Forum for Nordic Dermato-Venereology Nr1,2019

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 risky behaviour increases with alcohol use. Having casual sex under the influence of alcohol was a way for participants to gain personal acknowledgement. In recent decades, since the outbreak of the HIV virus, research has increased regarding sexual risk-taking behaviour among young people (8, 18). A large part of this research is quantita- tive in nature and involves mapping the behaviours of young people. Common denominators in risky sexual behaviour are sporadic condom use, casual sexual relationships and a lower age of sexual debut. Statistics available about sexually transmitted disease and unwanted pregnancy confirm that many young people are practicing unprotected sex, or “one night stands” (10, 19). Although it appears that almost all participants were aware of the benefit and value of using condoms as protection, more than half did not always use them. Many people feel a reason not to use them is inconvenience or perceived reduction in the pleasure of having sex (20). Alcohol consumption has a big influence on the decision-making process regarding whether or not to use a condom. It appears that it only takes one or two drinks to influence judgement toward the view that it is not necessary to use a condom. The results of this study are consistent with other studies showing that condom usage has decreased among young adults. In a Swedish study performed at Gothenburg University (10), it was found that young adults are taking just as many risks as teenagers. However, young adults have less access to con- traceptives, as teenagers are provided with free contraceptives through the healthcare system (10). In a recent study by RFSU, an organization in Sweden, that provides information on sex- ual behaviour to Swedish people, it was found that condom usage had fallen from 48% in 2013 to 43% in 2016 in the 21–35 years age-group (11). According to the report “Alcohol and sexual risks taken” (21) there is a correlation between lower education levels, unemployment and instances of unprotected anal intercourse. It was also found that people who are in the immigration process are more prone to sexually risky behav- iour (9). Among exchange students from a Swedish university, a cross-sectional study was conducted with 136 participants, using a web survey with questions about sexual behaviour, self-esteem and psychological well-being. Participants rated their health as good and the majority of them participated before departure in information sessions that addressed preventive efforts on HIV/STIs and safer sex, but sexual risk behaviour during exchange studies was reported (22). An example of a study that shows, in a very interesting way, how qualitative research can be designed, in addition to giving an account of the outcome, is “Individual experiences following Forum for Nord Derm Ven 2019, Vol. 24, No. 1 a 6-month exercise intervention: A qualitative study.” It is possible to follow the entire research step by step (23). There was no difficulty in recruiting participants. All respond- ents agreed to participate. Eighteen interviews were analysed and the results were used as the basis for this study. The theme was “risk-taking in sexual behaviour”. The theme consists of sev- eral sub-themes: “Meeting unfamiliar people at a bar or online,” “The resulting relationship is casual and the parties will probably not meet again,” “When alcohol is in the mix, judgement is im- paired”, “Using condoms is embarrassing and awkward,” “Drug use is minimal among participants in the study, but more common in society.” One positive aspect of the qualitative interview method is that it makes it possible for an interviewee to open up and reveal things about their personal and private life. Generally speaking, participants took very few risks in other situations in life. Most described themselves as cautious and responsible. For instance, they discussed their concerns about driving, among other aspects of their everyday lives. Their sexually risky behaviour under the influence of alcohol con- trasted with their otherwise conservative approach to risk. An individual’s sex life is of a private nature; there is no outside judgement on the behaviour in the moment. The interviewees were more sensitive to risk-taking when they were in the public eye and were scrutinized by their surround- ings. In the interviews, they were very open and honest about their sex lives and their decision-making processes. C onclusion The results of this study confirm that alcohol consumption was a major factor in the interviewees’ propensity for risky behaviour in sexual relations. Their risk-taking in other sit- uations had a large influence on whether they might expose themselves to environments that allowed or encouraged risky behaviour. A cknowledgements The study was supported by the Research Committee of Region Örebro County and the Department of Dermato-Venereology, Örebro University Hospital, Sweden. R eferences 1. WHO – World Health Organization, Department of Reproductive Health and Research. 2012. Available from: https://www.who. int/reproductivehealth/publications/rtis/stisestimates/en/. 2012. 2. European Centre for Disease Prevention and Control. Available from: https://ecdc.europa.eu/en/news-events?s=annual-epidemi- ological-report. 2012. D ermato -V enereology in the N ordic C ountries 13

Forum for Nordic Dermato-Venereology Nr1,2019 | Page 15