Forum for Nordic Dermato-Venereology Nr1,2019 | Page 14

Margret Lindberg, Magnus Lindberg, Ann-Britt Ivarsson and Annsofie Adolfsson – Attitudes to Risky Behaviour Among Young Adults
Treated for Chlamydia at an STI Clinic: A Qualitative Study
One of the justifications was that everyone else was drinking
and they were therefore going along with the crowd. One
interviewee admitted to working specifically in order to af-
ford buying alcohol and participating in nightlife and social
activities.
“If you are drunk you are obviously not thinking very clearly
and you can end up taking risks.”
The interviewees acknowledge that they put themselves in
compromising situations when under the influence of alcohol.
When sober, they would not even consider undertaking the
behaviours they engaged in when drinking.
Interviewees described that they would regret making the
decision to have sex in a drunken state. These people were
clear that having sex with strangers represented risky beha­
viour. Even though they were normally aware that this sort of
risk-taking was not a good idea, in the drunken state and the
heat of the moment they went with their impulses.
“You are in the heat of the moment and you see how far it
goes. It’s fun…exciting.”
These types of situations illustrate what happens when indi-
viduals go along with the crowd by consuming alcohol and
engaging in risky sexual behaviour. Judgement is impaired
and behaviour is influenced accordingly.
“When you’re drunk, you don’t use a condom, thus taking
more risks.”
Only one of the interviewees said that they used alcohol
because it tasted good, especially in social contexts, such as
sharing a meal. The person with the lowest consumption
described their usage as:
“I drink a little alcohol when I hang out with nice people.”
Using condoms is embarrassing and awkward
Regarding information about sexually transmitted diseases, it
appears that all of the participants had received information
at some time, from either school, parents or friends, about
the importance of condom use as protection against sexually
transmitted diseases.
Choosing not to use a condom is risky behaviour. Most of the
interviewees did not use condoms. The majority of interview-
ees considered condom use to be a matter of course, but they
had still somehow contracted chlamydia. The explanations
for not using condoms varied and the most frequent were that
it was embarrassing and awkward, not to mention there was
a degree of difficulty. The combination of the awkwardness
of using a condom and the embarrassment in suggesting it
sometimes discouraged use of condoms.
“Nobody proposes use of a condom, since it’s embarrassing.”
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D ermato -V enereology in the N ordic C ountries
“The condom thing ruins the moment and you basically don’t
care when you’re drunk.”
“It is what it is and it is pretty obvious, you get carried away
even though it is not so smart. But when you are drinking it
is easier to just not bother about it.”
One informant described that they would be forced to argue if
they wanted to use a condom and this would have the effect
of ruining the moment. Those who insist on using a condom
put themselves at risk of being rejected because of it. Another
informant said that if they were going to have sex abroad, they
would always use a condom.
“I am convinced that condoms make a difference, but it isn’t
always the actual case realistically.”
“I usually regret it the day after if I didn’t use one.”
Throughout the interviews, the interviewees said that when
alcohol was in the mix and they became intoxicated, judge-
ment went out the window and condom usage did not occur.
Drug use is minimal among participants in the study, but more
common in society
The interview participants did not use drugs. Most of them
stated that they had never used drugs, some admitted to
having experimented but were not current drug users. The
interviewees drew a line between high alcohol consumption
and the decision not to use drugs.
D iscussion
The new European health policy framework (6) aims to support
action across governments and society. How can healthcare
professionals in everyday care contribute to reducing ill
health? Meetings between healthcare professionals and pa-
tients are important for raising awareness of risk behaviour.
Prevention work is invaluable. Communication between peo-
ple at all levels of care can contribute to a change in lifestyle
and living conditions. A person is never more receptive than
when he/she is worried. Social media is good and innovative
in many ways, but it can also contribute to influencing young
people who are building a platform in adulthood. Not every-
one is capable of dealing with social media in a sufficiently
mature way, so some people may expose themselves to risks
without thinking about consequences.
The common factor among the interviewees, who had all
contracted chlamydia, was risky sexual behaviour. The par-
ticipants were aware that having unprotected sex with people
they did not know well was risky sexual behaviour, as also
described by Carré (17). The study shows that, in the bar and
pub environment, where alcohol is being consumed in excess,
Forum for Nord Derm Ven 2019, Vol. 24, No. 1