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The ‘casual shag’ – a case of rebranding, or a misguided attempt at health promotion?

July 14th, 2008

Dr Petra

If you’ve read the papers today you can’t have missed the headlines screaming about the rise in the ‘casual shag’. I’m not talking about a type of bird or a groovy expression Austin Powers might say. No a ‘shag’ is a catchy new acronym thought up by the Health Protection Agency (HPA) which stands for ‘Syphillis, Herpes, Anal Warts and Gonorrhoea’.

According to the HPA there has been a 6% rise in the overall numbers of diagnosed STIs since 2006 in the 16-24 year old age group. New cases of herpes are up by 20% with a 7% increase in warts and chlamydia.

To try and draw attention to this problem the HPA are now talking about the risks of a ‘casual shag’ – with a spokesperson saying ‘It’s increasingly the case that among young people a casual shag is part of the territory, it’s part of life’.

Which is a bit of a problem.

Now I’ve absolutely no issue with the HPA creating a clever term to alert us to rising STI rates. There is undoubtedly a major crisis we’re facing in the UK around our rising STIs, particularly ones like syphillis and herpes that had been controlled well by public health workers, but are now on the rise. And that’s alongside infections like chlamydia that now affect 1 in 10 young people.

My problem is the pairing of the term ‘casual’ with ‘shag’. If the HPA were just to talk about how having a ‘shag’ could put you in contact with STIs I suspect people would listen and remember what ‘shag’ stands for. But including ‘casual’ undoes the work the HPA have put in as it’s judgemental, preachy and above all else indicates the HPA are out of touch with young people.

Before it seems like I’m just making excuses for young people, let’s look at the facts. We know that many young people in the UK do not get adequate sex education. Those who do get education often complain they are told lists of names of STIs and contraceptives – but are not told how to negotiate safer sex, or what STIs may do to them. Often STIs in particular are used as a scare tactic in sex negative education, with some teachers incorrectly believing if you show images of yukky infections it’ll put people off having unprotected sex.

The thing is most young people assume they won’t get an STI. They assume it’s something that happens to someone else. They reason the person they’ve met looks hot and therefore couldn’t possibly be carrying any infection. They may well believe a potential partner who says ‘I’m clean’, or incorrectly assume because they are using contraception like the pill that they won’t get an STI. Many STIs are asymptomatic so warning signs may be missed, and most young people in the 16-24 age group are far more worried about an unplanned pregnancy than contracting an STI.

At the same time as young people are not fully informed about STIs, prevention and how to negotiate safer sex; they are also living in a highly sexualised culture that tells them to be a fully functioning adult they ought to be having lots of sex all the time. Drugs and alcohol play a role within socialising and sex, which can make it difficult to remember to use a condom, ask a partner to use one, or put one on correctly. Most young people may have been told about STI names, but they don’t know where to get condoms, how to use them, that they are free, and that reproductive health services are confidential (meaning their parents won’t be notified if they use them). These issues make it difficult for young people to adequately manage their sexual relationships.

The HPA’s use of the term ‘casual sex’ ignores these complex factors – which is worrying since evidence clearly tells us this is what is going on in young people’s lives. Even more concerning is the misunderstanding of young people’s relationships by calling them ‘casual’. As adults we may define a ‘relationship’ as something long term – something that lasts for several years. For young people it would be inappropriate to expect them to be in a relationship that lasted so long. It is equally inappropriate for us to assume because young people are having relationships that last for a brief period that these are less relevant.

Some young people may well have several sexual partners. They may do this because they want to explore sex with different people, or because they are trying to get into a relationship but don’t manage to achieve this. They may have multiple partners because they feel pressured by their friends.

The main problem for young people is if they are having multiple partners and not practicing safer sex, are having sex because they think it will get them a partner (or stop a potential partner from leaving), or are having sex to fit in with their peer group. This represents sex that isn’t working for someone, but to just dismiss it as ‘casual’ belittles the experience of young people and makes it less likely they’ll access support or education services. If a young person has deliberately decided to have some sexual adventures but are upfront about this and always use condoms then we’re wrong to use labels for them that imply they are irresponsible when they are not.

In fairness the majority of young people are having unprotected sex because of a lack of education, information and often peer pressure or the effects of alcohol. But again slapping on a negative label won’t make them think ‘hey I could be at risk from STIs, I’d better use a condom’, it’ll simply be another way to worry parents and leave teens excluded.

The HPA are clearly worried about STIs and are trying to reduce the prevalence of infections. But they don’t seem to have looked at the wider evidence base, they don’t seem to have listened to young people, and they don’t seem to have looked at what other government agencies are trying to do in their public information campaigns.

The idea of drawing attention to STIs with the term ‘shag’ was a great one. But what a pity the HPA felt they had to stick to the standard approach of sexual health by using negative labels and teen blaming. If they’ve any evidence this approach works I’d love to see it. Yes, they got media coverage but did any young people change their behaviour as a result? I doubt it.

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