Sex Research Update

Article excerpt

This instalment of Sex Research Update summarizes recent research on Canadian sexually transmitted infection rates; sexual behaviour and condom use of Canadian young people; the effect of correct and consistent condom use on chlamydia and gonorrhea prevention among adolescents; testosterone, sexual offence recidivism and treatment of male sex offenders; sexually inappropriate sexual behaviour among elderly people with dementia; and the association between circulating androgen levels and sexual function in women.

Public Health Agency of Canada (2005). Supplement: 2002 Canadian sexually transmitted infections surveillance report. Canada Communicable Disease Report, 31S2.

This report from the Public Health Agency of Canada provides the most recent (i.e., up to the end of 2002) epidemiological data on nationally reportable sexually transmitted infections (STI) (chlamydia, gonorrhea, syphilis). Other, very common STI, such as human papillomavirus (HPV) and genital herpes (HSV) are not reportable to public health authorities and therefore are not included in the report. The authors caution that "Many STI are asymptomatic, therefore some infections may go unnoticed, undiagnosed, and unreported" (p. iii) and "among symptomatic individuals, only those who seek testing or medical care will be captured by this passive surveillance system. Because of these limitations, the counts in this report are likely to be an under-estimate of the true burden of disease" (p. iii). In general, this latest report confirms the upward trend in STI rates that began in 1997 and that has continued up to 2002.

Chlamydia remains the most common reportable STI in Canada. National data for chlamydia has been available since 1990 and from that year until its lowest point in 1997, the chlamydia rate had declined steadily. According to the Public Health Agency, "The picture has changed drastically over the last 5 years. The rate of chlamydia in Canada has reached an all-time high of 179.3 per 100,000 in 2002, compared with 113.9 per 100,000 in 1997" (p. 1). Between 2001 and 2002, the chlamydia rate increased by 11.1%. As in past years, in 2002, the majority of cases were in 15-to 24-year-olds and 69% of reported cases were among females. The highest rate was among 20- to 24-year-old females at 1,376.6 per 100,000 closely followed by 15- to 19-year-old females at 1,362.0. For both groups the rates have increased every year from 1997 to 2002. In 2002, the total chlamydia rates per 100,000 for each of the provinces and territories were as follows: Nunavut (2853.2); Northwest Territories (1448.1); Yukon (468.1); Saskatchewan (362.9); Manitoba (291.7); Alberta (235.6); British Columbia (187.2); New Brunswick (175.0); Nova Scotia (168.5); Quebec (149.3); Ontario; (148.8); Prince Edward Island (105.8); Newfoundland (100.5).

Gonorrhea also reached its lowest rate in Canada in 1997 (14.9 per 100,000) and steadily increased to 2002 (23.5). In 2002, as in past years, the gonorrhea rate was considerably higher in males (29.6) than in females (17.5). Among males, the highest rate was in the 20-24 age group (102.0), followed by those aged 25 to 29 (76.5) and those aged 30 to 39 (55.6). The pattern for females was different. Among females, the highest rate was in the 15 to 19 age group (101.3), followed by those aged 20 to 24 (83.0), and those aged 25 to 29 (36.2). In the more populous provinces (Quebec, Ontario, British Columbia) males account for the majority of reported cases of gonorrhea. For example, in 2002, 84% of the reported cases of gonorrhea were among males. However, in other less populous jurisdictions (Nunavut, Nova Scotia, New Brunswick, Saskatchewan) the rate is higher among females than males. In view of the higher number of reported gonorrhea cases among males compared to females in Canada, the authors note that "... males are more likely to be symptomatic than females and therefore would be more likely to present to the health care system for diagnosis and treatment" (p. …