January 23, 2013

January 23, 2013


Young People Know Less About HIV
Part 2


Welcome to another day in my life. Today is Wednesday and we have almost made it through the middle of another work week. I hope you are having a beary safe and great week so far. It is another busy week for Dab the AIDS Bear and me.

Yesterday, I started blogging about a recent study I read about young people in France knowing less about HIV and losing their trust in condoms that I will conclude today. If you have not read the blog from yesterday yet I would recommend reading it first.

Results: practice

Are changing beliefs about condoms reflected in changes in use? The answer is yes, in some cases. Condom use at first sex has remained steady, at 62% in men and 50% in women in 1994 and almost exactly the same proportions now.

Before the public HIV campaign, a quarter of men and half of women aged 20-29 reported “never” having used a condom. Seven years later, in 1998, this was down to 3.7% of men and 7.4% of women. Since then, figures have wobbled but, even so, in the last survey only 7.5% of men and 11% of women had never used a condom.

When it comes to condom use at last sex, however, this has declined considerably since the 1990s. In 1998, the peak year, 49% of men said they had used as condom last time they had sex while in 2010 it was 36% (a 27% decrease). In women, these proportions were 38% in 1998 and 24% in 2010 (a 37% decrease).

Condom use among higher-risk people – namely those reporting two or more partners in the past year – has held up, standing at 57% in men and 46% in women, with little change since 1994.

Condom use in longer-term relationships, however, has decreased considerably; in relationships lasting more than six months, last-time condom use has gone down from 60% in men and 53% in women to 41 and 33% where the partners do not live together.

Condom use where partners are married or cohabiting has always been low, and indeed women scarcely report condom use at all with cohabiting partners; in men, it has declined from 15 to 9%. Women also reported a decline since 2004, from 71 to 51%, in condom use with partners known for less than six months, though this was not statistically significant and not reflected in the figures for men (75% for 2004 and 72% for 2010).

Declines in condom use are, by and large, not due to people switching to non-barrier contraception methods. While more people are now using the ‘belt and braces’ approach of using both condoms and ‘medical’ methods (hormonal, IUDs etc.), the proportion reporting using no method of contraception has increased from 9.2 to 19% in men (statistically significant) and 7 to 12% in women (not statistically significant).

Conclusions

General-public surveys like this are interesting but do not directly demonstrate a link between knowledge, behaviour and HIV prevalence, as it is possibly the people who would never have been exposed to HIV in the first place who have stopped taking precautions. Certainly the fact that risk behaviour has not increased in people with more partners is relatively encouraging.

The decline in condom use in longer-term relationships and in particular the decline in their image as the most important way to guard against HIV is striking, though: as the researchers comment, young people may now be more concerned about pregnancy than HIV and may perceive HIV as little worse than other sexually transmitted infections, so condom use has slipped downwards in the hierarchy of sexual health measures.

Hopefully, we can keep this from happening in the United States and help other countries stop the spread of HIV.

Hope you have a beary safe and great Wednesday!

Until we meet again; here's wishing you health, hope, happiness and just enough.

big bear hug,



Daddy Dab