"There is no condom for your heart."
In 2011 this was the sexual education I received from a religious agency commissioned by my secondary school. They did not mention how to put on a condom, where to get an STI check, or how sex works outside of a heterosexual relationship or without a penis.
Unfortunately, experiences like the above are not uncommon. The group Pure in Heart, which promotes abstinence, reportedly told students that condoms fail one in six times. In reality, when used effectively, the male condom is 98% effective, and the female condom 95% effective.
The National Council for Curriculum and Assessment (NCCA) recently published a draft report on relationships and sexuality education in primary and post-primary schools. The draft report found that many young peoples' view of the RSE they receive is "inadequate or at best partially meeting their needs".
Post-primary students who contributed to the report discussed "abstinence and problem-based approach to RSE" as a common experience, which often emphasises the risks and dangers of sexual activity. However, students indicated that "merely pointing out the dangers of sexual activity is unhelpful and misguided."
In the draft report, a student commented: "People are going to have sex without condoms and going to get STIs, and we need to be able to talk about it and take away the taboo aspect".
The above information suggests that this country has a lot of room to improve when it comes to sexual health, but what are the implications of this, and what does it take to make Ireland talk about sex?
Symptoms (or lack thereof)
"If you go in for an asymptomatic screen, it's just a blood sample and a urine sample, and that diagnoses most infections. If you have additional risk factors, you take a swab from the mouth, you take a swab from the rectum. If you have symptoms you might take a female internal swab, as well", says Dr. Lambert.
However, if you do have symptoms, men should be cognisant of burning and pain in urination, discharge when they pee, and pain in the testicles. Whereas women may have abdominal pain, discharge, and drainage coming from the vagina, he explains.
"One of the only symptoms women come in with is that they are on the pill for a few years and everything is going well, and then they start having a little bit of spot bleeding during the pack when they wouldn't normally expect it. There is quite a high number of those people who are going to have a chlamydia infection" says Dr. Shirley McQuade, Medical Director of Dublin's Well Woman Centre.
However, she explains that if an asymptomatic STI is left untreated, it can have serious long term implications:
"The problem with chlamydia with women, in particular, is it can cause a long term low-level inflammatory process in the pelvis. And depending on what organs become inflamed that can cause a problem with the fallopian tubes, so there's an increased risk of ectopic pregnancy in women who have had inflammation in their pelvis".
She suggests that patients wait at least two weeks before getting tested. "The first time you have sex doesn't necessarily mean whatever they've got, you suddenly have it, as it can take up to two weeks for it to show in the system".
While condoms are a good method of controlling bacterial infections, they can't guard against herpes and genital warts.
"People are having non-penetrative intercourse, and they are catching sexually transmitted infections. In fact, that's a very common way for people to be catching everything from herpes, syphilis, hepatitis, gonorrhea, and chlamydia" says Dr. Lambert.
The gender divide
The practical side of sexual health is imperative to the prevention of STIs. However, it is not the only issue people have with sexual health. Recently a friend informed me that she asks every sexual partner (whether long term or casual) if they've had an STI check, however, they will often insinuate she is "crazy".
"They tried to make me feel weird, but it's so normal and important to me, and never, ever, did they decide after that conversation that they didn't want to have sex with me," she said.
Her problem is a universal one, and while it can be challenging to muster the courage to ask a new sexual partner about their STI status, Dr. McQuade advises people to come prepared.
"Some women will say to any new partners - have you got screened? We give them a copy of their results, so there is an exchange of paper. I think you're on the higher moral ground if you can say - well I've done the checks where is your result".
When it comes to sexual health there seems to be a gender divide - "I often have conversations with women who have come in for testing, but their partner has actually got symptoms" says Dr. McQuade.
"Talking about sex for a lot of people is taboo, talking about sexual health is far more taboo," says Patrick McElligott, an LGBTI (lesbian, gay, bisexual, transgender, and intersex) Support Project Worker for GOSHH (Gender Orientation Sexual Health HIV).
"I think for people who might be LGBTI it is a little bit more accessible because there is so much information out there around prevention and protection; whereas I think within the heterosexual community there may not be a visible advertisement, so the conversations aren't as open as they could be".
"I think a lot of people who are LGBTI historically in Ireland would have been sexualised and would have been looked at as people who have sex. As a result of those assumptions made by society, often people within that environment end up being more focused on their sexual health. I think it's kind of the invisibility, as well as the visibility" he says.
According to McElligott, people who are transgender have predominantly negative experiences in sexual health centres, which do not specialise in LGBTI issues. "I suppose it's difficult because there is one side where the people in the medical profession are trying their best, but their best isn't good enough".
How then do we call a halt to our nation's problematic relationship with sex, and ensure future generations adopt a healthier and more inclusive attitude towards sexual health?
Dr. McQuade suggests a written curriculum for schools around the country, as she feels the level of information people receive about sexual health can vary.
Dr. Lambert believes sexual education should be taught regardless of the school's religion: "I just think education should be automatic, independent of whether there's a religious influence or not in the school."
McElligott says LGBTI people need to be considered when sexual health training happens in school. "They have to source their own information from different places, and often those places do not provide clear information. They talk about sex rather than the importance of a relationship. The other side of that is also like HIV would've been called the 'gay man's disease' for a very long time, and I think the shadow of that is still lurking" he says.
"We're not here to criticise people, judge them, anything. We're here to do the test, explain what the process is, give treatment if necessary, and reassurance. It should just be seen as another appointment that you have, just the same as if you're coming in with a chest infection," Dr. McQuade.
According to the Health Protection Surveillance Centre (HPSC), the current number of reported HIV and Sexually Transmitted Infections for 2019 is 12,254.
The only method of STI protection which is 100% accurate is an STI check.
Don't put yourself, and others at risk - get checked, flaunt the receipts and be safe.