Article

Health safety knowledge in Portugal and Spain

David L. Rodrigues; A. Catarina Carvalho; Diniz Lopes; Margarida V. Garrido; Richard O. de Visser; Rhonda N. Balzarini; Marília Prada;
Project selected in the Social Research Call 2020 (LCF/PR/SR20/52550001)

Reports have shown a decline in condom use and an increase in sexually transmitted infections (STIs) worldwide. For example, an increasing number of adolescents in Portugal and Spain failed to consistently use condoms between 2002 (10%) and 2018 (20%), and STIs rates in 2019 had increased, on average, 40% since 2015 in Europe. This indicates that many people lack adequate knowledge or fail to enact sexual health behaviours regularly, therefore increasing the risk of negative health consequences. This article examines how being motivated by disease prevention (“safety”) or pleasure promotion (“pleasure”) shapes the way people construe sexual health and pursue their sexual goals. Participants were categorised into each group based on their responses to the Regulatory Focus in Sexuality Scale (364 participants focused on safety; 378 participants focused on pleasure) and asked a series of questions regarding their knowledge about 13 STIs, past testing practices, use of contraceptive methods, and beliefs about condoms. Results show the importance of individual motives in sexuality in modulating different facets of sexual health. This research can help inform the development of new theoretical perspectives, evidence-based interventions, or education programmes aimed at increasing sexual health literacy to help curb this public health concern in Portugal and Spain.
Key points
  • 1
       Participants lacked specific knowledge about half of the STIs presented to them and had never been tested for most STIs. Primary care was the most common site for getting tested. More than half of participants used condoms as their contraceptive method.
  • 2
       The two most common reasons attributed to using condoms were risk awareness and safety concerns. The two most common reasons attributed to condomless sex were lack of behavioural control and lack of infection risk.
  • 3
       When participants were asked to provide attributes of condoms, 46% of mentions were about condoms’ ability to prevent health problems, and 27% of mentions focused on their ability to prevent unwanted pregnancies.
  • 4
       Safety-focused participants had only heard of (as opposed to having specific knowledge of or never having heard of) 53% of the STIs (vs 48% of pleasure-focused participants). A greater share of safety-focused participants used condoms as their contraceptive method and among this group, a greater share of mentions involved safety concerns and behavioural control as reasons that facilitate condom use in others , a lack of sexual education as a reason that encourage condomless sex, and the ability of condoms to protect health as an attribute of condoms.
  • 5
       Pleasure-focused participants had specific knowledge about 25% of the STIs (vs 19% in the safety-focused group) and had been tested for 23% (vs 14%). A larger share of these participants had been tested for STIs, either in primary care or at free clinics and used the birth control pill. A greater share of mentions among this group involved risk awareness as a reason that facilitates condoms use, unexpected encounters and physical sensations as reasons that facilitate condomless sex, and condom’s tendency to inhibit pleasure.

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