Sex Lives Report 2024 by LetsStopAIDS

NAVIGATING INTIMATE CONVERSATIONS

CONTENTS

06

14

MESSAGE FROM SHAMIN

STI AND HIV TESTING

08

16

OVERVIEW

STI AND HIV DISCLOSURE

12

20

STI AND HIV TRENDS

CONDOMS

30 CONSENT

38 CONCLUSION

40 METHODOLOGY 41 ACKNOWLEDGEMENTS

MESSAGE FROM SHAMIN

This year, the World Health Organization (WHO) released a report showing that many 15-yearolds are already sexually active, and most of them didn’t use a condom the last time they had sex. It’s an alarming statistic, but unfortunately, it’s not new.

6 - Sex Lives Report

Since 2022, LetsStopAIDS has been tracking a similar trend among youth aged 18 to 24 — condom use is dropping, and today’s sex-ed curriculum just isn’t meeting the needs of young people.

The year’s Sex Lives Report takes things a step further. LetsStopAIDS wanted to understand not just what’s happening, but why. Why are fewer young people using condoms? What makes it so difficult to negotiate condom use? Beyond that, we wanted to know how well-informed Canadian youth are about their sexual rights — things like consent, STI and HIV disclosure, and other factors that shape their sexual experiences.

One thing became really clear to us: young people need someone to talk to about all this.

Right now, we’re seeing provinces put up barriers to sexed in schools, healthcare providers aren’t discussing HIV testing options with young patients, and sex-ed curricula are outdated, leaving young people with little practical knowledge. On top of all that, prevention tools like condoms are either out of reach or too expensive for many youth. That’s why it’s no surprise that Canada is the only G7 country where HIV transmission rates are rising.

That’s where LetsStopAIDS comes in. Our goal is to work alongside schools, families, governments, and especially young people themselves to ensure their sexual health is fully supported. We want to make navigating sexual life as easy and open as talking about consent and condom use should be.

Shamin Mohamed Jr. Founder & President LetsStopAIDS

LetsStopAIDS - 7

OVERVIEW

Let’s talk about sex

In 2024, LetsStopAIDS is focusing on understanding why young people are not consistently using condoms, the challenges they face around HIV awareness and testing, and important aspects of partner communication, such as negotiating condom use. In addition, the research explores young people’s understanding of “sexual rights,” such as sexually transmitted infection (STI) and HIV disclosure, and consent.

This year, LetsStopAIDS conducted a nationally representative survey of 1,105 Canadians aged 18 to 24 through the Angus Reid Group. The results reveal that the majority of sexually active youth practiced casual condom use.

Alarmingly, the percentage of young people who reported using condoms “all the time” fell from 53% in 2020 to 24% in 2024. This means that most young people were not consistently using condoms — a trend with serious implications for their sexual health, as lower condom use leads to increased vulnerability to STIs and HIV. 8 - Sex Lives Report

Condom use: All the time vs Infrequent Infrequent

All the time

100%

75%

47%

55%

77%

73%

53%

45%

23%

27%

2020

2022

2023

2024

50%

25%

0%

Several key findings contribute to increased vulnerability to STIs and HIV:

Nearly half of young Canadians viewed condoms primarily as a method of birth control, not as protection against STIs and HIV

7 in 10

reported never having been tested for STIs or HIV It’s no surprise, then, that negotiating condom use was a significant issue among sexually active young Canadians. 2 in 5 sexually active young Canadians reported feeling unsafe or uncomfortable during sexual encounters involving condom negotiation.

This number rises to 47% among LGBTQ+ youth and a startling 62% among Indigenous Canadians.

Additionally, 14% of sexually active youth reported experiencing stealthing — the non-consensual removal of a condom during sex — an act that is now illegal in Canada.

LetsStopAIDS - 9

OVERVIEW

Given these findings, it is clear why STIs and HIV are on the rise among youth. The survey found that 6% of young Canadians had been diagnosed with an STI or HIV in the past six months, an increase from the 4% reported in 2022 and 2023. The 2024 Sex Lives Report findings underscore critical gaps in sexual health knowledge and behaviour that need urgent attention to better support Canadian youth. Among those diagnosed, 21% had chlamydia and 13% had HIV. Even more concerning is that 34% of youth diagnosed with a STI or HIV, did not receive treatment.

34%

of youth diagnosed with an STI or HIV did not receive treatment

10 - Sex Lives Report

Stigma also impacts the sexual health of Canadian youth. 70% of respondents indicated that conversations about STIs and HIV are stigmatized, with 62% claiming that conversations centred around STI and HIV prevention are very challenging to have. In addition to not discussing the topic, a worrisome trend is that only 43% of Canadian youth felt knowledgeable about how to have conversations with others about STIs and HIV. Not only were youth uncomfortable discussing sexual health with others, but 67% of young Canadians did not recall discussing STI and HIV testing with any healthcare provider.

The good news Youth agree that conversations about STIs and HIV are important. 84% of young people were in agreement that having conversations about STI and HIV history, and that risk should be discussed with each new partner.

In addition to discussing STI and HIV history, young Canadians reported having conversations with their partners regarding sexual rights and consent, with 79% indicating that consent should be discussed at every stage of sexual interaction.

Condoms don’t impact sexual pleasure The research also debunks the myth that condoms hinder sexual pleasure. When the pleasure ratings of youth who used condoms during their last sexual encounter are compared with those who didn’t, the data shows no difference in their reported enjoyment. This finding is crucial for young people struggling with condom negotiation, as it provides them with evidence.

Overall, the mix of these suggests a continued need for the development of new tools and approaches to sharing knowledge and informing young people about how to have these conversations and better understand their sexual rights.

LetsStopAIDS - 11

STI AND HIV TRENDS

The State of STIs and HIV amongst youth

Canada is the only G7 country where HIV rates are rising.

The importance of condom use is magnified due to the rising rates of chlamydia, gonorrhea, and syphilis.

According to the Government of Canada, between 2011 and 2019, rates increased by 26% for chlamydia, 171% for gonorrhea, and 389% for infectious syphilis, with chlamydia as the most commonly reported STI. The survey results show that in the last 6 months, 6% of young Canadians have been diagnosed with an STI or HIV — up 2% from the 2023 Sex Lives Report data. Of those diagnosed, 21% were diagnosed with chlamydia, 13% with HIV, 12% with gonorrhea, 10% with hepatitis B, and 8% with syphilis. In both 2022 and 2023, only 8% of youth diagnosed with STIs reported it to be HIV. This year, that number increased to 13%.

12 - Sex Lives Report

Which STI(s) were you diagnosed with?

2022

2023

2024

Gonorrhea

54%

24%

12%

Chlamydia

13%

26%

21%

Hepatitis B

11%

11%

10%

HIV

8%

8%

13%

Syphilis

7%

6%

8%

Herpes simplex virus

6%

11%

3%

HPV

3%

8%

6%

Prefer not to answer

12%

35%

36%

Three-year Trend1

1 - The three-year trend accounts for a relevant change taking place from 2022 to 2024.

LetsStopAIDS - 13

STI AND HIV TESTING

Most youth have never been tested Testing is a clear way to combat rising STI and HIV rates.

However, the research indicates that 67% of young Canadians had never been tested for HIV, and 65% had never been tested for STIs. This means that nearly 7 in 10 young Canadians had never been tested despite 61% of youth indicating that they had more than 1 sexual partner in the last 3 months.

Have you been tested for HIV in the past?

7 in 10 young Canadians have never been tested

Have you been tested for other STIs in the past?* ing *not includ

67% 11% 7% 11% 5%

No Yes, in the last 6 months Yes, between 6 months and a year ago Yes, longer than a year ago Prefer not to answer

14 - Sex Lives Report

65% 12% 7% 11% 6%

V HI

No Yes, in the last 6 months Yes, between 6 months and a year ago Yes, longer than a year ago Prefer not to answer

Lack of discussion from healthcare providers Ensuring that family doctors are accessible and understand the present context of sexual health, while providing guidance on the short and long-term consequences of STIs and HIV, should be a societal priority to effectively reduce transmission. However, the data indicates that doctors and other healthcare providers had not actively been discussing STI and HIV testing with youth.

Do you recall any healthcare providers proactively discussing STI and HIV testing with you?

67%

British Columbia

Ontario

71%

25%

Alberta

71%

70%

Yes

Prefer not to answer

24%

Quebec

22%

Saskatchewan / Manitoba

62%

No

27%

59%

36%

Atlantic

32%

68%

26%

LetsStopAIDS - 15

STI AND HIV DISCLOSURE

Youth are not seeking treatment following a diagnosis After receiving a diagnosis, it is expected that people would receive treatment. The shocking trend, however, is that many youth were not seeking treatment following a diagnosis.

34%

of youth diagnosed with an STI or HIV did not receive treatment

16 - Sex Lives Report

Factors influencing STI and HIV transmissions in Canada The diagram combines data from the Sex Lives Report 2022, 2023 and 2024, and media outlets.

HEALTHCARE SUPPORT

POLITICS, RELIGION AND IDEOLOGY

Healthcare providers not proactively discussing STI and HIV testing, and youth not seeking treatment after diagnosis

SEX-ED CONTENT AND DELIVERY METHODS Sex-ed curriculum and delivery methods outdated, failing to address relevant youth concerns and be engaging

Provincial backlash against sex-ed in schools, as seen in Saskatchewan and Alberta

INCREASE IN NEW HIV TRANSMISSIONS

CONDOM USE AND ACCESS TO HIV PREVENTION Low condom use and barriers (stigma, availability, cost) to testing and prevention tools (PrEP, PEP)

The percentage of youth that did not receive treatment following a diagnosis is higher than that of 2023, where 27% of youth did not receive treatment. This is alarming for multiple reasons, but especially because a large number of STIs, including HIV, have treatment options.

Advancements in HIV treatment have made it possible for people to achieve a low enough viral load that they would not transmit HIV to another person even during sexual contact; this is also known as Undetectable = Untransmittable (U=U) status.

LetsStopAIDS - 17

STI AND HIV DISCLOSURE

Stigma and Disclosure It is evident that the stigma associated with STIs and HIV has made youth less likely to disclose their status.

When asked why they felt people with an STI or HIV may not disclose their status, youth confirmed that shame, embarrassment, fear of rejection, and stigmatization still played a prominent role when it came to disclosure.

13%

of young Canadians felt that they may have received an STI from a sexual encounter even though their partners said they had no STI Furthermore, 5% of respondents admitted to withholding information.

18 - Sex Lives Report

Why young Canadians think people do not disclose if they have an STI

42%

11%

Embarrassment

Other

16%

8%

Fear of Sexual Rejection

Don’t care

12%

5%

Stigma

Fear of Judgment

11%

5%

Shame

Selfish

96%

of young Canadians reported feeling very unfamiliar with STI and HIV disclosure laws in Canada Only 4% feel very familiar with STI and HIV disclosure laws in Canada

Many youth lacked proper understanding of the legal requirements for STI and HIV status disclosure. Data from this year’s Sex Lives Report shows that 96% of young Canadians were not very familiar with these laws. Without this knowledge, they are at greater risk of both transmitting and being affected by STIs and HIV due to nondisclosure.

LetsStopAIDS - 19

CONDOMS

Condom use on decline Despite the high efficiency of condoms in preventing STI and HIV transmissions and pregnancies when used correctly, 64% of sexually active Canadian youth reported inconsistent condom use, with 1 in 5 youth never using a condom. Additionally, the percentage of youth who reported wearing condoms “all the time” dropped from 53% in 2020 to 24% in 2024.

Unnecessary and expensive.”

Makes everything dry.”

They ruin the feeling.”

I already have difficulty achieving orgasm and condoms make it impossible for me.”

Condoms are “bad vibes..”

64%

of sexually active Canadian youth reported inconsistent condom use, with 1 in 5 youth never using a condom

Respondents were allowed to pick more than one reason for their lack of condom use.

Real respondents testimonials

20 - Sex Lives Report

Reasons why youth did not use a condom the last time they had sex

34%

We are exclusive and do not use condoms

25%

There was no risk of pregnancy

25%

We don’t like using condoms

19%

Other STI and pregnancy prevention methods were used

19%

We have been tested for STIs and HIV

13%

Didn’t have a condom

5%

I felt pressured not to use a condom

4%

We were under the influence of alcohol and substances

It causes me pain.”

It feels like having a garbage bag inside me.”

Feels less intimate, feels less good.”

They are uncomfortable.”

I want to feel the real shit.”

The sensation is not nearly as good.”

Condoms blow.”

LetsStopAIDS - 21

CONDOMS & PLEASURE

Sex and Pleasure How youth rated how pleasurable their last sexual experience was

37% Great 32% Good

19% It was OK 7% Meh 3% Horrible 3% Can’t remember

/ Prefer not to say

22 - Sex Lives Report

69%

of Canadian youth said they were having great/good sex

How was the sex?

While not everyone is “doing it”, the young Canadians who are having sex are generally having a good time. When asked to rate how pleasurable their last sexual encounter was, 69% of sexually active youth said sex was great or good. 19% said it was ok, 7% said it was meh and only 3% said it was horrible.

Debunking the myth that condoms hinder sexual pleasure To dispel the “condoms = lack of pleasure” myth, respondents were asked if they wore a condom the last time they had sex. Half of youth said they used a condom, and half said they did not use a condom. These same youth rated how pleasurable this last sexual encounter was.

The research shows, the amount of youth that had pleasurable sex (great/good) with condoms is the same as the amount of youth who had pleasurable sex without condoms. This indicates that condom use does not decrease pleasure levels.

LetsStopAIDS - 23

CONDOMS & PLEASURE

The correlation between pleasure and connection

Great/Good Sex

100%

rried

, engage d, l ivi n

Co n

High Conn

Mid Co n ts )

58%

d tan

Lo w

fi ts)

70%

n

40% Low Connection

Everyone surveyed for this question wore condoms during their last sexual encounter.

24 - Sex Lives Report

Mid Connection

High Connection

er) eth

ne be

n (booty call, on tio e-

h ig

60%

c ne

84%

ith

80%

n (dating, frien tio ds c w ne

g to

ec ti

g

on

a (m

Higher connection level = More pleasurable sex The level and depth of connection youth have with their sexual partner appears to be a large contributor to how pleasurable the sex is.

Then generally, the pleasure level goes down as the level of connection goes down. Only 57% of youth who had sex with a one-time sexual partner (one night stand) said the sex was great/good. Conversely, 40% of youth who have sex with a one-night stand said the sex was ok to horrible. And 44% of youth who had sex with a sexual partner whom they had sex with more than once but have no commitment to (booty call) said the sex was ok to horrible.

Given everyone surveyed for this question wore condoms during their last sexual encounter, this factor was held constant.

LetsStopAIDS - 25

CONDOM NEGOTIATION

Challenges to negotiate condom use Many youth who do want to use a condom are facing challenges when negotiating the use of a condom with their partners.

Nearly 2 out of every 5 (37%) sexually active young Canadians reported having felt unsafe or uncomfortable during a sexual encounter involving the negotiation and/or use of condoms. This number was higher (47%) among LGBTQ+ youth and even higher (62%) among Indigenous Canadians.

26 - Sex Lives Report

When respondents were asked, “Have you ever felt unsafe or uncomfortable during a sexual encounter involving the negotiation and/or use of condoms?”

TO

6%

5%

YES

RO

YES

AL XU SE

L TA

HETE

NO

32%

YES

37%

NO

64%

Prefer not to answer

NO

57%

RO TE

6%

NO N -H E

NO

47%

47%

SEXUAL

YES

Bisexual

YES 51%

NO 46%

3%

Gay

YES 41%

NO 53%

6%

Lesbian

YES 29%

NO 46%

25%

Queer

YES 55%

NO 35%

10%

Asexual

YES 34%

NO 45%

21%

Pansexual

YES 50%

NO 50%

Other

YES 49%

NO 51%

LetsStopAIDS - 27

CONDOM NEGOTIATION

Even though we both preferred to have sex without a condom, I was scared of the risk of pregnancy and STIs so I wanted to use protection.

But in the end I felt pressured into having sex without a condom.”

Beverly - Toronto, ON

They just begged and begged not to use one until I gave in even though I continued to mention that I wasn’t comfortable with it.”

Bill - Saint John, NB

Real respondents testimonials Pseudonyms used 28 - Sex Lives Report

I wanted him to wear a condom but he asked me 4 times throughout the night to not wear one. So I caved but I regret it.”

Ruth - Long Creek, PEI

My partner refused to wear condoms because they are uncomfortable and would try all the time to use manipulation tactics to convince me to give in and do it anyways. Sometimes he would get angry or violent when I refused to give in.”

Michelle - Vancouver, BC

LetsStopAIDS - 29

CONSENT

Discussing Consent To give and receive consent is a key part of discussions around sexual and reproductive health and rights. As such, it needs to be widely understood.

But do young people truly understand what it means to give consent?

When asked if they understood the meaning of consent, 1 in 5 of Canadian youth answered, ‘I don’t know.’ This highlights the failure of the current sex-ed curriculum a to effectively teach reliable, complete, and up-to-date sexual health concepts.

30 - Sex Lives Report

1 in 5

answered when asked if they understand the meaning of consent

I don’t know

3 in 10

youth reported feeling anxious about sex, fearing their partner(s) might later say it wasn’t consensual

Breakdown by gender identity

4%

Other

28%

Transmen

40%

Men

50%

Transwomen

Women

19%

The research shows young Canadians have experienced a range of insecurities around consent.

Almost twice as many men (40%) agreed compared to women (19%). The numbers were also generally higher for transwomen (50%) and transmen (28%).

LetsStopAIDS - 31

CONSENT

Consent & Intoxication

The survey asked respondents about the connection between alcohol, drugs, and consent.

32 - Sex Lives Report

Responses to whether or not a partner’s intoxication level should be considered before attempting to engage in sexual activity

3% 5% 7%

4 in 5

85%

Canadian youth agreed that when a person become intoxicated involuntarily (i.e. being drugged), they cannot consent to sexual activity

More effective sexual health programming that discusses the connection between alcohol, drugs and consent, is needed.

Agree

Disagree

Neither agree nor disagree

Don’t know/ Prefer not to say

LetsStopAIDS - 33

CONSENT

Condom Removal without Consent (a.k.a. Stealthing)

The 2024 Sex Lives Report indicates that 14% of sexually active Canadian youth had felt unsafe because someone pretended to wear a condom and/or removed it before or during sex without their consent. This is known as “stealthing”.

Stealthing is the non-consensual act of removing a condom, or any barrier, during sexual activity without the awareness or consent of the other person or people involved.

14%

of sexually active Canadian youth have felt unsafe because someone pretended to wear a condom and/ or removed it before or during sex without their consent 34 - Sex Lives Report

Testimonials from young respondents that have been stealthed provide insight into the ways in which sexual partners can manipulate others into being sexually assaulted:

He removed it just when my back was to him without my consent and just before ejaculating.”

I was hooking up with a guy and he insisted on turning off all of the lights. I asked him to wear a condom and he told me he put one on, but it was in the dark so I couldn’t see if he put one on. When he entered I didn’t physically feel a condom and when he finished the lights were still off, so I never saw a condom so I’m not sure what actually happened.”

Daniel - Sundre, AB Phyllis - Normétal, QC

It was my first time and my partner removed the condom without my consent during intercourse. I was made aware once we had finished and I took a Plan B pill. It was a very hard experience.”

He took the condom off even though I didn’t agree.

But I didn’t stop having sex with him because I was worried he would get angry.”

Jon - Mississauga, ON

Darnell - Winnipeg, MB

Real respondents testimonials Pseudonyms used LetsStopAIDS - 35

condom?”

id “D

con

dom?”

The Court determined that the requirement to wear a condom forms part of the “sexual activity in question” to which a sexual partner must voluntarily agree by law, as part of the definition of consent. In other words, legally speaking - consenting to sex with a condom is different and distinct from consenting to have sex without a condom1.

be

the condom see I row it o an u th u “C yo

e for ” t?

1 - case source: R. v. Kirkpatrick, 2022 SCC 33, some source articles: Canadian Bar Association, Supreme Court Briefs Real respondents testimonials 36 - Sex Lives Report

you take o ff t

he

Recently, the Supreme Court of Canada decided that a partner’s refusal to wear a condom, or removing a condom during a sexual encounter, can invalidate consent previously granted.

e th

“Whe re i

s

CONSENT

The report shows that seeking help was challenging for youth.

7 in 10

sexually active youth in our sample who experienced an unsafe or uncomfortable sexual encounter involving the negotiation/or use of condom, did not seek help

Equally concerning is that 1 in 2 youth who experienced stealthing, did not seek help.

LetsStopAIDS - 37

CONCLUSION

38 - Sex Lives Report

The findings from our research underscore the critical need for youth to engage in more open and honest conversations with their sexual partners.

We know young Canadians are facing challenges when navigating topics like consent, condom negotiation, and STI and HIV disclosure, and while these conversations can be difficult, they are essential for fostering healthy relationships and empowering youth to take control of their sexual health.

So how can we help youth?

We believe it starts with actively listening to youth voices, acknowledging their experiences, and working collaboratively to dismantle barriers that hinder open communication about sexual health.

Implementing inclusive and comprehensive sex-ed, which frames sexual health in a positive light, is key. Rather than instilling fear and silence, sex-ed should encourage youth to speak openly about these issues. What is clear is that sex-ed should not only address the physical aspects of sexual health, but also the emotional and communicative skills necessary for positive sexual experiences.

LetsStopAIDS - 39

METHODOLOGY

How and with whom was the survey conducted?

Sex Lives Report 2024 was conducted by LetsStopAIDS from March 28 to April 9, 2024 among a sample of 1,105 Canadians aged 18 to 24 and was hosted on the Angus Reid Forum. The survey was conducted in English and French, and consisted of a representative sample of 1,005 Canadians aged 18 to 24 and an additional boost of 100 Canadians 18 to 24 who identify as LGBTQ+. For comparison purposes only, a probability sample of this size would carry a margin of error of +/-2.9 percentage points, 19 times out of 20.

How were respondents’ data protected?

LetsStopAIDS and the Angus Reid Group are committed to protecting the privacy and confidentiality of personal information collected. To ensure anonymity, Angs Reid Group assigned each respondent a unique panelist ID. The survey captured IDs of the panelists who completed the survey and appended it to the data file shared with LetsStopAIDS. All survey data is stored on secured servers located in Canada.

40 - Sex Lives Report

Additional questions?

If you have additional questions about the methodology, or if you would like to request the LetsStopAIDS Sex Lives Report 2024 for precise data manipulation and survey question wording, please contact slr@LetsStopAIDS.org.

ACKNOWLEDGEMENTS

As a registered Canadian charity built by the hands of thousands of volunteers around the world, we would like to give a special thanks to these people who are dedicated to pursuing our purpose and values.

We would also like to extend our thanks to Dr. Yvonne Su, Dr. Robin Milhausen, and Victoria Yang (J.D.) for their invaluable support with the 2024 LetsStopAIDS Sex Lives Report. A special thank you to Gilead Sciences for supporting Scan to watch our 2024 video campaign

the video campaign associated with this report, enabling us to bring science and information to Canadians across the country.

LetsStopAIDS - 41

LetsStopAIDS is Canada’s Youth-HIV charity dedicated to fostering youth leadership and enhancing awareness on HIV and sexual health. We focus on research, knowledge exchange initiatives and community engagement globally.

Since 2004, LetsStopAIDS has engaged over 200,000 young people through 10 global projects, supported by 15,000 volunteers.

20 years later, and we continue to inspire young people to take action within their local communities.

To learn more and get involved with LetsStopAIDS or make a charitable donation, please visit LetsStopAIDS.org or contact us at +1 (416) 231-2333.

Publication Date: October 2024 Copyright © LetsStopAIDS 2024 ISBN: 978-1-7381438-1-8

Citation LetsStopAIDS Sex Lives Report: Navigating Intimate Conversations Survey Design Dr. Yvonne Su, Dr. Robinson Mihausen, Victoria Yang (J.D.), Sabrina Sam Data Analysis Dr. Yvonne Su, Dr. Robinson Mihausen Data Collection Angus Reid Group Design and Layout Ludivine Méténier Director of Video Campaign Dan LeMoyne Director of Photography Daniyal Shah

160 John St, Suite 200 Toronto, ON M5V 2E5

Canadian Charitable No. 86145 2639 RR0001

Editorial Support Tadek Chmiel, Tatiana Goulart, Shamin Mohamed Jr., Smit Patel, Dr. Gerson Scheidweiler, Dr. Yvonne Su, Tyler Valiquette, Dana Won

ISBN 978-1-7381438-1-8