14 Jul 2014

Playing a game of sexual roulette

9:32 am on 14 July 2014

Cersei*, 17, says she doesn’t like condoms. “I’m glad they exist though”.

The Wellington High School student was 15 and using the contraceptive pill when she had sex for the first time. “We didn’t use a condom ‘cause my boyfriend was a virgin. I knew he wasn’t going to have an STI.”

Since then, she says she’s had eight sexual partners and has never used a condom. “I had some very pregnant-making sex, but I luckily didn’t get pregnant. I could have... easily.”

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This kind of behaviour is, by all accounts, not exactly uncommon in New Zealand.

A study of nearly 3000 university students [pdf] aged between 17 and 24 found that only 58 per cent of men and 51 per cent of women had used a condom the last time they had sex. The study also reinforced other data that New Zealand has high rates of pregnancy termination, compared with most OECD countries.

Last month it was estimated 633 cases of chlamydia occurred per 100,000 people. Infection rates were highest amongst women aged between 15 and 19. In general, both men and women aged between 15 and 24 were more likely to test positive than those in older age groups.

We all know the risks of unprotected sex – so why are we taking them?

At the moment, Catelyn*, 23, isn’t seeing anyone, but when she was, she regularly went without any form of contraception. “I a) was terrible at taking the pill and b) couldn’t find one that didn’t make me very depressed … [and] the guys I was sleeping with weren’t really into condoms,” she writes over email.

Catelyn also had trouble accessing contraception – through both Family Planning and her GP – because of her high Body Mass Index.  She should have then used condoms, she says, but she thought insisting on them with her primary sexual partner could cause conflict in “our already shitty ‘thing’”.

There was an element of “morbid curiosity” at play. “It is so irrational. Like, what did I think would happen? I would get pregnant and have to watch my world implode? I don’t even know.”

“I didn't want to use them. But that is such a cop-out.”

Catelyn knew she was risking an STI or unwanted pregnancy: “I think I dissociated myself quite a bit. I never really thought I could be pregnant (despite a number of scares). And I’ve never had an STI.

“I think it got to the point where it was like, ‘Come on, nothing’s happened?’”

What’s more, she says, she’s “pretty terrified” of falling pregnant. There was an element of “morbid curiosity” at play. “It is so irrational. Like, what did I think would happen? I would get pregnant and have to watch my world implode? I don’t even know.”

She does feel like her negative experiences accessing contraception left her angry and ambivalent about the whole thing. “Like, ‘Psssh, if this is what I get when I try?’ Again, not an excuse, but another factor.”

Loss of sensation with condoms is another big factor for many. Tyrion*, 22, agrees he is ardently anti-condom. “They kill the mood. They’re a nuisance. I feel physically separated from the woman, and I don’t mind the extra mess.

“For me, it’s about being as natural as possible.”

Asked whether it’s normal for a woman to take hormonal birth control pills, or have a piece of wire shoved in her uterus, Tyrion shrugs. “I don’t want to have babies. But I don’t want to use condoms. I agree with women when they say it’s their body so they can do what they want with it.”

He says if his sexual partner insists on condoms he'd ask for oral sex instead and would reciprocate the favour.

Tyrion has had chlamydia. Twice.

“It was no problem. I got tested. It came back positive. I took some pills and it was gone.”

He didn’t know that multiple bouts of chlamydia can cause infertility.

He also doesn’t know if any of his nine sexual partners had ever become pregnant. He hopes that, if they had, they’d have told him – and that he would have been supportive, whatever the outcome.

“It’s never happened before. I’m pretty safe with the girls I sleep with. I ask them if they’re on the pill or have an IUD or whatever. The clap wasn’t that bad. Nothing like the ‘pissing razor blades’ the teacher told us about.

“For me it’s just better without a condom. I guess I haven’t been burnt by taking the risk and I don’t think I will be.”

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Because health services, for the most part, do not record the sexuality of patients, there is little data about STI rates among gay males. Joe Rich, spokesperson for Love Your Condom, says the biggest risk for gay males is HIV/AIDS, but estimates that gay men are disproportionately affected amongst other STI infections as well.

Joffrey*, 23, who is gay, doesn’t use condoms because he trusts his sexual partners. “The people I end up sleeping with are friends, whose sexual history I know backwards ... or people I’ve had longstanding casual sex relationships with,” he says.

“But if they ask [to use a condom], I always say yes. I don’t have a huge preference either way; the feeling of no-condom sex is not worth not having sex in my mind.”

His main issue is cleanliness. “Of course, you don’t really know that until you go there.”

Joffrey has never had an STI, though he knows the risk. When he was 16, he had a drug-fuelled unprotected foursome, with two guys he didn’t know, and a friend who he knew had unprotected sex regularly. “It’s a situation I wouldn’t get into now for lots of reasons, but I think I’m lucky that I didn’t catch anything from any one of those people.”

I wish I had not forgotten to take the pill or that I had used condoms. I don’t regret the abortion or the experience overall, but it would have been a lot easier in my life if I hadn’t had to do that. I did insist on condoms after that.

He now prioritises making good decisions about who he sleeps with. “It’s more about trusting your partner than trusting the condom for me. I’m long past the age where I’m having anonymous sex, so I don’t consider myself at risk.”

Margaery*, 28, is bisexual. She started taking the pill when she was 15, and used condoms when having sex with men from about age 16. She got “a bit more lax” in her mid-20s, using condoms about 75 per cent of the time.

“I got lazy, I think,” she says. “I got lucky that far in my life to have not fallen pregnant. So I just became a bit foolhardy, a bit like, ‘Oh well, if it hasn’t happened by now, I guess it won’t happen’.”

She’s never had an STI but she’s fallen pregnant twice. The first time, in 2011, the guy promised he’d withdraw; she took the emergency contraceptive pill, about 60 hours later, but fell pregnant. She had an abortion. The second time, she had a miscarriage.

“I wish I had not forgotten to take the pill or that I had used condoms. I don’t regret the abortion or the experience overall, but it would have been a lot easier in my life if I hadn’t had to do that. I did insist on condoms after that. The guy who got me pregnant also did the same. He had always been of the ‘It’s more the chick’s problem’ persuasion.”

The stakes are greater for sex workers. Brienne*, 24, has been a sex worker for almost three years, and is vigilant about protecting her sexual health. She changes condoms when moving from oral to penetrative sex, or if she’s been having penetrative sex for a while, and subtly checks it’s still in place during the deed.

She gets STI checks every three months, including for bloodborne pathogens, and is vaccinated for Hepatitis A and B, as well as meningitis.

Clients sometimes try to pressure her about condom use, especially when they’re drunk, but she sees it as non-negotiable. “I had to end a booking early because a guy just would not stop asking about it.”

In her relationship, Brienne doesn’t use condoms. “Weve decided that we're both comfortable with the risk, although if I had a condom break at work wed go back to using condoms until I could be tested. That hasnt happened, though – touch wood.”

It seems common that in monogamous relationships, people tend to stop using condoms. And that’s a problem, says Family Planning’s Dr Christine Roke: “Condoms are absolutely useless if they’re still sitting in the packet.”

She recommends using both condoms and a long-acting, reversible contraceptive like an IUD or implant, that isn’t as vulnerable to human error as the contraceptive pill.

“Condoms have got to be put on every time. For somebody who uses them 90 per cent of the time, it’s lovely that they do, but it’s 10 per cent of the time that they’re exposing themselves to pregnancy or STI. Condoms and pills have to be used all the time to be effective. It’s hard work.

“You need to protect yourself. You need to decide if he is worth it. I know that you say you like him, but is he really worth it if he’s not prepared to use a condom?”

Plus, she points out, using a condom can be “quite useful as a semi-treatment for premature ejaculation”.

But Cersei and her classmates Daenerys* and Sansa* say they’re under pressure not to use condoms because of the loss of sensation.

“Heaps of guys don’t want to use a condom,” says Daenerys*. “I have heard heaps of guys saying ‘Na, I don’t like it. It turns me off’.”

“If you’re on the pill, you don’t really need to use them, as long as you know that the other person is clean,” Sansa says.

“You never know that,” Cersei retorts.

Daenerys recently had a pregnancy scare after her boyfriend at the time talked her into not using condoms. “Looking back, it was so stupid. I can’t believe I let him talk me into not using a condom,” she says. “In the moment ... when you’ve got your clothes off and you’re there, you don’t think about the risk.”

* Names have been changed to Game of Thrones characters to protect their identities. New Zealand is a small place.