Of the 85 articles, 40 were published in ‘mid-market’ newspapers, 24 published in ‘serious’ newspapers and 21 in ‘tabloid’ newspapers. Overall, 51 news articles focused on women and girls, 14 articles focused on men, and 20 articles included both sexes. Of the articles focused on men, seven had a particular focus on heterosexual men and seven on gay men. Even from this crude summary it was evident that in these negative articles there was a predominance of focus on women. Thematic and latent analysis of the data enabled grouping around issues of risk and responsibility for sexual health.

Women, responsibility and men as risk to their health

A key theme in the articles was men being framed as a risk to women’s sexual health. Some articles referred to men pressuring women into not using condoms: “…so much pressure from men not to wear a condom” (The Sun, 26th Aug 2010); “Doctors say young women are particularly vulnerable because they are sometimes being persuaded not to use condoms” (The Daily Mail, 25th Aug 2010). In these extracts, men/boys were depicted as having the influence or power to ‘persuade’ women/girls to act in ways that might be risky, and teenage girls were frequently portrayed as being pressured to become involved in sexual relationships at an early age: “…there is pressures on girls to get into sexual relationships way too early” (The Observer, 29th Aug 2010). Risk not only included pregnancy, but also STIs. There were several articles reporting warnings of STI risks to females because men were reluctant to get tested: “So a man could go on for years unaware that he has an infection he may be passing on to women, who are even less likely to develop symptoms” (The Mirror, 7th Apr 2010); “Young men don’t wear condoms and it appears it is young women who end up with the infection” (Natika Halil of the Family Planning Association, The Daily Mail, 25th Aug 2010). Within the articles, it was also common for phrases such as “particularly amongst women” or “especially women” to follow statements highlighting increasing STI or teenage pregnancy rates. The framing of women as “worst hit” (Text extract, The Sun, 25th Aug 2010), “vulnerable” and particularly affected was common:

“The Health Protection Agency, which compiled today's shocking figures, admitted they are "too high" - especially among under-25 s - and called for new safe-sex campaigns. It said girls are "particularly vulnerable"” (The Mirror, 25th Aug 2010).

Some articles also reported on how the provision of contraception to teenage girls could place girls in a vulnerable position by encouraging boys to: “bully them into sex” (The Daily Mail, 25th Feb 2010). Another related theme in articles was the notion of part of a women’s role being to “resist” men’s advances. Such discourses tended to portray a power imbalance in sexual relationships between women and men, as highlighted by a quote from Nancy Mahon, Executive Director of the MAC Aids Fund, stating: “British women feel they lack the power in their relationships to negotiate safe sex” (The Observer, 28th Feb 2010). A number of articles argued that it was women who needed to take more responsibility for ensuring that they do not become infected with an STI or become pregnant (and teenage pregnancy articles rarely mentioned males). This focus on female responsibility was epitomised in one article commenting on the news of a women becoming pregnant to an infamous father of 14 children:

“But idiots like MacDonald can only keep siring children because the women he beds have never heard the world contraception or are too dim to use it. MacDonald is undoubtedly a toe-rag but women have to bear some responsibility for what happens to them. A woman who doesn’t want to get pregnant does one of two things – she doesn’t have sex or she uses contraception” (News of the World, 26th Sep 2010).

Women, education and vulnerability

Articles repeatedly suggested that women and teenage girls in particular, lacked the skills and confidence to negotiate safe sex, further highlighting this sense of vulnerability concerning sexual health. A number of articles highlighted a need for women and girls to be re-alerted to the dangers of unprotected sex and hinted to significant gaps in HIV awareness and education and in sexual health knowledge more generally (The Observer, 28th Feb 2010). Articles that focused on HIV suggested that many British women did not think that this is a disease women are at risk from, with the findings of a study reporting that many women would never consider being tested: “British women ‘in denial’ over growing HIV risk: False sense of security means females neglect to protect against virus” (Headline, The Observer, 28th Feb 2010). Low levels of awareness were also mentioned in relation to young girls’ understandings of sex and contraception: “research shows that there is a lot of confusion about contraception” (The Daily Record, 22nd Mar 2010). However, a number of articles also focused on older women (described as a “forgotten group” in one article, text extract, The Scotsman, 9th Feb 2010) and their lack of awareness: “Women aged over 35 who believe they can have unprotected sex because their fertility is on the wane are fuelling the demand for abortions, according to a sexual health charity” (The Scotsman, 9th Feb 2010). There was also a focus on teenage girls not understanding or using contraception accurately as exemplified in this headline: “Scores of teens having their third abortion; Girls ‘can’t do’ birth control” (The Mirror, 14th Jun 2010). These discourses varied from girls lacking knowledge to discourses about girls being irresponsible in not ensuring safe sexual health and contraception practices. It was highlighted that there was a need for a greater focus on sex education: “Starting sex education early, promoting strong female role models and continuing sex education programmes would help to encourage women to get tested and use protection” (Dr Anke Ehrhardt, Director of the HIV Centre for Clinical & Behavioural Studies, The Observer, 28th Feb 2010). However, in contrast some were critical of sexual health education programmes and initiatives, arguing that they had failed to improve young women’s sexual health, citing evidence of rising rates of teenage pregnancy or STI’s to emphasise such ‘failures’. A number of articles went further than this, suggesting that sex education programmes and initiatives had not only failed, but had been harmful, contributing to women being at risk. For example, one reported that 16% of girls involved in a Teenage Pregnancy programme became pregnant – a higher proportion than in the general population, resulting in the initiative having “a negative impact on the girls taking part” (The Daily Express, 26th Aug 2010). It is of note that comparatively few articles focused on the need to educate men and boys in matter of sexual health compared to the focus on women and girls, suggesting that women are represented as being responsible even if not always in control.

Men, responsibility and risk to their own health

Men were frequently portrayed as being more promiscuous and engaging in more risky sexual health behaviours than women. One published study was widely reported in the newspapers: “Men are twice as likely as women to be promiscuous” (The Express, 6th Apr 2010) and men “…admitted to riskier behaviour 13 out of 100 men said they’d had unprotected sex with more than one person over the past five years, compared with just seven in 100 women” (The Mirror, 7th Apr 2010). Men were more likely to be presented as thoughtless and one article suggested that men were described as “useless at thinking” about their sexual health (Sun, 30th Apr 2010), while another article reported that STIs were seen by some men as a “badge of honour” (Genevieve Edwards from Terrence Higgins Trust, The Sun, 26th Aug 2010), and that males were governed by their “primitive urges” (The Sun, 26th Aug 2010). Articles also made reference to the common stereotype of men being reluctant to go to the doctors or seek medical help: “…especially when it involves their manly bits” (The Mirror, 7th Apr 2010) and several articles reported that despite having some of the highest levels of STIs, men usually waited until they had symptoms before getting tested and doing anything about their health. In contrast, just one article, reporting on recent research revealing that men are less likely to be screened and more likely to test positive for Chlamydia, drew attention to the lack of focus on male responsibility in safe sexual health behaviour: “We have a duty to be responsible for not just our own sexual health but the consequences for others. That includes men too!” (Text extract, The Mirror, 7th Apr 2010).

In articles describing infection rates among other at risk groups, gay men were often used as a bench mark against which rates were measured, for example: “And men indulging in wifeswapping are suffering similar rates of infection as traditionally high risk groups such as gay men” (The Daily Record, 24th Jun 2010). Gay men were also presented as being a health risk with increased rates of HIV and other STIs blamed on risky sexual behaviour, particularly among young gay men. Their behaviour was described as “cavalier” (The Herald, 30th Nov 2010), “risky” and “unsafe” (The Guardian, 7th Sep 2010). In addition, many articles made reference to gay men taking more risks with their sexual behaviour since the introduction of antiretroviral treatments for HIV. It was suggested that their widespread availability in recent years had contributed to many believing protection was not required, and that information about the real risks of HIV were no longer reaching or being understood by many men. One article mentioned that “despite” there being many prevention programmes and “easily available testing facilities” and “supposedly broad public awareness of infection and possible routes of transmission”, men who have sex with men continued to have high levels of HIV (The Guardian, 7th Sept 2010). Therefore although many resources are being targeted at and made easily available to gay men, it was suggested that many gay men were not taking responsibility for their sexual health and therefore continue to be at risk.