| Who listens to the safety drill when you’re on an airplane, right?
Well you might sit up and listen if the flight attendant was wearing a penis costume. And I’m sure you’d pay attention if he or she was being chased to the back of the plane by someone dressed as syphilis.
That was the thinking behind a recent campaign in San Francisco that aimed to draw attention to the shocking rise of syphilis among the city’s gay male population. "These kind of clever, creative, community-based programs work," says Dr. Gina Olgilvie, the associate director of STD/AIDS Control for the B.C. Centre for Disease Control.
I don’t know if a guy dressed as a penis being chased by syphilis man would make you buckle your safety belt, but the "Healthy Penis" campaign did mafe a few more gay men in San Francisco put on a safe. And, according to Dr. Olgilvie, it definitely made more of them get tested.
Clearly, knowing your audience – in this case, a savvy, hip community immune to more traditional safer sex messages – is the key to getting people to take notice, says Olgilvie. But getting the message out to today’s youth, who believe they are "immortal, invincible and infertile," is a huge challenge, says Olgilvie.
Obviously, messages like the following – "The fountain source of venereal diseases has overflowed and the contaminated waters are rushing rapidly toward helpless children, to homes, whose doors are open to the relative flood into schoolhouses and where its running and oozing slime can penetrate" – from William Lee Howard’s 1910 Plain Facts on Sex Hygiene, while no doubt sufficiently dramatic to perk up an ear or two, aren’t so helpful in this day and age.
For one, no one calls them "venereal diseases" anymore. Today, they are more accurately referred to as Sexually Transmitted Infections (as it is viruses and bacteria, not diseases, that are being transmitted). Still, STIs – while maybe not flooding schoolhouses – are definitely rising rapidly.
"Numbers were decreasing in the late ’90s, but rates of chlamydia, gonorrhea and syphilis are all increasing," says Olgilvie, adding that rates of syphilis are the most alarming. "We had all but eliminated it in the mid-’90s," she says. "There were .5 cases per 100,000 but now, in urban centres like Vancouver, Toronto and Montreal, we’re seeing five to six cases per 100,000."
Olgilvie sites less condom use among certain populations – mainly men having sex with men – as part of the reason for the rise.
"There is a sense that HIV is treatable so there is less panic," she suggests. Olgilvie also believes there is a perception, whether true or not, that others aren’t being safe, so "why should I?"
The other perception is that oral sex is safe when, in fact, both syphilis and gonorrhea can be transmitted this way.
The good news is that, unlike in the past, both infections are easily treatable. Of course, you have to know you have them first. Syphilis will most often show up as a chancre sore, usually on the genitals. But, if the sore is on the cervix and not painful, it may go undetected. Or if it’s near a male’s scrotum, he might not see it, says Olgilvie. If untreated, more serious symptoms – from hair loss to neurological problems – can show up. Transmission to the fetus in pregnant women is also a serious risk.
Syphilis isn’t the only STI making a comeback. Recently, a rarer STI called Lymphogranuloma Venereum (such catchy names, these STIs), or LGV, has re-emerged.
LGV is caused by chlamydia and symptoms include inflamed lymph nodes, abscesses and scars, explains Olgilvie. "We saw it first in the developing world but never in North America." As of May of this year, 22 cases have been reported in Canada.
Again, LGV is treatable, but you have to know you have it, which can be tough since early stage symptoms are often painless and undetectable.
Which is why using condoms and getting tested regularly is so important, says Olgilvie.
Well, duh, right? So why aren’t we?
Part of the problem is education, says Olgilvie. While Canada recently revised its national guidelines for sex education (http://www.phac-aspc.gc.ca/publicat/cgshe-ldnemss/cgshe_ack1.htm), there is no national sex ed curriculum, meaning sex education is inconsistent from province to province. It’s also the first thing that gets cut when there are fiscal concerns, adds Olgilvie.
But rising STI numbers may not be all bad news. Numbers may be up because more people are getting tested and screening methods have improved, she suggests.
"We’re also seeing a decrease in PID (Pelvic Inflammatory Diseases), ectopic and tubal pregnancies," she says, all long-term risks of undetected and untreated STIs like chlamydia, meaning people are getting tested and treated earlier.
More effective, single-dose treatments are also now available and research into STI vaccines is positive, adds Olgilvie, with an HPV (human papilloma virus, or genital warts) – vaccine expected to be on the market within 18 months.
But the bottom line?
"You can only acquire an STI from someone else," she explains. "So if everyone were safe from day one, we could rapidly decrease these numbers."
Simple, right?
But people still don’t know how to negotiate safer sex, says Olgilvie.
"We don’t get freaked out discussing what restaurant to meet at for a date, but we can’t handle talking about taking care of each other’s sexual health," complains Olgilvie. "Obviously, you don’t want to bring it up in the heat of the moment," she says, "but letting someone know that you care about him or her and want that person to be safe should be a positive, natural thing."
Sadly, fear of judgment often holds us back.
"It only takes one unprotected encounter to contract an STI," explains Olgilvie.
In other words, disclosing an STI and/or insisting on using a condom doesn’t automatically make you a big old slut.
And, as I always say, if someone is going to judge you for being honest and wanting you both to be safe, what are you doing with the lunkhead? |
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