Sex education programmes 'not working'

Malta needed an "urgent reappraisal" of its sex education and health promotion programmes, because year after year no improvement was being registered, warned Philip Carabot, who runs the Genitourinary Clinic.

"Whatever we are doing is not working. We need to reappraise where we are going because all the good intentions are fizzling into nothing. Something is wrong somewhere," he insisted. "We must not wait for a crisis situation. This would only force us into a panicked knee-jerk reaction, which would be completely counter-productive."

The GU clinic is already witnessing disturbing situations where sexually transmitted diseases are steadily on the rise - in 2006 cases of HIV soared to a record high of 10 (from two cases in 2000), and gonorrhoea shot up to 32 cases (from 23 in 2005).

Reacting to an opinion poll conducted among 12 European countries, which portrayed the Maltese as the most careless Europeans when it came to contraception, Dr Carabot stressed the need to intensify safer sex health promotion campaigns.

The Bayer Health Care Yasminelle Opinion Poll showed that when embarking on their first sexual venture, 62 per cent of Maltese failed to protect themselves from sexually transmitted diseases or an unplanned pregnancy, preferring to withdraw or use no contraception at all.

Dr Carabot was unfazed by the poll's results, pointing out that all the reports conducted by the GU clinic since its inception in 2000 portrayed the same picture - the vast majority (on average 70 per cent) never used contraception.

"At the same time there is a high rate of casual sex. Although many describe their partner as regular, or even as l-gharus (the boyfriend), this relationship, more often than not, lasts just a few weeks," he said.

"The turnover of relationships is also high, so the actual rate of casual sex is even higher than is apparent."

The clinic's report for 2006, which is just being released, shows that the rate of casual sex is "depressingly, consistently high and showing no signs of diminishing".

Last year 1,946 people attended the clinic, with 70 per cent of these being new patients. The report shows that 46 per cent described their partner as casual, while 67 per cent never used a condom.

"This pattern of high casual sex with very poor condom use is persistent through the years. We must eventually recognise that our sex education and sexual health promotion efforts are simply not adequate and are not giving any positive results," the report said.

Dr Carabot questioned why the youngest Maltese sampled in the opinion poll were 18 years old, when he saw patients as young as 13, and from the clinic's statistics the average age of the first sexual encounter was 15. He was also baffled by the poll's figure on one-night stands, where Maltese (33 per cent), emerged as having the least experience with such flings.

"I disagree that the Maltese do not do one-night stands. To me, this practice seems de rigueur during the weekends in Paceville, at least with some."

The clinic's report recommended that national prevalence studies of the major sexually transmitted infections (HIV and Chlamydia in particular) are urgently carried out.

"One cannot plan any sensible policies without this basic information," the report said.

It proposed that the National Sexual Health policy be rewritten under the chairmanship of a world-recognised expert on the subject. The report also strongly recommended that sex education in schools be thoroughly reviewed.

Charmaine Gauci, newly appointed director of Health Promotion and Disease Prevention, said when contacted that everybody had a role to play in tackling the problem of irresponsible and unprotected sex.

"We need to tackle this matter in a multidisciplinary approach, be it from the health aspect, the education department, the Church, non-governmental organisations, and not least the parents who are in charge of instilling responsibility in their children from an early age," she said.

Dr Gauci said the European opinion poll showed that many Maltese were obtaining information from friends and the internet, which may not always be the correct way of garnering information.

"We need to work harder to find ways where we can reach those who are most at risk," she said.

Did she feel that the Church's message of abstinence was affecting the message of health promotion from getting across effectively?

"It is essential to remember that if we want individuals to take up a particular behaviour then we need to see the person as a whole, including their beliefs. However, we are obliged to present all there is available, as a means of prevention, based on scientific evidence," she said.

"We are seeing an upward trend in STIs in many countries and one needs to assess health promotional campaigns in order to evaluate their effectiveness and decide on the way forward," Dr Gauci concluded.

The naked facts

The GU Clinic's report for 2006 shows some very bleak figures, clearly portraying that the pattern of sexual behaviour remains "depressingly unchanged". These are some of the figures extrapolated from the report:

• There were 10 cases of HIV diagnosed in 2006, the highest figure since the clinic started collecting data. The ages of patients ranged from 31 to 73 years. Nine were male, four were men who have sex with men, and six were heterosexual.

• There were 12 cases of syphilis, a decrease from the record cases registered in 2005.

• Young people (aged between 13 and 25) made up 41 per cent of the new patients - 54 per cent were male and 46 per cent female. The majority (79 per cent) had referred themselves, and 97 per cent were single.

• A high 40 per cent of these young people admitted to illicit drug use at least occasionally, marijuana being by far the most prevalent, followed by ecstasy and cocaine.

• The clinic is very worried about the fact that 35 per cent of young people practise anal sex, at least occasionally (over one third were heterosexual). This high risk activity was significantly higher than the 28 per cent noted in 2005.