What a new sexual health campaign for young Aussies gets right and wrong

The Australian government recently launched a new campaign, Beforeplay^[1], to promote better sexual health among young people.

Beforeplay is focused on encouraging people aged 20 to 34 to seek frequent STI tests, and to use barrier methods (such as condoms and dental dams) to protect against the transmission of STIs.

The national campaign began on January 14 and will run for nine weeks, with content to appear^[2] on social media and online, on dating apps such as Tinder and Grindr, and around universities, bars and clubs.

The campaign material includes links to information and resources^[3] as well as three videos and several posters, carrying messages including “it’s the test part, before the best part” and “it’s checking your fun parts, before the fun starts”.

The campaign message is simple and direct. Getting tested, as well as using condoms and dental dams to prevent the spread of STIs, will create a more fun and safe sexual encounter. But does the campaign get everything right?

Read more: Sex ed needs to talk about pleasure and fun. Safe sex depends on it and condom use rises^[4]

Beforeplay aims to combat increasing rates of STIs

A recent annual surveillance report on STIs in Australia^[5] found in 2022, young people made up the majority of chlamydia and syphilis diagnoses.

For chlamydia, 69% of diagnoses occurred among people between 15 and 29, with an almost even split between men and women.

For infectious syphilis, notification rates were highest among people aged 25 to 29 (58.1 cases per 100,000 people), 30 to 39 (55.7 per 100,000), and 20 to 24 (38.2 per 100,000). More than 80% of all syphilis infections were among men.

Although the report highlighted increasing rates of STIs (syphilis notifications, for example, have tripled^[6] over the past decade) testing rates were lower than usual. The authors suggested this may be an effect of the COVID pandemic, but highlights a need for more STI testing, particularly among young people.

Young people already know to get tested

The Beforeplay campaign appears to be premised on the idea that young people lack knowledge about adequate STI testing and don’t feel barrier methods are important.

Research, however, suggests this isn’t the case. A recent national survey^[8] of Australian high school students found 94% of those surveyed felt condom use was important. Some 75% of respondents said condoms were available during their most recent sexual experience, but less than 49% used them.

Similar results were seen with STI testing – more than 72% of participants believed young people should be tested for STIs. But less than 13% thought it was a common practice among their age group. And only 26% believed STI testing was easily accessible.

A 2023 study^[9] of young adults in Australia aged 15 to 29 also showed STI testing and condom use remains low among this group.

Read more: Around half of 17-year-olds have had sex and they're more responsible than you think^[10]

There could be a variety of reasons young people may not use condoms. For example, research has shown gendered norms^[11] in heterosexual couples mean women continue to carry the burden^[12] of contraceptive responsibility, including having to ask men to wear condoms. Men may refuse these requests or engage in stealthing^[13], the removal of a condom during sex without consent.

Meanwhile, long-standing social taboos^[14] and shame surround young people engaging in sexual activity, which can make it difficult for them to access sexual health services for STI testing. This can be particularly significant for LGBTQA+ young people, those living in rural and remote areas, and young people from religious, cultural and ethnic backgrounds where sex outside marriage may be discouraged.

As access to sexual health clinics can be difficult, including links and resources for at-home screening kits^[15] where available could be effective in encouraging more people to test.

More clarity in the posters and videos as to how often the campaign is recommending testing – whether before every sexual encounter with a new partner, or just general frequent testing as good sexual health practice – would also be helpful.

A diverse campaign?

Beforeplay’s content depicts couples of different genders, orientations and ethnicities to promote inclusivity.

I would argue there is an undercurrent of queerphobia^[16] and discomfort with queer sex in the campaign videos, despite the attempts for inclusion.

The two videos featuring a heterosexual couple show more physical intimacy and engagement, such as kissing and bodies touching. The video featuring the queer couple, however, only shows them holding hands, with their bodies appearing further apart.

In contrast, queer sexual health campaigns designed by and for queer people, such as The Drama Downunder^[17] and Down an’ Dirty^[18] (note, this one is not suitable for work) promote sexual intimacy between queer partners through sexualised imagery and intimate representation.

Content will also be adapted and translated for multicultural and First Nations audiences. However, there are already sexual health campaigns designed by and for Aboriginal and Torres Strait Islander communities. YoungDeadlyFree^[19] and Take Blaktion^[20] are just two of these. They meet the needs of their audience through community consultation, and use of local language, humour, cultural references, and representation.

Read more: Teaching young people about sex is too important to get wrong. Here are 5 videos that actually hit the mark^[21]

The focus on pleasure is a plus

Despite these criticisms, the focus on pleasure and having a good time is a strong positive for this campaign when young people still sometimes experience shame and stigma around sex.

We know historic campaigns^[22] around HIV/AIDs that were sex and pleasure-positive (as opposed to negative and fear-mongering) were much more effective in reducing the transmission of HIV among gay and bisexual men.

Advocating for STI testing and the use of appropriate protection while emphasising fun and enjoyment is a progressive step towards recognising and affirming young people’s sexual rights and agency.

References

1. ^{^} Beforeplay (www.health.gov.au)
2. ^{^} to appear (www.health.gov.au)
3. ^{^} links to information and resources (www.health.gov.au)
4. ^{^} Sex ed needs to talk about pleasure and fun. Safe sex depends on it and condom use rises (theconversation.com)
5. ^{^} STIs in Australia (www.kirby.unsw.edu.au)
6. ^{^} have tripled (www.abc.net.au)
7. ^{^} Australian Government, Department of Health and Aged Care (www.health.gov.au)
8. ^{^} national survey (www.latrobe.edu.au)
9. ^{^} 2023 study (www.publish.csiro.au)
10. ^{^} Around half of 17-year-olds have had sex and they're more responsible than you think (theconversation.com)
11. ^{^} gendered norms (theconversation.com)
12. ^{^} carry the burden (www.ncbi.nlm.nih.gov)
13. ^{^} stealthing (theconversation.com)
14. ^{^} social taboos (theconversation.com)
15. ^{^} at-home screening kits (www.qld.gov.au)
16. ^{^} queerphobia (theconversation.com)
17. ^{^} The Drama Downunder (www.thedramadownunder.info)
18. ^{^} Down an’ Dirty (downandirty.org)
19. ^{^} YoungDeadlyFree (youngdeadlyfree.org.au)
20. ^{^} Take Blaktion (takeblaktion.playsafe.health.nsw.gov.au)
21. ^{^} Teaching young people about sex is too important to get wrong. Here are 5 videos that actually hit the mark (theconversation.com)
22. ^{^} historic campaigns (healthequitymatters.org.au)