The most important four-letter word in the world By Cheryl Springer
Stabroek News
May 15, 2004

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Wait. That's it, wait. And the reasons we should be telling our children to wait are more important now than they have ever been. Thirty, even twenty years ago the worst outcome of not waiting, was an unwanted teenage pregnancy. And although it may have seemed so to the 14 or 15-year-old mother-to-be, this was not the end of the world. In fact, for some it became a beginning. While not wanting to romanticise teenage pregnancy, some adults now admit that having a baby in the face of angry and disappointed parents proved to be the turning point in their lives which previously lacked direction.

Today, the means to avoid pregnancy are as accessible as they will ever be. But this is all the more reason to wait. Today, mothers must take every possible opportunity to tell their daughters to wait. And they must be equipped and prepared to tell them why and for how long.

Why wait?

One good reason to wait is cervical cancer. Cancer of the cervix is linked to early sex, multiple partners and the human papilloma virus (HPV or genital warts). The only way to prevent HPV infection is to avoid direct contact with the virus, which is transmitted by skin-to-skin contact. A first-ever, ground- breaking survey, which included Pap smears to detect cervical abnormalities and cancer, done among indigenous women in the hinterland found a 15% prevalence of this cancer. A preliminary report from the Guyana Cancer Registry Board which was made public last week, revealed that there were 136 reported cases of and 41 deaths from cervical cancer between January 2000 and June 2003, admitting that there was underreporting. And while this cancer is preventable and curable in its early stages, it remains undetected in many women until it is too late.

I knew two women, both of them young, both of them mothers, both of whom were gainfully employed, for whom it was too late. I know a third, who is now gravely ill.

Another good reason to wait is Chlamydia. And this one is tricky. This is a sexually transmitted infection for which there are very often no signs and symptoms. In women, untreated chlamydia can spread into the pelvic area and infect the uterus, fallopian tubes, and ovaries - leading to pelvic inflammatory disease (PID). PID can be serious if immediate medical care is not sought. It may cause permanent damage to the woman's reproductive organs and can lead to infertility, chronic pelvic pain, and an increased risk of ectopic pregnancy. While chlamydia is a bacterial infection which can be safely treated with antibiotics, research has found that about 90% of infected women are blissfully unaware because they have no symptoms.

A third good reason to wait is HIV; also sexually transmitted, and both dangerous and deadly. Information about this virus is more publicised than the others, with youth-friendly and ante-natal services springing up around the country. But it is still being transmitted, along with some amount of scorn for the infected. Women are particularly vulnerable to HIV because their biological make-up increases their risk of exposure to seminal fluids from their male partners. Women and girls' susceptibility to domestic abuse, which includes rape, incest and other non-consensual sex; sex without condom use, and the high-risk behaviours of their partners, also increases their risk.

Cognisance of this and the need to change it is evident in the UNAIDS World AIDS Campaign 2004, which has as its theme, 'Women, Girls, HIV and AIDS.' The campaign seeks to accelerate the global response to HIV and AIDS through a focus on women and girls - preventing new infections, equal access to treatment and mitigating the impact of AIDS, UNAIDS says.

UNAIDS is doing its part, are you?

How long to wait?

Tell them to wait as long as it takes. If they do not know their partner's sexual history they have not waited long enough. If they cannot, do not know how to, or are afraid to ask their partners for this information, they need to wait some more.

If they are not empowered enough to demand that the requisite tests are done - wait. If they are not empowered to negotiate for safe sex - wait. There is no age by which one ought to have sex. What is required is mental maturity, by both partners. If they do not know this, they are nowhere near ready to take such an important step. They should wait.