Young Canadians' knowledge-behaviour gap in safer sex practices

Teenagers and Safe Sex

Despite efforts to educate youth regarding safe sex, the practice of safer sex is still not at optimum levels. This is due to several factors, but chief among these is the belief of "invincibility" among youth, the belief that "it won't happen to me." In order to implement effective campaigns to increase safe sex practices in teenagers, education efforts must be directed to combat this false notion of safety, and problem-solving skills must be taught to facilitate the implementation of this knowledge.

Although sex education is a component in most schools' curricula, there is some question about the effectiveness of its message regarding safe sex. Since "by age 17 about half of both males and females report having had sexual intercourse" (Bee et al., 2003, p300), the necessity of delivering accurate information about sexually transmitted diseases (STDs) and HIV / AIDS transmission is critical.

Bennett and Murphy (1997) point out that, although we may assume safe sex knowledge among teenagers to be adequate, "the low prevalence of safer sex practices may still, in part, be attributable to a lack of knowledge." (Bennett & Murphy, 1997, p70). They consider this possibility based upon research that has been done (Wenger et al. In Bennett & Murphy, 1997) that indicates even when a person considers their sexual behavior to have been "safe," in many cases it was not. This indicates that the foundation of any targeted campaign to reduce HIV transmission in teenagers must have accurate information as a prerequisite.

Once a foundation of knowledge has been established, safe sex campaigns for teenagers can aim specifically at targeting high risk behavior. When HIV transmission is the issue, getting youth to use condoms is the major goal. However, even when teenagers express the intention to use condoms, research indicates that they often do not.

There is one area in which people's attitudes are often inconsistent with their behavior, even though the consequences can be fatal. The inconsistency takes the form of their having positive attitudes toward using condoms, expressing intentions to use condoms, but then failing to actually use them in sexual encounters. (Aronson et al., 2004, p233).

Targeting such high risk behavior as unprotected sex seems like a simple solution, however, as Aronson points out, even affecting teenagers' attitudes doesn't necessarily lead to a change in the behavior.

For the purposes of the first goal of a HIV / AIDS campaign aimed at youth, the education component would ideally be administered in schools. This could be incorporated as part of the curriculum and would reach most teenagers in question. However, education campaigns to date have fallen short of their goals and would need some changes to be more effective. A more accurate assessment of the risks associated with unsafe sex should be included so teens appreciate the data that supports the message. Different delivery media have also proven to be effective. Videos that inform and encourage situational coping skills have been shown to work. "These permit ways of handling conflict, embarrassment, and stress surrounding the potentially awkward social transactions required in sexual risk reduction to be modeled." (Bennett & Murphy, 1997, p71).

An important extension of the basic educational efforts to reduce high risk sexual behavior is the additional of skills training and problem solving. Specifically, youth must be introduced to strategies for introducing condom use when the situation presents itself. This has typically been where safe sex campaigns fall short, as even when teenagers' attitudes are favorable toward condom use, an awkward situation can cause them to ignore these attitudes and engage in high risk behavior. "Even when they are knowledgeable about STDs, many teens may lack the assertiveness necessary to resist sexual pressure from a romantic partner or to discuss condom use." (Bee et al., 2003, p301).

There are various methods being used that foster the assertiveness necessary to insist on safe sex practices. Seminars are conducted in schools that deal with specific issues such as broaching the subject of safe sex, and putting on a condom. Role-playing has proved to be an effective way of encouraging these skills. Research conducted at the University of British Columbia (Dahl et al., 1998) has found that groups of students who actually went on field trips to buy condoms were more likely to use condoms after the study was over. The embarrassment over buying the condoms was considered to be a significant impediment to implementing safer sex practices.

Another promising area of research regarding safer sex and HIV transmission involves the promotion of cognitive dissonance in the subjects. Researchers emphasized to subjects the discrepancy between their stated intentions and their actual behavior. This was done by encouraging students to advocate condom use to other students. When these students were not behaving in accordance with their role as peer advisor, their hypocrisy often motivated them to adopt the safer practices. This points to potential new methods of influencing behavior change by actively recruiting students to spread the safe sex message to their peers.