'Cultural views affect STI rates'

By Eleanor Bradford Health correspondent, BBC Scotland

Prostitution has been legal in the Netherlands since 2000

Here, the sex industry is a tourist attraction.

Today I took a stroll up the Warmoestraat in the red light district.

Prostitutes sell their services openly, and there's a shop selling every imaginable kind of condom (and some unimaginable ones - who would have thought you could make one in the shape of Big Ben?)

You might expect the Netherlands' relaxed attitude towards sex to result in high rates of sexually transmitted infections, but nothing could be further from the truth.

For many years the country has had the lowest rates of sexual infections and teenage pregnancies in Western Europe.

Scotland has some of the highest.

But rates of teenage births here are five times lower than in Scotland.

Not a lot of research has been conducted to explain exactly why this should be, but public health specialist Dr Edwin van Teijlingen has his own theory.

She has friends who are already sexually active, and we are talking a lot about that Magda Vogelenzang Mother of a 14-year-old girl

He was born in the Netherlands but married a Scot and raised his family in Aberdeen.

"I think there's definitely a difference between us and the average parents around here - how they talk and what age they talk about sex and sex education," he said.

"We probably start much earlier."

In the pretty suburban town of Leiden, just outside Amsterdam, I meet Dr Paul Kocken, from the Dutch research organisation TNO Quality Of Life.

In 2007 he carried out a survey of sex education.

When he compared it to a similar survey carried out in Scotland, he found the results surprising: in both Dutch and Scottish schools sex education is patchy.

His conclusion is that it's not sex education which is important, but culture and parent-child relationships.

"The commonly accepted reason amongst scientists is the attitude of a country towards discussing sex with your child," he said.

"In the Netherlands it's a more open attitude, so this attitude is very important."

More accepting

What research there is, echoes Dr Kocken and Mr Van Teijlingen's conclusions.

In all countries with low levels of teenage pregnancies and sexual infections, adults are more accepting of sexual activity among teenagers.

However, these countries also give clear messages that sex should occur within committed relationships and that teenagers should protect themselves against pregnancy and infection.

Some Scottish health boards are trying to apply this research to reduce infection rates.

NHS Dumfries and Galloway and NHS Greater Glasgow have programmes to encourage parents to talk to their children about relationships and sexual issues more openly.

The project I visited in Dumfries started by encouraging parents to use the real words for their children's body parts, rather than euphemisms or 'baby talk'.

The idea of talking to young children about sex sounds shocking, but the parents on the course were all enthusiastic about the results, and all had had useful in-depth discussions with their children as a result.

'Jasmine' told Eleanor Bradford that many of her friends were not virgins

Research suggests that children who have this kind of relationship with their parents delay their first sexual experience, and are more likely to have safe sex.

One 14-year-old girl I spoke to in Paisley summed up the problem.

Unlike many of her friends, "Jasmine" is still a virgin, but she told me that when she refused to "go all the way" with a boy he'd roll his eyes and call her "tight".

Young children are facing situations that require maturity and the ability to discuss sexual issues confidently, yet as adults many of us are embarrassed to talk about them.

In Rotterdam I met Magda Vogelenzang, a colleague of Dr Kocken.

Her daughter Pam is also 14.

Pam is negotiating the same tricky situations as Jasmine, but Magda speaks to her daughter at length about them.

"She has friends who are already sexually active, and we are talking a lot about that," she said.

"We are talking about what kind of moment you can choose for making sex, but you cannot be making sex with everybody ... and when you are really feeling inside that you really want to do it I say to her, come and tell me and I can give you condoms.

"I think she is very responsible, but I don't know."

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