Let's talk condoms

It’s National Condom Week 2007. We know that to bring about the dramatic decline we need to see in rates of sexually transmitted infections (STIs) we must encourage much greater use of condoms, alongside other forms of contraception that protect against pregnancy.

In 20 years we have seen dramatic changes in public attitudes towards condoms, but there is a long way to go.

This week see how many times you can talk about condoms, see if you can slip them into conversations wherever you are and whoever you’re with. Have one hour each day when whatever you are asked you reply condoms, play word association games starting with condoms, have serious conversations with your children and friends about condoms & safer sex. Just get everyone talking about them. Be a condom champion.

Emergency contraception - myths and misinformation

About a decade ago I went with a friend to a health centre for emergency contraception. Let’s call my friend Susie. Susie went bright red as she was asked loudly at reception why she was there – “the morning after pill” she tried to whisper and was asked to repeat louder. She was so red and hot, I thought she may explode. We were told to sit down and wait. I tried reassuring Susie who felt embarrassed and ashamed, “accidents happen, no, you are not a slag. No, no-one heard you”. Imagine her horror when the receptionist bellows “where’s the one who needs the morning after pill?” And then, dropping her voice to normal levels to say, “room one”.

Fast forward ten years – A woman like you, a woman like me - a report published yesterday by Schering Health Care Limited, is an interesting read. It is a tale of myths, misinformation and embarrassment about emergency contraception. Emergency contraception is most often used by women aged 25-29 who are in a long term relationship, and yet the report reveals the incorrect perception that it is most likely to be used by teenagers, students and single women. It also shows that many women still lack basic knowledge about where to get emergency contraception, how it will affect them and how it works.

I wish I had been surprised by the findings. So what can we do so things change in the next ten years?

- Stop talking about the morning after pill and start talking about emergency contraception
- Accept mistakes happen and that taking emergency contraception is much more responsible and gives greater peace of mind than crossing your fingers
- If or when you use it, tell someone – don’t keep it a guilty secret
- Think about your workplace, school or college – what can be done to promote the truth about emergency contraception….which is that it is responsible, safe and easy to use it and that it is used daily by women just like YOU.

With these changes the next time someone like Susie needs emergency contraception there should be no stigma; no shame or embarrassment, just a recognition that she is taking responsibility for her sexual health.

Brook meets the young farmers

Last weekend Brook had a stand at the National Federation of Young Farmers Clubs annual convention in Torquay. Five people from across the Brook Network gave out condoms and talked with delegates about sex, sexually transmitted infections and sexual health on two of the three big ‘disco’ nights. We also ran a quiz about sexual health which included the question “what is the most important thing for you to know about sexual health?” Among the responses: “be careful it can kill you”; “it’s good fun”; “always use a condom”; and “practice often but be safe”.

Both Brook and Young Farmers staff observed how much more confident people were coming to our stand on the second night to ask for condoms or advice. We know that changing cultures and attitudes towards condoms requires community interventions. We need to promote dialogue with young people and make the issue visible.

We enjoyed ourselves thoroughly and are now busy identifying other opportunities like this through which we can help make condoms a mandatory requirement for young people on a big night out.

Valuing health

I recently went into the West End for some new clothes and apart from the crowds (I am from Cornwall) I loved the big stores. I started thinking about advertising and what attracts us to buy things or catches our attention. Young people, like adults, are bombarded with sophisticated advertising, and when they go shopping, it is a real experience. Stores are exciting, slick and cool and researchers have spent thousands and thousands working out what will appeal to their audience. I was left wondering how do adolescent health services fare in comparison and if they don’t fare well what message does that give to our young people – that their health is not as valuable as fashion or music? And if that is the case, what do we have to do better to make health an important asset for young people that they value and ‘invest’ in?

Brilliant relationships education

The other day I was just walking home from the bus. A few feet in front of me two women were holding hands, and between the two women and I, a man was walking with two children aged probably about 4 and 6. The older one asked, ‘daddy why are they holding hands?’ and he simply said, ‘probably because they love each other and so it is nice to hold hands’. And then they carried on talking about what they had done at their friend’s house. Brilliant, brilliant relationships education. I am not a fan of listening in to other people’s conversations but I am glad I couldn’t help but overhear this one – it set my day off to a flying start.

Why the words 'sex' and 'secret' don't go together

Last week I was given some publicity about a condom scheme for young people. Generally it was brilliant. But there was a sentence that worried me. It described their policy on confidentiality as being about keeping a secret. I fully understand the message it was trying to convey to young people and yet to me the words ‘secret’ and ‘sex’ should not go together. Too many people with huge courage and dignity who I know personally and professionally have told me that as a child they never told anyone about the sexual abuse they experienced because they were told it was a secret between them and the adult who hurt them.

About a decade ago, Brook published a poster with the simple and powerful statement, here to listen, not to tell. It was produced because young people told us they worried their parents or carers would be told if they asked for contraception or sexual health advice. Ten years on, confidentiality continues to be one of the top concerns of the young people who come to us. Brook is the leading advocate for confidential services for young people and I believe absolutely and passionately in young people’s right to confidential services. But still I am unsettled by the word ‘secret’.

If sex is not talked about openly and sensibly children learn to be embarrassed and ashamed by it. Nowadays many live in two worlds – one where sex is everywhere, with sexually explicit images easily available via new technologies; and another where sex evokes virtual silence. With silence there is inevitably shame, embarrassment, guilt and secrecy.

So when I read publicity for services that says ‘we keep everything secret’ I worry about the message this gives young people about sex. Yes, we must recognise where we are now and the importance of confidentiality. But to really change the world, we must also open up the conversation and help create an environment in which young people can talk about sex so they can enjoy it, take responsibility for it, and get the help they need from parents and professionals. I look forward to the day when young people are as confident about going for sexual health and relationships advice and counselling, as they are about going for a haircut or to the dentist.

A bit of respect!

I was leaving a Brook Centre yesterday just as it was opening. About 12 young people had settled in the waiting room within the first few minutes. As always I listened and watched for the intimidating young people that the papers write about – I couldn’t see them. I looked for the noisy and uncontrollable youth that people talk about on the bus – I couldn’t see them, and I looked for the sexually irresponsible young men that dads warn their daughters about – there were none to be seen.

The young women and young men sitting in this waiting room were waiting patiently for their turn, talking to each other and supporting one another. They were excited, nervous, worried, brave, responsible and respectful. Are they unusual? Not in my experience. As I left the Centre I said to the receptionist that I would love to bring those adults who fear or condemn young people to observe this waiting room. Her response: ‘as long as you are good to young people, they are good to you. The trouble is, if you bring someone who doesn’t like young people into the room, they smell it and the mood changes, so it wouldn’t really work’.

Many of our European neighbours have very different attitudes to young people. They want young people to be happy, to be safe and responsible in their intimate relationships. We rightfully continue to look for evidence of the effectiveness of our work but how do you measure the impact of care, respect and attention on young people’s sexual health? A randomised control trial won’t do it – but if you want to visit a Brook waiting room you will see that it works. As Dona Milne said in her reply to an earlier blog yes we need to involve young people and listen to their views, but they don’t really ask for much, a bit of respect, a friendly service and people who like them. I agree with her and in my experience when you really enjoy young people’s company you keep on learning, you keep on living and you keep on laughing. A win-win situation.