How can you talk to your child about difficult topics, including HIV and sexually transmitted diseases?

Interview with Professor Zbigniew Izdebski, Head of the Department of Humanization, Medicine and Sexology, University of Zielona Góra and the Department of Biomedical Foundations of Development and Sexology at the University of Warsaw.

Do Poles engage in risky behavior more often now than a few years ago?

If we consider risky behavior as intimate contacts in relationships that are not constant, in which we do not know the partner’s past, we do not know their previous sexual experiences and their serological status, we can say that more often. The number of casual contacts is also increasing, although it should be said that in general the sexual activity of Poles has been decreasing over the last 10 years. Looking at the frequency of intercourse, Poles are not as sexually active as they used to be, but at the same time they engage in risky sexual behavior more often. They are most common in the group of young people and in the group of men who have sexual relations with men (MSM).

According to my 2017 research entitled “Sexuality of Poles”, interest in oral sex is growing in Poland – it was declared by 65% ​​of men and 63% of women. In 2005, however, there were 50% of men and 35% of women, respectively. If we look at the issue of experiences with anal sex, it is also clear that the number of such people is increasing, because in 2005 there were 16% of men and 12% of women who had such experiences, and now there are 22% of men and 20% of women. We can say without any doubts that anal sex without a condom is the most dangerous form of sexual relationship from the point of view of HIV.

I have the impression that Poles have become too familiar with the subject of HIV and therefore feel less fear of being infected. My 2017 study shows that only 5% of men and 3% of women experience the fear of contracting HIV. In turn, in studies from 1997 or 2001, fear of HIV and unplanned pregnancy were the most frequently mentioned fears in sexual relations. Please note how disturbingly far is the fear of HIV today, and the fact that less and less is said about it makes Poles think that this problem does not concern them.

What are the dangers of risky behavior?

Each of us, when entering into sexual relations, must remember that he is responsible for his own health, but also that of his partner. Generally, Poles are not afraid of other diseases because they have a low awareness of sexually transmitted diseases. 74% of the condom is used as a contraceptive method. The fear of contracting a sexually transmitted disease, venereal disease, is 5% for men and 2% for women. What is the greatest difficulty in approaching sexual matters is fatigue and stress – this is what 21% of men and 31% of women think, fear of unwanted pregnancy – 13% of men and 26% of women. My illness and malaise – 9% of men and 16% of women. Please note that fatigue and stress have never been so high in the difficulty ranking. Consider the analysis of the lifestyle of young people working in corporations, earning well, but constantly under the influence of great stress at work and relieving this stress during the weekend. This is a group of people who often engage in very risky behavior.

The desire to satisfy our passions and drives is so great that sometimes we become irrational. People who are highly aware of the HIV problem, have a lot of knowledge about it, and yet engage in risky behavior, are also infected. We are now in a more difficult situation than a decade before. Much has changed in favor in the area of ​​treatment, but this means that in the group of people who behave risky, there are uninfected people who mentally allow themselves to be infected.

 Who should be tested for HIV and tested for other sexually transmitted infections?

Tests should be done by everyone who has ever undertaken risky behavior. It’s not about frequency. If someone engages in sexual behavior and does not use a condom or does not know who they have had sex with, they have engaged in risky behavior. After all, we do not know when an infection may occur. What is a barrier to HIV testing? Even in the group of pregnant women, despite the recommendations of the Polish Gynecological and Obstetricians Society, despite the educational campaigns of the National AIDS Center, these tests are not commonly performed. So – we either idealize our partner’s past, or we believe that it does not apply to us, or we feel offended by the fact that someone offers us a test at all. Fear of taking the test may occur in those people who often undertook various risky behaviors and prefer to live in the unconscious than to be examined.

Why is it so troublesome to talk about difficult health topics, especially with your own child?

Because we are raised and educated in a way that the topic of sexuality does not usually arise. Over the years, nothing special has changed. There are homes and schools that mostly do not deal with sexuality openly. Unfortunately, parents feel deeply reluctant to talk about sexuality, and some do not even have the right language. Sometimes they have a good knowledge of human sexuality, but due to psychological resistance they find it difficult to talk to their child, even though such a conversation is not troublesome for them with other children. For this reason, parents should consistently require the school to thoroughly implement a pro-health program related to sex education, which will also talk about HIV / AIDS.

How can parents overcome the resistance to having such conversations?

Let’s start with the fact that we should teach children to use the correct terminology not only in family life education classes, but also in biology, Polish, or during educational hours. In an appropriate formula, similar education should also be conducted with parents so that they are aware of their children’s educational needs and their level of psychosexual development. Parents often know that adolescent sexuality exists, but they do not allow themselves to think that their child may be sexually active. And my research shows that 15% of Polish teenagers have sex by the age of 16.

So how should these discussions be conducted?

Parents may not feel up to having such an interview with their child. Therefore, you should look for excuses to talk. For example: Poles often watch TV series in which, among others, the topics of sexuality, betrayal, drug use, violence, sexual orientation, disappointed love, unplanned pregnancy, etc. are discussed. In my opinion, all these are pretexts for parents or grandparents to raise this topic at home and encourage other household members to express their views. The point is not to ask directly if the child experiences such situations, but whether what is shown in the series or in the reportage may also apply to them. How does it feel about that? If we do not talk to children about the dangers, including those existing in the Internet space, we will not know what environment they live in and what they are exposed to.

What is the reason why young people prefer to search for information on the Internet and not from their parents?

There is a lot of resistance among children to discuss sexuality with their parents. And it is not a question of their concerns. Children often feel uncomfortable asking mom or dad what to do when they have sexual health problems. Therefore, the child does not ask or talk to the parents about these topics. Often, parents are surprised that it takes up such a topic at all. Many times children’s knowledge of sexuality is vulgar, which does not mean that it is small. Young people sometimes don’t know how to talk about it, but they know how to do it because they’ve seen it in movies, often pornographic, that don’t correspond to reality. The intimate close-ups shown in them can be vulgar and very risky. Unfortunately, some people build their image of sexual relations on this basis. On the other hand, parents deny the fact that such negative education may also apply to their child.

Should the popularity of online dating sites among young people be a concern, or is it just a natural consequence of the technological revolution?

Dating sites do exist and I treat it as one of the manifestations of social changes. In my opinion, they have already entered our lives firmly and will not disappear because people have gotten used to them. However, we must be aware of what they are, what we are looking for in them and how we should behave. I do not judge whether it is moral or immoral. It is important to know if it is safe for your health.

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