France, Germany fight back against rise in STDs

You can't put a price on safety, at least in France: Since January 1, its government has made condoms free for everyone under the age of 26. The move follows the country's decision last year to give women up to the age of 25 free birth control.

President Emmanuel Macron described the new policy as a "small prevention revolution" to arrest the spread of sexual transmitted diseases, or STDs, which are on the rise around Europe. France reportedly recorded a 30% jump in STDs in both 2020 and 2021.

Germany, by contrast, is less giving when it comes to reproductive health care. Women need to pay for contraceptives such as the pill or intrauterine devices (IUDs), although those under the age of 22 may be reimbursed for their prescriptions by their insurers.

While such contraceptives prevent pregnancies, unlike condoms, they do not offer protection against STDs. Condoms, which are available over the counter in Germany, must be paid for.

STD infections on the rise in Europe

The Surveillance Atlas of Infectious Diseases of the European Centre for Disease Prevention and Control shows that reported STD cases have been increasing in recent years throughout the European Union. Reported gonorrhea cases increased across the region since 2009, though fell drastically since 2019, possibly due to a pandemic-related drop in social interactions and reduced screening. Most cases were reported in Spain, the Netherlands and France, with 25- to 34-year-olds most heavily affected.

Although the Surveillance Atlas does not provide EU-wide data for chlamydia infections, confirmed case numbers do show a marked rise since the early 1990s and a consistently high case number until 2019. Most infections were recorded among those aged 15 to 24.

An even more concerning picture presents itself with regard to reported syphilis cases in the region, which have been rising steadily in recent years, though a sudden drop can also be seen in 2019.

Why condoms matter

Condoms are very effective at preventing the spread of STDs like gonorrhea and chlamydia. Though often symptomless and curable, gonorrhea can cause serious health issues. Chlamydia, too, is often symptomless and curable but can have dangerous consequences, for instance by damaging a woman's reproductive system.

Syphilis is significantly more dangerous: it's caused by the bacterium Treponema pallidum and can cause serious health problems if left untreated. It can spread to and damage the brain, nervous system, eyes and ears.

Majority of German teens use condoms

Although condoms are not free in Germany, younger generations appear to understand the importance of using them. A representative survey among young Germans published in 2020 by Germany's Federal Center for Health Education found that a vast majority of 14- to 17-year-olds used condoms for protection during sexual intercourse. Survey data from five years prior indicates condom use is up among German teens.

The study also found a link between respondents' level of education and their likeliness to either forgo contraception or rely on riskier contraceptive methods instead.

Those surveyed said they learned about sexual issues and reproductive health from their parents, through sex education classes in school and on the internet.

Sex education is key, but improvements are needed

As not all parents are able or comfortable with educating their children about reproductive health and STDs, and some online sources may be unsuitable for younger audiences, schools continue to play an important role in sex education.

Sex education was introduced in 1968 in West Germany and 1959 in East Germany. Today, it is the norm in German schools, often taught in the context of biology classes.

Few German sex education classes, however, teach students about the risks of contracting and spreading STDs. One study found that most German curriculums left out any mention of chlamydia, for example.

For the past 20 years, French middle school students have been obliged to take three sex education classes. However, as French daily Le Monde reports, in reality these are not always offered, citing an audit that found stark variations between schools, classes and regions.

Upon announcing the free condom scheme, French President Macron acknowledged that his country was not very good at providing sex education at schools, saying teachers needed better training to do so.

Previously, French Health Minister François Braun called sex education a "public health" duty which would help reduce teenage pregnancies, reduce STD infections, and combat discrimination.

Edited by: Martin Kuebler