Public Health England has released updated figures on the rates of sexually transmitted infections (STI’s), with 440,000 STI’s diagnosed in 2014 in England alone. Chlamydia still tops the list of the commonest STI, accounting for 47% of all new diagnoses. Patients under the age of 25 remain most at risk, with increases seen in men who have sex with men (MSM) of syphilis and gonorrhoea.
In the coming days and weeks as the figures are digested, a number of reasons as to why rates remain so high will be discussed. Early theories have suggested higher detection rates through more accurate testing and as well possible reduced rate of condom use. STI’s are transmitted via unprotected sexual contact. With well-documented issues in the UK with alcohol and illicit drug use in the under-25 population, could it be that engaging in these risky behaviours is increasing the chance of condoms not being used?
It was concerning to see that whilst overall rates remain high, testing rates across the younger populations has fallen in parts of England and we need to look at how we can engage these groups in taking an active role in maintaining their sexual health. The demands on the health service continue to grow and community services such as GP’s and sexual health clinics are feeling the strain. However with parts of England demonstrating a fall in testing rates, it is paramount these services are protected as they remain the corner stone of diagnosing and treating STI’s
A common myth I hear in my practice is that only people who have multiple sexual partners get STI’s, the classic “it won’t happen to me” mind set. The reality is that STI’s can occur in any patient who is sexually active and an infection will not discriminate or care about your sexual history.
Another common myth often shared is how we diagnose STI’s. Patients tell me plenty of horror stories that they have heard from a friend’s sister’s friend about the over-sized swabs the clinic used and the pain they felt. In most cases women can provide self-swabs (which look like cotton buds and are inserted by the patient) or a urine sample. In men, a urine sample is most commonly used. For conditions such as HIV, Hepatitis C and Syphilis a blood test can be taken. There will be times when we need to examine patients, but techniques of diagnosing STI’s continue to advance and are not as fearsome as some would have you believe. I recently enjoyed reading about the teenagers who have invented a condom that can change colour to indicate contact with an STI (http://www.independent.co.uk/life-style/love-sex/a-condom-that-changes-colour-when-it-comes-into-contact-with-stis-has-been-invented-by-a-group-of-school-pupils-10339578.html).
Sexual health clinics and Genito-Urinary Medicine (GUM) clinics can be found up and down the country and help thousands of people with concerns about their sexual health on a daily basis. To find your nearest sexual health clinic, the national website http://sxt.org.uk has details of clinics across the UK. Your GP is also a source of support when it comes to matters of you sexual health.
Some patients may display symptoms with a STI. The most common being a painful rash on the genitals, pain when passing urine, symptoms of discharge, bleeding after sex or between periods, testicular soreness or pelvic pain in women.
However a significant number of patients will not display any symptoms at all. Some of the latest figures suggest that up to 50% of men and 80% of women will not experience symptoms if they have a chlamydia infection. Based on the statistics released from Public Health England, it is troubling to think that as many as 138,500 patients may not have experienced any symptoms at all.
The lasting effects of an untreated STI can be devastating to a patient’s sexual health, fertility and relationships and yet it is avoidable. Effective use of barrier contraception such as condoms is the best weapon in the battle against STI’s.
The treatment of an STI can be straight forward. In the case of chlamydia and gonorrhoea it can be treated with antibiotics. Genital warts and herpes symptoms can be managed but both are life-long diagnoses as the viruses that cause them cannot be cleared from the patient’s system and can flare up over time, and will need further treatments. Another crucial aspect of treatment is letting partner(s) know about a patient’s positive test result, staff in the clinics can be a great source of support in this and help a patient through the process.
Sexual health is incredibly important and affects patients in all stages of life. The medical profession can be guilty of neglecting to ask about sexual issues, particularly in older patients. Understandably patients can feel apprehensive or embarrassed about raising these issues with their GP but with the effects of being so far-reaching it is not to be ignored. It is distressing to see patients with untreated STI’s worry about their fertility or treat women with complications such as pelvic inflammatory disease.
My advice when it comes to your sexual health is if you have symptoms, get tested. If you think you might have an infection, get tested. If you have never been for a test, get tested.
We are moving into an era of medicine when patients are more empowered than ever with their health, with a greater control over types of treatments and where they can receive it be it via your GP, specialist clinics, your local pharmacy and even online. Your sexual health is as important as your physical health and we all need to stop sweeping it under the carpet.