sexually transmitted infections
by John Illman
More than half a million diagnoses of sexually transmitted infections (STIs) were made in UK specialist sexual health clinics in 2000 – a third more than in 1995, says fpa (formerly the Family Planning Association).
© Getty
And it now estimates that almost 12,000 people a week are being treated at genitourinary medicine (GUM) clinics – an average of one for every minute of the day.
Yet these figures underestimate the true scale of the STI epidemic because common infections such as chlamydia and gonorrhoea may show no symptoms and remain undiagnosed. If left untreated, they can cause serious problems such as infertility.
the high cost of unprotected sex
fpa attributes the dramatic rise in the figures to:
- Increase in the number of sexual partners
- More unprotected sex
- Traditional British reluctance to talk about sex
- The lack of consistent health education campaigns
- Better tests to diagnose STIs that show no symptoms, resulting in an increase in the number of detected cases.
Specialists expected that the upward trend would be reversed in the wake of the 'safe sex' campaign to prevent HIV/AIDS, but many sexually active young people have either forgotten or don't know these messages – or are ignoring them.
fpa warns: 'Anyone who has sex can get and pass on a sexually transmitted infection (STI). Condoms help to protect against most STIs, and should always be used during sex unless both partners are certain that they do not have an STI.'
The four most commonly diagnosed STIs are chlamydia, gonorrhoea, genital herpes and genital warts, but HIV/AIDS is the most dangerous.
chlamydia
What is it? The most common sexual disease. A bacterial infection, it can affect the genitals and the cervix (entrance to the womb), the urethra (tube where the urine comes out), the rectum (back passage) and sometimes the throat and the eyes. Babies born to mothers with chlamydia infection are susceptible to eye infection.
How is it passed on? Mainly from one person to another through vaginal, oral or anal sex, or by sharing sex toys.
Signs and symptoms Over 70% of infected women and 50% of infected men have no symptoms. Symptoms include unusual discharge from the vagina or penis or pain when peeing or urinating.
What happens if it isn't treated? It can spread to other parts of the body, causing serious long-term health problems such as reduced fertility or infertility.
Treatment Antibiotics.
For a longer article about chlamydia, see public enemy number one.
gonorrhoea
What is it? A bacterial infection also known as 'the clap' which can infect the genitals, urethra, rectum and throat.
How is it passed on? By vaginal, oral or anal sex.
Signs and symptoms About 10% of men and up to 50% of women have no symptoms at all. Symptoms can include unusual discharge from the vagina or penis and pain when urinating or peeing.
What happens if it is isn't treated? It can also spread to other reproductive organs causing serious long-term health problems such as reduced fertility or infertility.
Treatment Early treatment with antibiotics is usually simple and effective.
genital herpes
What is it? A virus. Two types of herpes virus can affect the genitals; one also affects the mouth.
How is it passed on? Through direct skin contact, mainly during vaginal, oral or anal sex, or kissing.
Signs and symptoms? Many infected people show no signs of the virus. Others don't recognise the symptoms, which can be very mild and include tingling in the genitals followed by blisters that leave painful sores.
What happens if it is isn't treated? Serious problems are unusual. Genital herpes doesn't affect fertility and treated women can go on and have a normal pregnancy and birth.
Treatment The virus will always remain in the body and no treatments get rid of it completely. Tablets taken during the first outbreak will help clear it up. Self-help measures include avoiding stress and cutting down on smoking and alcohol.
genital warts
What are they? They are caused by the human papilloma virus (HPV) and can appear anywhere on the genital or anal area.
How are they passed on? By penetrative sex and direct skin-to-skin genital contact.
Signs and symptoms A doctor or nurse can usually tell if you've got genital warts just by looking – they produce pinkish/white small lumps or larger cauliflower shaped lumps on the genital area, either occur singly or in groups. To check for hidden warts it may be necessary to carry out an internal examination of the vagina or anus.
What happens if they're not treated? They generally don't cause any serious long term health problems, according to fpa. It says: 'There's no direct link between visible genital warts and cervical cancer. There are over 100 different types of HPVs. The types of HPVs that cause visible genital warts are rarely associated with genital cancers. But it's always best to have warts treated'. The main problem with genital warts is that they are unsightly, but they could indicate that you've had unprotected sex – and may have developed a more serious infection.
It's important to distinguish between visible genital warts and more dangerous infections linked to some types of the wart virus. These may be associated with changes in cervical cells that can lead to cancer. All women over the age of 20 should have a regular cervical smear test.
Treatment Depends upon the type, number and position of the warts. They may be painted, frozen or subjected to laser therapy. A common treatment is a brown liquid (podophyllin) which is painted on the warts and later washed off. This may be prescribed for use at home. It may be necessary to use more than one type of treatment to get rid of genital warts. Most people whose warts initially disappear have a recurrence.
Never treat genital warts with remedies bought over the counter in pharmacies.
HIV/AIDS
More than 15,000 people in the UK have died from HIV/AIDS over the last 20 years. There is no cure for HIV/AIDS, but almost a third of 18-24 year olds think that there is, according to a survey published by the HIV/AIDS charity, the Terence Higgins Trust, in July 2002.
Paul Ward, the trust's deputy chief executive, said: ' Sex education in this country is failing a whole generation of young people and this, combined with the recent dramatic rise in rates of STIs, demonstrates that we are storing up problems for future generations.'
Teenagers who were at school during the AIDS awareness campaigns in the 1980s are now adults and still recall the campaigns, but a survey in 2001 by the Schools Health Education Unit revealed that today's youngsters are much less aware of the facts. It revealed that 40% of 11-year-old boys had never heard of HIV/AIDS.
Contrary to popular perceptions that the HIV/AIDS epidemic has gone away, more people than ever before were diagnosed with HIV/AIDS in 2001 – and the numbers of people living with HIV/AIDS is set to rise by half over the next five years. It is now more common in heterosexuals than in homosexuals.
getting tested
If you're worried about an STI and want to know how to find your nearest sexual health or GUM clinic, or what will happen when you get there, there's lots of advice and information in this feature. Or have a look at your clinic experiences to read the stories of other people who've already been to get checked out.
help and info
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organisations
Brook
421 Highgate Studios
53-79 Highgate Road
London NW5 1TL
Helpline: 0800 0185 023 (Mon-Fri 9am-5pm)
E-mail: admin@brookcentres.org.uk
Website: www.brook.org.uk
Provides free and confidential sexual health advice and contraception for anyone under 25. The website has tons of useful information including a secure on-line enquiry service and a text messaging service.
FPA
50 Featherstone Street
London EC1Y 8QU
Helpline: 0845 310 1334 (Mon-Fri 9am-6pm)
fpa Scotland: 0141 576 5088 (Mon-Thurs 9am-5pm; Fri 9am-4.30pm)
fpa Northern Ireland: 028 90 325 488 (Mon-Thurs 9am-5pm; Fri 9am-4.30pm)
Website: www.fpa.org.uk
The fpa can advise on all sexual health matters, including contraception, abortion and sexual health. A range of factsheets are available to download free from the website. You can also get details of family planning clinics, sexual health clinics and other sexual health services anywhere in the UK.
Herpes Viruses Association
41 North Road
London N7 9DP
Tel: 0845 123 2305
E-mail: info@herpes.org.uk
Website: www.herpes.org.uk
Helps to improve life for those with herpes simplex.
Sexual Health Line
Tel: 0800 567 123 (24 hours)
Textphone: 0800 521 361
Gives confidential advice and information about STIs or any other aspect of sexual health. Can also tell you where to find local sexual health services.
Sexwise
Helpline: 0800 28 29 30 (every day, 7am-midnight)
Website: www.ruthinking.co.uk
Offers information, advice and guidance to young people aged 12-18 about sex, relationships and contraception. The website also allows you to search for services anywhere in the UK.
Terrence Higgins Trust
52-54 Grays Inn Road
London WC1X 8JU
Helpline: 0845 1221 200 (Mon-Fri 10am-10pm; Sat-Sun 12-6pm)
E-mail: info@tht.org.uk
Website: www.tht.org.uk
Offers a wide range of free and confidential services for people with HIV, including specialist advice and representation on welfare rights, housing and legal matters, practical help and befriending.
websites
AVERT
www.avert.org
Information for young people about HIV infection and AIDS, sex, puberty, sexuality, contraception and condoms. Includes personal stories, articles and resources such as quizzes, statistics, FAQs and printable booklets.
Condom Essential Wear
www.condomessentialwear.co.uk
For more information on condoms, sexual health, how to protect yourself from STIs and how to find your nearest GUM Clinic.
Sexually Transmitted Infections (STIs)
www.nhsdirect.nhs.uk/articles/article.aspx?ArticleID=436
Straightforward but brief outline of sexually transmitted infections (STIs) and their treatments. Part of the NHS Direct website.
Society of Sexual Health Advisers
www.ssha.info
Contains answers to frequently asked questions about STIs, information about infections and treatments, a discussion forum and details of GUM clinics around the UK.
reading
Sexually Transmitted Diseases by Derek Llewellyn-Jones (Faber and Faber, 1990) |
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Sexually Transmitted Diseases by Lisa Marr (The Johns Hopkins University Press, 1999) |
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Sexually Transmitted Infections by Mary-Claire Mason (Sheldon Press, 2002) |
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(updated December 2002, resources updated February 2005)
