RECENT articles and letters on premarital sex among our youth seem to suggest that the answer to this issue lies in "a robust sexuality education package" promoting the use of contraceptives ("Teen births drop to 20-year low"; Feb 9, and "Sexuality education, support still needed" by Mr Han Ming Guang; Feb 13).
Such an approach presupposes that:
contraceptives are effective in cutting pregnancy and sexually transmitted infections (STIs);
teens will use contraceptives correctly all the time.
Some doctors have noticed an increasing number of youth who have asked for the morning-after pill in recent times.
The condom may help reduce the risk of acquiring STIs, but not entirely.
It can reduce the risk of HIV transmission by about 80 per cent, gonorrhoea by about 50 per cent to 62 per cent, and chlamydia by about 26 per cent.
It offers less protection against STIs that are spread through skin-to-skin contact, such as herpes and genital warts, since there are areas of the genitalia that are not covered by the condom.
The condom can be effective in reducing risk only when it is used consistently and correctly. Many people, especially youth, do not use it consistently.
Studies have shown that condom use declines with time because of a phenomenon called "condom fatigue".
One local survey of at-risk youth also found that about 42 per cent experienced slippage, and about 32 per cent experienced breakage.
An adequate response to this issue must go beyond a merely biological response.
Dr Stephen Genuis says in the British Medical Journal that merely promoting condoms "disregards the complex nature of human sexuality and fails to tackle the underlying social and emotional needs of young people, who are often trapped in high-risk sexual behaviour as a consequence of difficult life circumstances".
A 2004 consensus in medical journal The Lancet emphasised the importance of calling for a delay of sexual debut in youth or the return to abstinence in those who are having casual sex.
Studies have shown, and counsellors agree, that teens are less likely to engage in risky behaviour when they have good self-esteem and good relationships with their parents.
We must, therefore, find ways to involve and empower parents in sexuality education, especially since they are the primary educators of their children in the first place.
John Hui Keem Peng (Dr
This article was first published on Feb 21, 2015.
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