our responsibilities?

In the article, Dr Ebeigbe further noted that about 65% had had sex at age 15 years. But, perhaps more worrying is that only 31% (31 in 100) used a condom consistently, 39% practiced coitus interruptus while 25% relied on ‘washing the private parts’ to prevent pregnancies and diseases! The high level of ignorance highlighted by this study is incredible, especially in this age of the internet and wider availability of information. The second question I have is this: What is the policy on sexual education in our schools and when is such education delivered to the children?

Sex Stupidity

Exposure to sex and early sexual debut in teenagers is a risky behaviour and counter measures must tackle this aggressively. In one report, a substantial proportion of adolescents reported not being able to communicate with their parents about HIV/AIDS, abstinence, or condoms. There is very low level of sexual communication between children and parents and an uncomfortable silence is common across all socio-demographic subgroups. Previous studies suggest that mothers can help adolescents make responsible sexual decisions by talking with them about sexual health.

Yet, it is not clear how and when mothers make decisions about talking with their adolescents about sex. Studies are needed to determine how mothers make decisions about talking with their adolescents about sex, as well as to examine to what extent and in what instances mothers can reduce their adolescents' sexual risk behaviour by providing comprehensive, developmentally appropriate sex education well before adolescents are likely to debut. Information must be provided to children early emphasizing the importance of abstinence and delay in sexual experimentation. With the booming spread of HIV throughout the World, a sex education program in schools is urgent. The government has a duty to our future generations.

Abstinence and remaining a virgin must be promoted as desirable societal qualities. American Academy of Pediatrics recommends counselling teenage children on sexual behaviour and postponing sexual activity. Educated parents are still resistant to impart healthy knowledge and practice of sex with their adolescent children. Most teenagers use their peer groups as the sole responsible guides: to inform them about their sexuality and most of the time, may be driven to the wrong practices. As AIDS is spreading like fire in every part of the World, educating teenagers is an urgent need before HIV makes its way through among the innocent teen children. Parents cannot and should not be ashamed to discuss sexual matters with their children. Do not leave them sex stupid!

Condom use by all

Despite recent reports that there is increasing condom use, generally resistance to condom use is still high. There are studies, carried out between 1990-2004, showing that young people assess a potential partner’s disease risk, and the need for a condom, by their appearance and how well they know them socially. Factors inhibiting condom use and exploring issues of responsibility for safe sex practices to prevent infection must be discussed openly. We need to reinforce the thoughts that safe sex practices (specifically condom use) should be everybody's responsibility. It is not the 'other' persons’ responsibility. Each individual must be equipped with condoms and so eliminate the pressure associated with decisions whether to proceed with unsafe sex or not. With the real risk of such dangerous diseases as Hepatitis and HIV/AIDS on the horizon, you cannot afford to be complacent. It is wise to have a stack of condoms at home and in your wallet. It is foolish not to have one if there is even a remote possibility you might be having sex.

Sex is a dangerous game

With the exception of the few who engage in sexual marathons, most people agree that sex lasts on average about 5 minutes. Thereafter, the effect can last a lifetime with pleasure, pain or death to follow. In this regard, the pleasure could last for a short time afterwards, then followed by more pleasure on the background of a happy relationship, or be trailed by pain in unrequited love and the many tragedies related to unhappy liaisons. Or sex can be followed by tragedy, misery and even death. The question remains: Has attitudes to sex changed over the past decade? Do people now realise that sex is not just a passive pastime and more importantly, that ‘sex is a dangerous game’.  This of course, since the 80’s, is mostly because of the scourge of HIV and AIDS. HIV/AIDS has grown to become the biggest epidemic in modern history.

The people who should know

In 1997, at the Davos International Economic Forum, Nelson Mandela stated that "the poor, the vulnerable, the unschooled, the socially marginalized, the women, and the children, are the sectors of society which bear the burden of AIDS". Nearly a decade later, that statement still holds true, especially in Mr. Mandela's home country, South Africa.  In the same country, former South Africa health minister, Manto Tshabalala-Msimang, nicknamed, Dr Beetroot, was ridiculed for promoting garlic and beetroot rather than antiretroviral drugs for treating the HIV/AIDS. The tragedy was that she managed to persuade her government to apply these beliefs in national health policy, with disastrous consequences. South African politicians, including President Thabo Mbeki bought into such ‘lunatic thoughts’ and tens of thousands of South Africans lost their lives because of their ridiculous policies on HIV/AIDS.

You have heard, of course, seemingly sane people promoting herbal cures of HIV/AIDS in Nigeria. Radio and Television stations, because of the revenue, carry advertising of untested and possibly dangerous remedies. How many people are they killing, inadvertently?

There are huge gaps in the HIV/AIDS knowledge of the people in Nigeria especially the marginalised, rural and uneducated. It is often the fact that many hear of HIV/AIDS after the ‘horse has bolted from the stable’. Peoples’ sexual behaviours are affected by the environment they live in and influenced by thoughts and actions of peers and other people.

Accepted behaviour is reinforced within the community and is difficult to change by external interests or even health personnel. But we must try. Doctors, nurses, the educated and those in government should have up to date knowledge of best sexual health practices and the risks inherent in unsafe sexual practices.

No street cred

The point to note is that HIV/AIDS has no street credibility. You cannot be proud to have AIDS. It is not like cancer which is acceptable in the community and which can even be ascribed to a spiritual attack. It is currently not a disease to be proud of, despite the number of high profile cases in the news. HIV/AIDS is not fashionable and is regardless of how you contracted the disease. It could be you were infected by your loved one, or via a needle stick injury in a hospital or blood transfusion. It may even be after your very first sexual experience. It does not matter. Nobody truly cares about the history and how many people are you going to tell? As always, prevention is better than cure.

Sex is a dangerous game: it has always been, but more so now than ever.