Sexually transmitted infections among young people: enough of a moral panic
It's become common lately to read news reports every few months explaining the rise in sexually transmitted infections (STIs) among young people. The reasons need to be explained clearly. STIs have changed. Fortunately, we are no longer facing the same epidemiological reality as 10 or 20 years ago. Today, the most common STIs among adolescents and young people—chlamydia and gonorrhea—are bacterial, easily detectable, curable, and with very rare and extremely limited serious complications if treated early. In many cases, they are even self-limiting. However, the collective narrative—often fueled by professional discourse—remains anchored in old imaginings, with HIV as the sole and universal symbol of risk, fear as a preventative strategy, and the focus of blame on certain groups, hand in hand with stigma. It is key to recalibrate the situation and the risks, constructing more realistic, up-to-date, and useful messages for young people.
The reasons for the increase in STIs in Catalonia and many other countries are diverse and complex. In the Catalan case, this increase is also—paradoxically—a consequence of things we've done right. Public health has these qualities... Epidemiological surveillance systems have improved significantly, more screening tests are being done than ever before, and progress has been made in other key aspects of public health that indirectly affect STIs, such as expanding access to the morning-after pill, long-term contraception, and, undoubtedly, the way young people view sex is more open, informed, and connected to pleasure.
However, there are also things we haven't done right. There's a lack of comprehensive sex education—something that should shame us as adults—which leaves a gap that's being filled with misinformation. The health system still doesn't quite know where to place adolescents and young people; patriarchy continues to permeate relationships, and sexual violence is an all-too-present reality. If we want to move forward, we must face these shortcomings with responsibility and courage.
Therefore, we must begin to construct honest and useful self-care messages, without exaggerations or treating adolescents and young adults as children who need to be tricked or scared into doing what we want them to do. We must trust in each person's decision-making capacity—regardless of their age—and ensure that they can do so with all the information, without judgment or stigma.
And, above all, by simply presenting STIs as what they are: an unwanted consequence of sexual relations that we must try to avoid but also learn to live with. And this means normalizing and supporting secondary prevention and regular screening as a self-care mechanism. It seems we have a hard time admitting that zero risk doesn't exist and that it's not easy for anyone to always protect themselves with a condom.
This has been the spirit of CJAS, the Youth Center for Sexuality Care, which recently launched the Cuida't program, an initiative designed to facilitate access to routine STI testing as much as possible through quick visits, without an appointment, without judgment, and with self-collection of samples. The lesson we draw is clear: when young people are given the conditions to take care of themselves, they do so. There's no need to impose, just trust and facilitate. And we must continue to innovate, and the Testa't Jove project, promoted by CEEISCAT with funding from La Marató de TV3, will have a lot to say. It wants to explore new forms of access, such as sending kits Home self-sampling. It's a bold commitment to sexual health adapted to the present: more agile, more accessible, more people-centered.
In short, enough of the peevish song in which we indignantly ask ourselves what's happening with STIs and young people. We need new answers for new realities. Realistic and current solutions, leaving aside the ghosts of the past. Perspectives that trust and care, and a collective commitment to leave moral panic behind and move toward a culture of dignified, free, and meaningful sexual health.
